Vietnam Journal of Infectious Diseases

EPIDEMIOLOGICAL CHARACTERISTICS AND ANTIBIOTIC RESISTANCE OF ELIZABETHKINGIA ANOPHELIS AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES FROM 2020 TO 2024

Van Manh Pham — 2025-10-12

Objectives: To describe the epidemiological characteristics and antibiotic resistance of Elizabethkingia anophelis at the National Hospital for Tropical Diseases over a five-year period (2020 - 2024). Subjects and methods: A descriptive, retrospective study of patients with positive E. anophelis culture results (from specimens such as blood, catheters, respiratory tract fluids, cerebrospinal fluid, urine, etc.) at the National Hospital for Tropical Diseases from January 2020 to December 2024. Results: A total of 168 patients with 324 positive cultures. Respiratory tract fluid accounted for 97.53% of the specimens. Positive cultures mainly occurred in outbreaks during October-December 2021, March, May 2022, April-June 2023, and August-October 2024. The bacterium exhibited high resistance to β-lactams and aminoglycosides, while its susceptibility to quinolones was low. However, E. anophelis remained susceptible to tetracycline antibiotics (minocycline, doxycycline) and trimethoprim-sulfamethoxazole. Conclusions: E. anophelis was predominantly found in respiratory tract fluid and commonly found in the Emergency Department and ICU of mechanically ventilated patients. The bacterium demonstrated high resistance to β-lactams and aminoglycosides, but maintained good susceptibility to tetracycline antibiotics (minocycline, doxycycline) and trimethoprim-sulfamethoxazole.

STUDY ON THE MORTALITY PROGNOSTIC VALUE OF THE SAPS II SCORE ON ADULT PATIENTS WITH SEPSIS

Vu Phong Le — 2025-10-12

Introduction: Sepsis can progress severely, leading to rapid death due to septic shock and multiple organ dysfunction. Early diagnosis and prognosis of patients play a crucial role in reducing mortality rates. Objectives: This study aims to evaluate the prognostic value of the SAPS II score in adult patients with sepsis. Methods: A total of 228 patients with sepsis who met the inclusion criteria were enrolled in this cross sectional study conducted from March 2023 to June 2024. Results: The SAPS II score assessed within the first 24 hours demonstrated a fair prognostic value for mortality with a cut-off score of > 34; the area under the ROC curve was 0.712, with a sensitivity of 60.17% and a specificity of 74.55% (confidence interval: 0.649 - 0.770, p < 0.0001). After 48 hours, the SAPS II score exhibited good prognostic value for mortality at a cut-off score of > 30; the area under the ROC curve was 0.812 with a sensitivity of 77.88% and a specificity of 72.09% (confidence interval: 0.751 - 0.864, p < 0.0001). High-risk factors associated with mortality in sepsis patients included septic shock, mechanical ventilation, comorbid chronic conditions, and elevated SAPS II scores (> 52). The overall mortality rate among sepsis patients was 51.8%, with 66% of deaths attributed to septic shock. Conclusions: The SAPS II score is a valuable tool for predicting mortality in patients with sepsis, aiding in early identification of high-risk individuals.

EVALUATION OF SCREENING RESULTS FOR CARBAPENEM RESISTANT ENTEROBACTERIACEAE IN PATIENTS ICU’S AT BAC GIANG PROVINCIAL GENERAL HOSPITAL

Thi Hue Nguyen — 2025-10-12

Objects: To describe the percentage of carbapenem resistant Enterobacteriaceae in patients ICU’s at Bacgiang provencial general hospital. Subjects and methods: A cross - sectional of 500 patients treated in Intensive Care Units (ICU). Rectal swabs were collected at 4 time points: hospitalization, day 3, day 5, and day 7; Specimens cultured made in disc Carbapenem resistant selective agar (CRSA) supplied by Himedia India. Sample collection was stopped in cases of positive CRE. Results: CRE (+) percentage in ICU at 4 time points was 37,2% most concentrated on hospitalization. 55.9% of cases identified as acquired CRE had positive screeening results from the second isolation. The rate of nagative CRE turning positive was 20,8%; 74.7% of CRE strains isolated from patients rectal swab were K.pneumoniae. At the time hospitalization, the CRE strains isolated mainly had concentrations > 10^6 (CFU/mL). Conclusions: The highest rate of CRE was on hospitalization, and among the acquired CRE the majority occurred on day 3. K.pneumoniae was the main CRE strain isolated from rectal swab samples

