Tạp chí Truyền nhiễm Việt Nam

CLINICAL AND LABORATORY CHARACTERISTICS OF CHILDREN WITH MYCOPLASMA PNEUMONIAE AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES

Dang Thi Thuy — 2025-12-25

Objectives: To describe the clinical, laboratory, and imaging features of children diagnosed with Mycoplasma pneumoniae (M. pneumoniae) pneumonia at the National Hospital for Tropical Diseases (NHTD).Methods: This descriptive study included 37 pediatric patients aged ≤ 16 years who were diagnosed with M. pneumoniae and treated at NHTD between November 2023 and October 2024.Results: The mean age was 8.7 ± 4.1 years, and 67.6% were older than 5 years. The male to female ratio was 1:1.5. Admissions occurred throughout the year but were most frequent in winter. The most common symptoms were cough (100%) and fever (89.2%). Fever was mainly moderate to high (86.5%), and productive cough was frequent (84.6%), with 78.4% coughing for more than two weeks. Abnormal chest auscultation was found in 89.2% of cases, mainly moist or crackling rales (64.9%). Leukocytosis was detected in 23.5%, elevated liver enzymes in 17 - 23%, and CRP > 10 mg/L in 56.3%. Chest X-ray findings were diverse, most commonly lobar consolidation (48.6%).Conclusions:The clinical manifestations of M. pneumoniae are nonspecific and can resemble other respiratory infections, leading to delayed diagnosis and treatment.Recommendation: Testing for M. pneumoniae should be considered in children especially those over 5 years old with lobar pneumonia, or prolonged cough, or poor response to beta-lactam antibiotics.

SURVEY ON THE ROLE OF URINARY ANALYSIS, URINARY SEDIMENT SCIENCE AND BACTERIAL CULTURE IN THE DIAGNOSIS OF URINARY TRACT INFECTIONS ON PATIENTS AT TAM ANH GENERAL HOSPITAL, HO CHI MINH CITY IN 2024

Tran Thi Thanh Nga — 2025-12-25

AUTOIMMUNE HEPATITIS: DIAGNOSTIC AND TREATMENT SUMMARY FOR CLINICAL PRACTICE

Luong Thi Quynh Nga — 2025-12-25

Purpose of review:To provide a concise summary of the complete diagnostic and treatment methods to the autoimmune hepatitis, aim to creating a practical handbook for clinicians.Notes: Autoimmune hepatitis (AIH) should be considered in the diagnosis of all adults and children presenting with liver disease symptoms that cannot be explained by other causes such as viral infections or medication-related issues. AIH frequently occurs alongside or coexists with other autoimmune disorders. There are two main types of AIH: Type 1 (AIH-1), more common in adults, and type 2 (AIH-2), which predominantly affects children. A liver biopsy is essential for confirming the diagnosis. Steroid therapy is highly effective and treatment should be tailored to the individual patient. It is crucial not to stop medication prematurely; if the disease is not controlled, treatment should be continued. Typically, AIH treatment lasts for at least two years before considering withdrawal. Even after achieving remission and stopping medication, continuous monitoring is necessary since autoimmune diseases are chronic and may relapse.

ETIOLOGICAL SPECTRUM OF MENINGITIS AND ITS CLINICAL, PARACLINICAL CORRELATIONS: FINDINGS FROM THE NATIONAL HOSPITAL FOR TROPICAL DISEASES, 2024

