EVALUATION OF SPECTRUM AND ANTIBIOTIC RESISTANCE OF BACTERIA AT AN SINH PRIVATE HOSPITAL IN 2018

Abstract

Antibiotic resistance is serious problem in Vietnam. Each hospital is recommended to have their antibiotic resistance data annually.

Objective: This study was conducted to identify spectrum and antibiotic resistance of bacteria at An Sinh private hospital in 2018.

Materials and methods: Data regarding culture and susceptibility testing of the organisms isolated from clinical specimens such as urine, blood, wound swab/pus, stool, sputum and tracheal aspirations were collected from the records of the Microbiology Department at An Sinh private general hospital from January to December in 2018.

Results: Out of 620 specimen episodes in 494 patients, 187 (30.2%) were bacteria culture positive, in which, the highest positive culture rate was in wound swab/pus (74/95 samples, 77.9%), then in sputum (44/143 samples, 30.8%), in urine (52/188 samples, 27.7%). The positive blood culture rate was the lowest (5.5%) (9/163 samples). Among 24 mycobacteria genera founded, two most commonly occurring pathogens were Escherichia coli (64/187, 34.2%), mostly in urine (34/64 samples, 53.1%) then in swab/pur (20/64 samples, 31.3%). Staphylococcus aureus (27/187, 14.4%), usually in swab/pur (22/27 samples, 81.5%). Prevalence of extended-spectrum beta-lactamase (ESBL) produced E. coli was 57.8% (37/64 species). Antibiotics that Enterobacteriaceae were sensitive more than 80% included vancomycin, imipenem, meropenem, amikacin, cefoperazone/ sulbactam, piperacillin/tazobactam, ticarcilin/calavulanic and ampicillin/sulbactam. And Staphylococcus were resistant to most antibiotics. There are 3 medications including vancomycin, amikacin and linezolid acid that Staphylococcus were sensitive more than 80%. 17 Pseudomonas aeruginosa species were sensitive to only Polymycin B (100%), to Amikacin (73.7%) and below 54% to others.

325/420 patients received antibiotics before cultural samples taken. In which 75.7% had negative cultural result. Median of time from using antibiotics to sample taken was 21 hours (0-508h). 67.5% patients received inappropriate antibiotic regimens and 50.6% patients changed regimen as the susceptibility testing recommended.

So far, Beta-lactams and Quinolones used usually as empiric treatment regimens at our hospital.

Conclusion: Bacteria spectrum at An Sinh hospital is diversity in 2018. The most common pathogens in the hospital were E. coli and S. aureus and often ESBL and MRSA producers (respectively). Samples for bacteria cultural shoul be taken as early as possible and before antibiotic used. This may select the most appropriate antibiotic for patient treatment.