Thực trạng sử dụng kháng sinh và các yếu tố liên quan đến kết quả điều trị nhiễm khuẩn gram âm đa kháng tại Bệnh viện Đại học Y Dược thành phố Hồ Chí Minh

Abstract

Objective: To investigate the clinical characteristics, antibiotic utilization patterns, and factors related to treatment outcomes in patients with multidrug-resistant Gram-negative bacterial (MDR-GNB) infections. Subject and method: A retrospective, cross-sectional study was conducted on 284 inpatient adults at University Medical Center Ho Chi Minh City from August 2024 to December 2024. Eligible patients were those diagnosed with MDR-GNB infections, defined as non-susceptibility to ≥ 1 agent in ≥ 3 antimicrobial categories. Result: The median age of the study population was 72 (61 - 81) years old. Among 548 MDR-GNB strains isolated, Klebsiella pneumoniae was the most prevalent (34.9%). Respiratory tract and bloodstream infections were the most prevalent types of infection across treatment courses. Meropenem monotherapy and the combination of meropenem andlevofloxacin were the most frequently prescribed regimens. The overall clinical success rate was 77.1%. Factors significantly associated with treatment outcomes included septic shock (OR = 0.300; 95% CI: 0.133 - 0.681), Acinetobacter baumannii infection (OR = 0.459; 95% CI: 0.216 - 0.976), co-infection with other pathogens (OR = 0.462; 95% CI: 0.224 - 0.956), and comorbidities such as neoplasms (OR = 0.330; 95% CI: 0.149 - 0.731), hematological disorders (OR = 0.302; 95% CI: 0.136 - 0.673), and respiratory diseases (OR = 0.390; 95% CI: 0.188 – 0.806).Conclusion: These findings provide empirical evidence to support the optimization of antibiotic regimens for managing MDR-GNB infections within the hospital setting.