Tran Thu Trang — 2025-12-25

Objectives:To determine the etiologies of meningitis and evaluate their correlation with clinical and paraclinical characteristics in inpatients at the National Hospital for Tropical Diseases.Method: A cross-sectional study was conducted on 406 inpatients diagnosed with meningitis from 01/01/2024 to 31/12/2024.Results: Etiology was identified in 25.1% of cases, with BioFire FilmArray (ME) showing the highest yield (47.7%) compared to Gram stain (5.6%) and culture (8.9%). S. suis was the leading bacterial cause in adults (33.3%), Enterovirus predominated in patients ≤ 18 years (60%), and C. neoformans was the main fungal pathogen (66.7%). Clinically, bacterial meningitis had an acute onset with marked CSF inflammation (S. suis: leukocytes 2868.5/mm³, protein 1.8 g/L, glucose 1.0 mmol/L; E. coli: impaired consciousness, glucose 0.2 mmol/L). Enterovirus showed a benign course (111 leukocytes/mm³, protein 0.3 g/L), while VZV caused more severe manifestations with altered consciousness (p < 0.001) and higher CSF protein (0.7 g/L). Fungal meningitis was subacute with a mild CSF protein increase (0.9 g/L) and significant CSF glucose reduction (0.7 mmol/L).Conclusions:Bacterial meningitis predominates, with S. suis, Enterovirus, and C. neoformans as key pathogens. Distinct clinical and CSF features across etiologies, together with the superior diagnostic performance of BioFire FilmArray (ME), provide important implications for early diagnosis and treatment guidance.

STRONGYLOIDES HYPERINFECTION SYNDROME: A CASE REPORT FROM THANH HOA PROVINCIAL GENERAL HOSPITAL

Le Viet Nghia — 2025-12-25

Strongyloides stercoralis is a helminth, widely distributed in tropical and subtropical countries. Strongyloides infection in humans is usually asymptomatic. However, in some patients, severe and lifethreatening forms of this infection can occur, especially in immunocompromised individuals. We report a case of a male patient, 87 years old, with a history of hypertension and knee osteoarthritis who intermittently used Medrol when in pain. The patient was hospitalized due to prolonged diarrhea, abdominal pain, productive cough, no dyspnea, wheezing, and low-grade fever (38°C). Laboratory tests showed elevated eosinophils (32.7%, equivalent to 4.4 G/L), Strongyloides stercoralis larvae were detected in stool and sputum samples, and imaging revealed pneumonia with right pleural effusion. The patient was diagnosed with: Strongyloides hyperinfection syndrome - prolonged diarrhea - pneumonia - rightpleural effusion/hypertension - knee osteoarthritis. Specific treatment with ivermectin 12 mg/day combined with albendazole 800mg/day significantly improved the clinical condition. After 14 days of treatment, the patient was discharged with formed stool, no cough, no fever, and follow-up tests showed no Strongyloides larvae in stool and sputum.

CLINICAL CHARACTERISTICS, PARACLINICAL FEATURES AND TREATMENT OUTCOMES OF PATIENTS WITH LOWER RESPIRATORY TRACT INFECTIONS CO-INFECTED WITH STRONGYLOIDES STERCORALIS AT BACH MAI HOSPITAL

Pham Thi Quynh Huong — 2025-12-25

Objectives:To describe the clinical and paraclinical characteristics and assess treatment outcomes in patients with lower respiratory tract infections (LRTIs) co-infected with Strongyloides stercoralis at Bach Mai Hospital.Subjects and methods:A retrospective descriptive study was conducted on 42 patients aged ≥ 18 years who were admitted to the Respiratory Center, Bach Mai Hospital, from January 2024 to July 2025. Patients were diagnosed with LRTIs (including community-acquired pneumonia, acute bronchitis, COPD exacerbation, or bronchiectasis exacerbation) and had confirmed S. stercoralis infection via direct smear or ELISA.Results: The mean age was 73.3 ± 10.2 years, and 83.3% were male. Comorbidities were present in 54.8% ( ≥ 2 chronic diseases), and 47.6% had a history of corticosteroid use. The most common symptoms were productive cough (88.1%), dyspnea (76.2%), and fever (73.8%). The hyperinfection syndrome group (40.5%) showed more severe manifestations than the chronic infection group, particularly gastrointestinal symptoms (abdominal pain: 47.1% vs 28%; nausea/vomiting: 17.6% vs 4%). Chest CT commonly revealed diffuse patchy pneumonia (64.3%). Anemia was observed in 64.3%, hypoalbuminemia in 88,1%, hyponatremia in 50%, and eosinophilia in 23.8%. ELISA was positive in 90.5%, while stool microscopy detected larvae in only 23.8%. Overall mortality rate was 42.9%; patients with hyperinfection had a 13-fold higher risk of death compared to those with chronic infection (p < 0.05). Poor prognostic factors included septic shock (p = 0.031), hyponatremia (p = 0.016), neutrophilia (p = 0.020), hypoalbuminemia, and prior corticosteroid use.Conclusions:LRTIs co-infected with S. stercoralis are frequently seen in elderly patients with comorbidities and a history of corticosteroid use. Hyperinfection syndrome presents more severe clinical features and significantly higher mortality. Clinicians should be alert to poor prognostic factors in diagnosis and treatment.