POST-EXPOSURE PROPHYLAXIS AMONG INDIVIDUALS EXPOSED TO RABIES AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES (2024 - 2025)

Thi Kim Loan Tran — 2025-10-12

Objectives: To describe the current status of post-exposure prophylaxis (PEP) among individuals exposed to rabies at the National Hospital for Tropical Diseases during the period 2024 - 2025. Subjects and methods: A prospective cross-sectional study was conducted on 447 individuals who received PEP for rabies exposure at the National Hospital for Tropical Diseases from May 2024 to May 2025. Results: The average age of exposed individuals was 36.8 ± 19.1 years, with the 25 - 49 age group accounting for the highest proportion (39.4%). Males comprised 52.8% of the sample. Dogs were the most common source of exposure (60.9%). A total of 69.3% of individuals presented to the hospital within two days of exposure, and 57.5% properly washed their wounds before arriving at a medical facility. The completion rate of rabies vaccination declined after the second dose, with only 70% completing the fifth dose. Rabies immunoglobulin (RIG) was administered to 74.5% of cases, with lower completion rates of the fifth vaccine dose and RIG among the < 15 and ≥ 50 age groups. Post-injection reactions included local pain (71.5%) and swelling (18.6%), which were more common in those who received RIG. Conclusions: It is necessary to strengthen health education and communication, improve counseling at healthcare facilities, and support patients in maintaining a complete vaccination regimen, contributing to reduce the risk of rabies-related deaths in the community.

EFFECTIVENESS OF CONTINUOUS IRRIGATION IN THE TREATMENT OF MULTI-RESISTANT RECURRENT BRAIN ABSCESS: REPORT OF TWO CLINICAL CASES

Quang Thanh Nguyen — 2025-10-12

We report two cases of recurrent brain abscess successfully treated by continuous lavage technique. The first case was a 15-year-old male patient with a history of traumatic brain injury who had undergone multiple abscess debridement surgeries and antibiotic treatment but had recurrent abscesses due to multi-resistant K. pneumoniae and P. aeruginosa infection. After failure with intrathecal antibiotics, the patient underwent surgery to remove all the necrotic and brain abscess tissue and placed a two-way lavage-drainage system. The patient fully recovered after 14 days, with no recurrence recorded. The second case was a 65-year-old female patient who was in a deep coma after an accident and had multiple diffuse abscesses discovered after surgery to remove a hematoma. The patient underwent surgery to clean the abscesses and was continuously irrigated for 13 days, with good infection control and no recurrence of pus, but her consciousness did not improve. Continuous irrigation has been shown to be effective in controlling brain abscesses - especially in cases of multidrug-resistant bacterial infections - and is safe when drainage flow and pressure are tightly controlled.

SYSTEMIC LUPUS ERYTHEMATOSUS WITH ONSET FOLLOWING MEASLES INFECTION: REPORT OF A RARE CASE

Thi Thu Huong Vu — 2025-10-12

Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease in which environmental factors particularly viral infections-may trigger onset in genetically predisposed individuals. To date, post-measles SLE remains extremely rare globally and virtually unreported in Vietnam. We present a case of a 39-year-old woman who developed SLE two weeks after a serologically confirmed measles infection. She exhibited a malar rash, petechiae, anemia, thrombocytopenia, and leukopenia. Laboratory findings showed positive ANA and anti-dsDNA antibodies, mild proteinuria, a positive direct Coombs test, and mild bone marrow hypoplasia. The diagnosis of SLE was established based on the 2019 ACR/EULAR classification criteria (20 points), with moderate disease activity (SELENA-SLEDAI score of 9). The patient responded well to pulse methylprednisolone therapy and supportive treatment, with no need for intensive immunosuppressive agents.