ANTIBIOTIC RESISTANCE OF COMMON GRAM-NEGATIVE BACTERIA ISOLATED AT E HOSPITAL IN 2024

Pham Thi Van — 2025-12-25

Objectives:To determine the prevalence of common Gram-negative bacteria isolated and to assess the antibiotic resistance situation at E Hospital in 2024.Materials and methods:A cross-sectional study was conducted on Gram-negative bacterial strains isolated from clinical specimens of patients treated at E Hospital from January 2024 to December 2024. Bacterial identification and antimicrobial susceptibility testing were performed using the Vitek 2 Compact system (BioMérieux, France), and results were interpreted according to CLSI 2023 guidelines.Results:Among 630 clinical specimens, 345 (54.8%) yielded positive cultures, of which 172 (49.9%) were Gram-negative bacteria. The most frequently isolated Gram-negative bacteria were Klebsiella pneumoniae (28.4%), Pseudomonas aeruginosa (24.4%), Escherichia coli (23.2%), and Acinetobacter baumannii (9.9%). The multidrug-resistant (MDR) rates were 53.3% for E. coli, and for P. aeruginosa (64.5%), A. baumannii (81.8%), K. pneumonia (64.5%).Conclusions: Gram-negative bacteria are important causative agents of wound infections at E Hospital, with K. pneumoniae and P. aeruginosa being predominant. The high prevalence of antibiotic resistance, particularly multidrug resistance and carbapenem resistance in A. baumannii, poses major challenges for treatment, emphasizing the need for strict antimicrobial stewardship and infection control measures.

CASE REPORT: LIVER ABSCESS-ASSOCIATED BACTEREMIA CAUSED BY E. COLI AND E. RAFFINOSUS

Do Duy Cuong — 2025-12-25

We report a clinical case of a 77-year-old male patient diagnosed with bloodstream infection accompanied by a liver abscess caused by Escherichia coli and Enterococcus raffinosus. The patient had a medical history of hypertension and benign prostatic hyperplasia. He initially presented with fever and right upper quadrant abdominal pain. On the third day of illness, he was admitted to a district-level hospital with a presumptive diagnosis of sepsis. After two days of empirical antibiotic treatment without clinical improvement, he was referred to a provincial hospital, where the diagnosis of sepsis with liver abscess was made, along with known comorbidities of benign prostatic hyperplasia and hypertension. He received a combination of cefoperazone, gentamicin, and metronidazole; however, the patient remained febrile, and blood cultures grew E. coli (antibiotic susceptibility testing was not available). He was subsequently transferred to Bach Mai Hospital. Initial treatment with meropenem and percutaneous aspiration of the liver abscess led to gradual clinical improvement. Blood and abscess fluid cultures at our hospital revealed coinfection with E. coli and E. raffinosus. Targeted antibiotic therapy with meropenem and vancomycin was initiated, resulting in marked clinical improvement and eventual hospital discharge. This case underscores the importance of considering polymicrobial infections and the crucial role of early source control in managing intraabdominal sepsis.

ANTIBIOTIC RESISTANCE SITUATION OF THE BACTERIA CAUSING SEPSIS IN DIABETIC PATIENTS TREATED AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASE

Vu Minh Dien — 2025-12-25

Objectives: To study the antibiotic resistance of the pathogens causing sepsis in diabetic patients at the National Hospital for Tropical Diseases.Subjects and methods:We describe 60 patients with sepsis and diabetes, treated at the National Hospital for Tropical Diseases.from January 2022 to December 2024.Research results: The average age of the patients was 65.08 ± 12.3, male/female ratio 1.14/1. The average time of diabetes diagnosis was 8.0 ± 4.6 years, of which 8 patients (13.3%) had not been previously diagnosed with diabetes. Upon admission, 60% of patients had hyperglycemia ≥ 11.1 mmol/L, median 13.8 mmol/L, and 92.3% of patients had HbA1c ≥ 6.5%, median 9.4%. The initial site of infection was the respiratory tract (33.3%), digestive tract (25.0%), urinary tract (20.0%), skin-soft tissue (10%), brainmeninges (5%), and unknown (6.7%). The cause of bacteremia was 70% gram-negative bacteria: E. coli (28.3%), K.pneumoniae (25.0%), B. pseudomallei (13.3%); 30% were gram-positive bacteria: S. aureus (15.0%), S. haemolyticus (3.3%), L. monocytogenes (3.3%). 78.6% of gram-negative bacteria produced ESBL and 44.4%. Methicillin-resistant S. aureus - MRSA. E. coli bacteria are highly resistant to ampicillin (95.2%), cefotaxime (64.5%), ceftriaxone (67.0%); are also highly sensitive to some antibiotics such as: fosmycin (98.1%), imipenem (95.2%), meropenem (96.8%), ertapenem (96.4%), moderately sensitive to antibiotics: Piperacillin/tazobactam (79.0%), cefepime (73.3%), cefoxitine (73.0%), amikacin (88.9%), ceftazidime (67.2%), amoxicillin/clavulanic (61.9%).Conclusions: The pathogens cause of sepsis in diabetic patients is mostly due to gram-negative bacteria (70%), commonly E. coli (28.3%) and K. pneumoniae (25.0%), of which 78.6% produce ESBL. E. coli is highly resistant to ampicillin, cefotaxime, and ceftriaxone and is also sensitive to some antibiotics such as fosfomycin, ertapenem, imipenem, and meropenem.

BRAIN MRI FINDINGS IN VIRAL ENCEPHALITIS: AN ASSOCIATION WITH CLINICAL CHARACTERISTICS

Nguyen Viet Hang — 2025-12-25

Objectives: 1- Describe the characteristics of brain Magnetic Resonance Imaging (MRI) findings in patients diagnosed with viral encephalitis. 2- Examine the relationship between the brain MRI findings and clinical characteristics.Subjects and methods:A cross-sectional descriptive study of 107 patients with confirmed viral encephalitis diagnosed and treated at the National Hospital for Tropical Diseases, 108 Military Central Hospital, and Hanoi Medical University Hospital was conducted from January 2020 to December 2024.Results:Out of 107 patients with confirmed viral encephalitis, brain MRI revealed abnormal findings in 90 cases (84.1%). The predominant imaging pattern was multifocal, asymmetric parenchymal involvement (57.8%), with restricted diffusion present in 82.2% of these cases. Lesions were most frequently located in the temporal (63.3%), frontal (36.7%), and insular lobes (34.4%). A statistically significant association was observed between the number of parenchymal lesions and the presence of vomiting (p = 0.032) as well as meningeal signs (p = 0.026). Lesions were more frequently found in patients with headache and vomiting, and less common in those with underlying comorbidities. Parenchymal involvement with restricted diffusion was more prevalent among male patients and those presenting with fever. Meningeal enhancement was more commonly seen in patients with headache. Parietal lobe involvement was associated with seizures. Frontal lobe lesions were more frequent in patients with comorbidities and were less often linked to autonomic dysfunction, whereas diencephalic lesions showed a stronger association with autonomic dysfunction. Temporal and insular lesions were also more prevalent in male patients. Basal ganglia involvement was less common in patients with comorbidities, and brainstem or cerebellar lesions were less frequently associated with headache.Conclusions:Brain MRI findings in patients with viral encephalitis show a high lesion detection rate, multifocal-asymmetric parenchymal involvement, restricted diffusion, and a predilection for the temporal lobes. The brain MRI findings are significantly associated with clinical characteristics. Further studies with larger sample sizes are needed to validate these associations and explore additional contributing factors.