THE VALUE OF SMART-COP SCORE IN PREDICTING THE SEVERITY OF PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA

Xuan Vung Le — 2025-10-12

Objectives: Identifying the prognosis of community-acquired pneumonia (CAP) is crucial. Various scoring systems have been designed for this prognostic purpose, including the SMART-COP score, which is used to identify CAP patients who may require intensive respiratory or vasopressor support. Therefore,this study aims to evaluate the SMART-COP score's predictive value in assessing CAP patients' severity. Subjects and methods: A prospective study was conducted on 108 CAP patients treated at the Respiratory Department of Nghe An General Friendship Hospital from January 2023 to August 2023. Results: In our study, 63.9% were male, and 36.1% were female. The average age was 67.2 ± 17 years. A SMART-COP score ≥ 5 had a prognostic value for identifying CAP patients requiring intensive respiratory or vasopressor support (IRVS) with a sensitivity of 85.2%, specificity of 79%, and an area under the curve (AUC) of 0.905. For predicting ICU admission, the sensitivity was 93.3%, specificity 84.6%, AUC = 0.943, and for predicting 30-day mortality, the sensitivity was 90%, specificity 68.4%, AUC = 0.901. Conclusions: The SMART-COP score with a cut-off point of ≥ 5 has a high predictive value for identifying CAP patients who require intensive respiratory or vasopressor support, ICU admission, and predicting 30-day mortality.

THE EFFECTIVENESS OF THE CELL BLOCK TECHNIQUE IN THE CYTOLOGICAL DIAGNOSIS OF ASCITIC FLUID AT HA DONG GENERAL HOSPITAL FROM 2021 TO 2024

Dinh Chinh Le — 2025-10-12

Objectives: 1- To compare the diagnostic efficacy for malignant cytology between the Cell Block and Cell Smear techniques on peritoneal effusion samples at the Department of Pathology, Ha Dong General Hospital during the period 2021 - 2024. 2- To identify several factors associated with Cell Block results on peritoneal effusion samples. Subjects and methods: A cross-sectional descriptive study was conducted on 76 ascitic fluid samples at Ha Dong General Hospital from October 2021 to May 2024. Results: The Cell Block technique detected malignant cells in 17.1% of cases, significantly higher than the 7.9% identified by the Cell Smear method. The concordance rate between the two techniques was 90.8%. Statistically significant associations were found between Cell Block results and patient age, fluid color, and fluid volume. Conclusions: The Cell Block technique demonstrates higher sensitivity and serves as an effective complementary method in ascitic fluid cytological diagnosis. Combining both techniques is recommended to enhance diagnostic accuracy

EVALUATION OF TREATMENT RESULTS WITH ANTIVENOM SERUM IN COBRA-BITTEN PATIENTS AT THE POISON CONTROL CENTER, BACH MAI HOSPITAL

Van Duong Dang — 2025-10-12

Objectives: To evaluate the treatment results with antivenom serum in cobra-bitten patients at the Poison Control Center, Bach Mai Hospital. Methods: A prospective descriptive study on 117 patients bitten by cobras (Naja spp) treated at the Poison Control Center, Bach Mai Hospital from July 2023 to June 2024. Clinical features, treatment methods, and outcomes of antivenom serum therapy were collected. Results: Among 117 patients, 94 (80.3%) were indicated for antivenom serum treatment. The median dose of antivenom was 40 vials (IQR: 25 - 50 vials), with a median infusion time of 5.0 hours (IQR: 3.5 -7.8 hours). Most patients (66.7%) received antivenom within the first 6 hours after being bitten. Pain scores decreased gradually over time after antivenom administration, from 7.1 ± 1.1 points before treatment to 2.5 ± 1.4 points after completing treatment. Treatment outcomes: 100% of patients survived without any fatalities; 9.6% were discharged, 60.6% were transferred to primary facilities, and 29.8% were transferred to specialized departments. Conclusions: Treatment of cobra-bitten patients with antivenom serum is highly effective in improving clinical symptoms and minimizing severe complications. The rate of adverse reactions is acceptable and most can be controlled with appropriate interventions