CHARACTERISTICS OF MONOCYTE DISTRIBUTION WIDTH IN PATIENTS DIAGNOSED WITH DENGUE FEVER AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES IN 2024

Phan Van Manh — 2025-12-25

Objectives:To evaluate the characteristics of monocyte distribution width (MDW) in patients diagnosed with Dengue fever.Subjects and methods:A retrospective descriptive study with convenience sampling. Location and time: at the National Hospital for Tropical Diseases from January 2024 to December 2024. Inclusion criteria: Patients aged ≥ 18 years diagnosed with Dengue fever. Exclusion criteria: Presence of comorbidities or co-/superinfection with other pathogens.Results: Among 171 patients included in the study, 58.48% were male, with a mean age of 39. MDW gradually increased during the critical phase (days 4 - 7) and decreased during the recovery phase. There was a negative correlation between MDW and platelet count from day 4 to day 10 of the illness. No significant differences in MDW were observed across age groups or genders, but notable differences were seen among the Dengue severity classifications from days 4 to 6. The optimal MDW cut-off value on day 4 was 29.415, which could predict Dengue with warning signs and severe Dengue.Conclusions: MDW gradually increases during the critical phase and decreases in the recovery phase, showing a negative correlation with platelet count. MDW is a predictor of disease severity in Dengue fever

SURVEY ON THE RATE AND ANTIBIOTIC RESISTANCE OF SOME BACTERIA CAUSING SURGICAL SITE INFECTIONS OF PATIENTS TREATED AT NINH THUAN GENERAL HOSPITAL

Nguyen Vinh Nghi — 2025-12-25

Objectives: 1- Determine the common bacterial causes of surgical site infections. 2- Evaluate the antibiotic resistance of these bacterial strains.Subjects and methods: Descriptive, cross-sectional, retrospective analysis of all bacterial strains isolated from pus specimens of postoperative patients at Ninh Thuan General Hospital From October 1, 2019 to September 30, 2024.Results and conclusions: The pus specimens with pathogenic bacteria were 606 samples, accounting for 50.3%. The isolated bacterial strains were mainly Staphylococcus aureus (40.6%), Escherichia coli(18.3%), the isolated bacterial strains were mainly according to the clinical departments of Trauma Surgery (21.9%), Anesthesia and Resuscitation (21.1%), General Surgery (10.9%),… Acinetobacter spp. were resistant to bactrim, ceftazidime, ciprofloxacin, tetracycline (50%); Acinetobacter baumanii was resistant to amikacine, bactrim, cefepime, cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, doxycycline, imipenem gentamicin, levofloxacin, meropenem, piperacillin/tazobactam, tetracycline (100%); Burkholderia pseudomallei is resistant to cefotaxime, gentamicin (100%); Escherichia coli is resistant to Bactrim (69.4%), tetracycline (64.0%); Klebsiella pneumoniae is resistant to ampicillin/sulbactam, bactrim, cefepime, cefotaxime, ceftazidime, ceftriaxone, levofloxacin, meropenem, piperacillin/tazobactam, tetracycline (100%); Klebsiella spp. is resistant to bactrim (64.9%), tetracycline (45.6%); Proteus spp. is resistant to tetracycline (85.0%) bactrim (70%); Pseudomonas aeruginosae is still sensitive to most antibiotics;Pseudomonas spp. is resistant to gentamicin (41.7%); Enterobacter spp. is resistant to tetracycline (50%);Enterococcus spp. were resistant to tetracycline (75.0%); Staphylococcus aureus were resistant to penicillin (78.5%); Staphylococcus coagulase negative were resistant to penicillin (93.8%); Streptococcus spp. were also susceptible to antibiotics.

COMPARABILITY OF GLUCOSE QUANTIFICATION RESULTS BETWEEN ON CALL PLUS AND AU480 ANALYZERS AT PHAM NGOC THACH GENERAL HOSPITAL IN 2024

Bui Thi Ngoc Ha — 2025-12-25

Objectives: TThis study assessed the agreement between capillary glucose measurements using the On Call Plus point-of-care device and venous plasma glucose quantified by the AU480 automated biochemistry analyzer at Pham Ngoc Thach Hospital in 2024.Subjects and methods: A laboratory-based method comparison study was conducted involving 40 patients with diabetes mellitus. Paired blood glucose concentrations were measured using capillary blood with the On Call Plus point-of-care testing (POCT) analyzer and venous plasma with the AU480 automated chemistry analyzer. Data analysis was performed using Passing-Bablok regression and Bland-Altman difference plots, in accordance with the CLSI EP09-A3 guidelines. Statistical analysis was conducted using Analyse-it and MedCalc version 19.2.Results: The Passing-Bablok regression yielded the equation y = -0.2534 + 1.008x, with a correlation coefficient of r = 0.994 (p < 0.0001). The median relative bias was 3.26% (95% CI: 1.90-5.36%), exceeding the predefined allowable bias of 1.8%. At the threshold of 6.6 mmol/L, the absolute bias was 0.2005 mmol/L (95% CI: 0.1941 - 0.2127), surpassing the allowable limit of 0.12 mmol/L (Case E).Conclusions: A strong correlation was found between glucose concentrations measured by the POCT device and the AU480 automated biochemical analyzer. However, the two methods are not clinically interchangeable. Bias at the medical decision level of 6.6 mmol/L was 0.2005 mmol/L, exceeding the CLSI-defined allowable limit of 0.12 mmol/L. The POCT device should be used with caution in diagnostic and treatment decisions, particularly near medical decision thresholds..

OVERVIEW OF CYSTATIN C’S ROLE IN MONITORING RENAL FUNCTION IN TYPE 2 DIABETES AND THE FACTORS THAT AFFECT TEST RESULTS

Bui Thi Ngoc Ha — 2025-12-25

Objectives: This overview aims to summarize the role of Cystatin C test in assessing the renal function in patients with type 2 diabetes mellitus (T2DM), and to identify factors influencing cystatin C levels.Research methods: A scoping review was conducted using PubMed and Google Scholar to identify studies published between January 2015 and December 2023. Keywords included “cystatin C”, “type 2 diabetes”, and “renal/kidney disease”. Eligible studies involved patients with T2DM and reported the use or evaluation of cystatin C in renal function assessment.Results: Research on the use of the cystatin C test to evaluate renal function in people with type 2 diabetes has increased in recent years, peaking in 2022 with four studies (19%). The majority of studies were conducted in China (38.1%; n = 8). Of the 21 studies reviewed, 13 (61.9%) reported that cystatin C is useful for the early detection of renal disease, and 14 (66.7%) indicated that cystatin C offers advantagesas well as greater sensitivity and specificity-compared with creatinine in assessing renal function. Factors such as muscle mass, age, sex, race, and duration of diabetes were found not to influence cystatin C levels. However, certain conditions, including obesity, cardiovascular disease, and hypertension, were shown to affect cystatin C test results.Conclusions: Cystatin C serves as a complementary biomarker to creatinine for evaluating renal function, supporting monitoring, early detection of renal impairment, and estimation of glomerular filtration rate in patients with type 2 diabetes. Unlike serum creatinine, cystatin C is not influenced by factors such as muscle mass, age, sex, race, or disease duration, making it a more dependable indicator. However, certain conditions-including obesity, cardiovascular disease, and hypertension-can affect cystatin C levels..