CLINICAL EPIDEMIOLOGY AND PATHOGENESIS BACTERIA OF SEPSIS IN ADULTS PATIENS TREATED AT HUE CENTRAL HOSPITAL (2021 - 2023)

Van Duc Pham — 2025-10-12

Objectives: To describe the clinical epidemiological characteristics and pathogenesis bacteria of sepsis adult patients treated at Hue Central Hospital. Subjects and methods: This is a cross-sectional study with follow-up of 169 patients diagnosed with sepsis and treated at the Department of Tropical Diseases and Intensive Care, Hue Central Hospital, from January 2021 to August 2023. Results and conclusions: The mean age was 65.32 ± 17.86 years and 63.4% of patients were male. The most prevalent underlying diseases were cardiovascular disease (41.1%), diabetes (28.4%) and chronic liver disease (11.2%). The most prevalent primary infection sites are the respiratory (41.4%), gastrointestinal (26.6%), and genitourinary (8.9%). The most common bacteria isolated were E. coli (10.7%), K. pneumoniae (8.3%) and S. aureus (7.1%). The median hospital stay was 14.0 (10.0 - 20.0) days. The septic shock rate was 29.6%, MODS 29%. The mortality rate was 30.8%.

STUDY ON THE DISTRIBUTION RATE AND ANTIBIOTIC RESISTANCE CHARACTERISTICS OF COMMON PATHOGENIC BACTERIA FROM RESPIRATORY SPECIMENS AT MEDLATEC TESTING CENTER (2022 - 2023)

Thi Khanh Linh Tran — 2025-10-12

Objectives: 1. Determine the distribution rate of pathogenic bacteria isolated from respiratory specimens (2022-2023). 2. Analyze some antibiotic resistance characteristics of common respiratory pathogenic bacterial strains. Subjects and methods: This cross-sectional descriptive study and laboratory analysis involved 5338 patients who underwent culture, identification, and antibiotic susceptibility testing. Among these, 2640 respiratory specimen cultures identified pathogenic bacteria. Respiratory specimens were cultured, identified, and antibiotic susceptibility tests were performed at Medlatec Testing Center from January 1, 2022, to December 31, 2023. Results and conclusions: The majority of bacteria were gram-negative (70.4%) compared to gram positive bacteria (29.6%). The most common bacteria were Haemophilus influenzae (27.5%), followed by Pseudomonas aeruginosa (18.3%), Streptococcus pneumoniae (17.8%), Staphylococcus aureus (10.7%), and Moraxella catarrhalis (9.5%). Other bacteria such as Klebsiella pneumoniae (7.7%), Acinetobacter baumannii (7.4%), and Streptococcus spp (1.1%) were found at lower rates. Haemophilus influenzae: Carbapenem and piperacillin/tazobactam antibiotics were highly effective. Antibiotics such as ampicillin, trimethoprim/sulfamethoxazole, and cefuroxime had high resistance rates and should not be the first choice. Pseudomonas aeruginosa: Ceftazidime and amikacin were the most effective antibiotics with sensitivity rates over 50%. Cefotaxime was very ineffective and should not be used for treatment. Streptococcus pneumoniae: Penicillin G, ceftriaxone, cefotaxime, levofloxacin, vancomycin, and chloramphenicol were the top antibiotic choices with sensitivity rates over 90%. Clindamycin, erythromycin, trimethoprim/sulfamethoxazole, and tetracycline were less effective with very high resistance rates. Staphylococcus aureus: Nitrofurantoin and vancomycin were the most effective antibiotics. Penicillin G, oxacillin, cefoxitin, clindamycin, and erythromycin had very high resistance rates. Moraxella catarrhalis: Amoxicillin/clavulanic acid, ciprofloxacin, ofloxacin, and levofloxacin were very effective. Doripenem, imipenem, and meropenem were also good options. The macrolid group and cefotaxime were less effective with high resistance rates. Klebsiella pneumoniae and Acinetobacter baumannii: These bacteria had very high resistance levels to most antibiotics. Antibiotic use should be based on specific antibiotic susceptibility results, and multiple antibiotics may need to be combined for the best treatment outcomes.

CURRENT STATUS OF HUMAN RABIES IN QUANG NINH FROM 2014 TO 2023 AND PROPOSED INTERVENTION MEASURES

Thien Thuat Bui — 2025-10-12

Objectives:Describe the epidemiology of human rabies from 2014 to 2023 in the whole province. Characteristics of fatal rabies patients and intervention measures.Subjects and methods: Retrospective descriptive study. Patients receiving post-exposure prophylaxis (PEP): People exposed to rabies such as dog or cat bites were vaccinated with rabies vaccine and anti-rabies serum (HTKD), based on annual statistical reports from CDC Quang Ninh. Patients died of rabies.Results and methods:The study showed that 35.798 individuals underwent post-exposure prophylaxis (PEP) with vaccines and antiserum following exposure to animals suspected of having rabies. Among these individuals, males and females accounted for 56.3% and 43.7% respectively, this difference is statistically significant (p < 0.05). Children under 15 years old made up 28.1% of those receiving PEP, while the 25 - 49 age group presented the largest proportion at 34.5%. The lowest proportion (8.6%) was observed in the 15 - 24 age group. The proportion of patients seeking PEP within 10 days following exposure to animals suspected of having rabies accounted for 95.7%. Among the animals involved, dogs that bit individuals and exhibited signs of illness or death comprised 19.6%, and household dogs were the most common species responsible for bites, making up 92.6%. The majority of patient’s wounds were located on the legs (57.3%), while bites in high-risk areas near the central nervous system such as the head, face, and neck accounted for 36.5%. Notably, 6.8% of patients have also been prescribed antiserum following exposure. Among the fatal 11 cases, 02 individuals (18.2%) have been administered timely rabies vaccinations, but the treatment was ultimately ineffective, resulting in death. Both Tien Yen district and Mong Cai City reported 03 fatal rabies cases in humans, primarily attributed to the lack of rabies vaccination. The mutual coordination between the Human Health sector and the Agriculture and Rural Development sector in preventing rabies in both humans and livestock is crucial to the success of the province-wide rabies prevention program

STUDY ON THE STATUS OF EXCLUSIVE BREAST MILKFEEDING FOR THE FIRST 6 MONTHS IN MOTHERS OF CHILDREN 6 - 12 MONTHS OLD IN DA NANG CITY

Thi Diẹp Ha — 2025-10-12

Objectives:Determine the rate and some factors related to the rate of exclusive breastfeeding in the first 6 months among mothers with children 6 - 12 months old in Da Nang city.Subjects and methods:Cross-sectional description of 630 mothers with children 6 - 12 months old.Results and conclusions:The rate of mothers exclusively breastfeeding for up to 6 months reached 65.4%. There is a statistically significant relationship between the number of children at birth, child gender, child weight, mother's time off after childbirth and exclusive breastfeeding for the first 6 months, p < 0.05. There is a statistically significant relationship between receiving information/advice on breastfeeding during pregnancy and postpartum, between breastfeeding knowledge and exclusive breastfeeding for 6 months, p < 0.05.

KNOWLEDGE AND PRACTICE OF HEALTHCARE WORKERS IN DISEASE CODING ACCORDING TO ICD-10 AT NATIONAL HOSPITAL OF OBSTETRICS AND GYNECOLOGY

Duc Thang — 2025-10-12

Objectives: To assess the current situation of errors in medical records, knowledge, and some related factors of healthcare workers regarding ICD-10 coding at National hospital of obstetrics and gynecology (NHOG).Subjects and methods:A descriptive, cross-sectional study conducted on 512 medical records and 112 healthcare workers at NHOG from June 2024 to December 2024.Results: Principal disease coding according to ICD-10 was performed with 4-character codes in 27.1% of cases and with 3-character codes in 72.9% of cases. The rate of coding for comorbidities was 35.1%, with an overall coding accuracy rate of 75.0%. Healthcare workers had an overall knowledge rate of 73.2% regarding ICD-10 coding. Related factors: Educational level – those with postgraduate degrees had significantly better coding accuracy than those with only undergraduate degrees (OR = 2.26, p < 0.05). Healthcare workers who received comprehensive training on ICD-10 coding or had high self-learning capacity also demonstrated better coding quality (OR = 3.01, p < 0.05). Additionally, receiving information via email documents was associated with improved coding quality (OR = 1.16, p < 0.05).Conclusions:The diagnosis entry rate according to ICD-10 at NHOG achieved relatively good results, with errors mainly occurring in the coding of comorbidities. To enhance healthcare workers' knowledge within the hospital, training programs should focus on continuous knowledge updates through training sessions or direct exchanges.

STATUS OF MEETING THE PALLIATIVE CARE NEEDS FOR PEOPLE WITH HIV/AIDS AT NHANHAI HOSPITAL IN 2022

Van Hoc Le — 2025-10-12

Objectives:Describe the current situation of meeting the palliative care needs for people with HIV/AIDS treated at Nhan Nhan Hospital in 2022.Subjects and methods: A descriptive study was conducted on 180 people living with HIV/AIDS who were receiving treatment in four clinical departments of Nhan Ai Hospital from January 2022 to October 2022, meeting the selection criteria. Data were collected through direct interviews using a pre-designed questionnaire.Results:The medical response rate accounted for 91.1%, the response rate for care support accounted for 89.1%, the response rate for communication and relationships accounted for 87.3%, the response rate for spiritual support accounted for 87.3%. 85.5% and the rate of meeting the need for material support is 89.3%.Conclusions: People with HIV/AIDS had the highest level of need fulfillment in medical care (91.1%) and the lowest in mental health support (85.5%). Care should be based on the actual needs of each patient; therefore, accurate assessment is essential to develop appropriate and effective care plan for patients.

THE SITUATION OF PATIENS WITH TRAFFIC ACCIDENT INJURIES TREATED AT LONG AN GENERAL HOSPITAL FROM 2019 TO 2023

Van Hoang — 2025-10-12

Background:Traffic accidents are a major societal concern, posing dangers to anyone participating in traffic. Over the past year, the number of people admitted to emergency and hospitalized due to traffic accidents has been quite high. The study titled: "The Situation of Traffic Accident Injuries at Long An General Hospital from 2019 to 2023" was conducted to identify better solutions in management and treatment.Objectives: To describe the current state of traffic accident injuries treated at Long An General Hospital from 2019 to 2023 and to identify factors related to these injuries.Materials and methods:A retrospective, analytical, and synthetic study. Reports on traffic accidents from Long An General Hospital from 2019 - 2023 were used, with complete medical records as per regulations.Results and conclusions:The most affected age group was 20 - 60 years, with males accounting for more than double the number of cases compared to females. The majority of accidents involved motorbike and motorcycle users. Approximately 50% of patients had their blood alcohol levels tested, with a significant portion (45.1 - 60.1%) showing very high alcohol levels; however, in 2023, this dropped to 32.2%, indicating the effectiveness of the Ministry of Public Security's measures against alcohol violations. The injury situation remains severe, with over 3,000 cases admitted to the hospital each year, and the mortality rate has not decreased. Mortality rate is from 0.3 - 1.1%, referral rate ranges from 0.7 to 15.8% in 2023. Limb injuries account for 10 - 33% in 2023. Head, face and neck injuries account for about 28 - 37%. Multiple injuries account for 45.15%. Particularly, from 2019 to 2023, it only accounts for 15.52%. There is a need to continue enhancing control measures and raising awareness among traffic participants, closely monitoring, and adjusting policies accordingly.