A OVERVIEW OF GLOBAL AND VIETNAMESE PERSPECTIVES ON FECAL WET MOUNT EXAMINATION METHODS FOR PATHOGENIC PARASITE DIAGNOSIS

Nguyen Thi Hong Anh — 2025-12-25

Objectives: To summarize fecal wet mount examination methods for diagnosing pathogenic parasites and to assess the diagnostic performance of these methods in detecting pathogenic parasites in Vietnam and worldwide from 2010 to 2025.Subjects and methods: This review synthesized and analyzed data from 27 peer-reviewed studies and reports, addressing fecal wet mount examination methods and their diagnostic utility for pathogenic parasites worldwide and in Vietnam between 2010 and 2025. Data cited from Medline/PubMed, Google Scholar, and national medical journals.Results: Analysis of 27 peer-reviewed studies and reports revealed that the direct wet mount remains the most widely used technique; however, concentration methods such as Kato-Katz (KK) and formolether concentration (FECT/FEC) yield were higher accuracy in diagnostics. Staining techniques, including Trichrome (Tri) and Ziehl-Neelsen (ZN), facilitate the identification of parasite species that are otherwise difficult to detect, thereby enhancing sensitivity compared with the direct wet mount. Automated analyzers offer advantages in terms of speed and procedural standardization, though their diagnostic performance varies depending on the equipment type and operating conditions. The highest diagnostic yield is achieved when multiple methods are flexibly integrated according to research objectives and laboratory capabilities. In Vietnam, most studies still approach manual and conventional concentration methods.Conclusions: Diversifying methods, establishing standardized procedures, and integrating manual and automated systems are vital for optimizing sensitivity, minimizing false negatives, and raising the diagnostic quality in parasitology.

GENOTYPIC CHARACTERISTICS AND SUSCEPTIBILITY TO CEFTAZIDIME/ AVIBACTAM AND AZTREONAM OF CARBAPENEMASE-PRODUCING ENTEROBACTERALES ISOLATED AT VINMEC TIMES CITY HOSPITAL IN 2025

Dang Danh Luc — 2025-12-25

Objectives: (1) To identify carbapenemase-encoding genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48) in carbapenem-resistant Enterobacterales (CRE) isolated at Vinmec Times City Hospital in 2025; and (2) to evaluate the antimicrobial susceptibility of these isolates.Subjects and methods: A total of 80 CRE isolates, including 19 Escherichia coli (E. coli) and 61Klebsiella pneumoniae (K. pneumoniae), were collected and identified at Vinmec Times City Hospital from January 2023 to April 2025. A cross-sectional descriptive study was conducted.Results and conclusions: Among the 80 CRE isolates, E. coli was mainly obtained from urine samples (84.1%), while K. pneumoniae was predominantly recovered from lower respiratory tract specimens (42.6%); ICU-derived samples accounted for 35%. Carbapenemase gene analysis showed that blaNDM was the most prevalent (E. coli 57.9%; K. pneumoniae 68.9%), followed by blaOXA-48 and blaKPC, whereas blaIMP and blaVIM were not detected. Co-existence of multiple carbapenemase genes was common, particularly blaNDM+OXA-48 (K. pneumoniae 37.7%, E. coli 10.5%). Isolates exhibited high resistance to conventional β-lactams, quinolones, and trimethoprim/sulfamethoxazole, while aminoglycosides (amikacin, gentamicin) retained only limited activity (33% in K. pneumoniae, and 65% and 52% inE. coli). Remarkably, the ceftazidime/avibactam-aztreonam (CZA-ATM) combination demonstrated excellent inhibitory activity, achieving 100% susceptibility in E. coli and 95% in K. pneumoniae, including multi-gene strains across groups A, B, and D.

KNOWLEDGE AND PRACTICES REGARDING RABIES PREVENTION AMONG INDIVIDUALS RECEIVING POST-EXPOSURE VACCINATION AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES, VIETNAM (2024 - 2025)

Tran Thi Kim Loan — 2025-12-25

Objectives: To assess the knowledge and practices regarding rabies prevention among individuals receiving post-exposure prophylaxis (PEP) at the National Hospital for Tropical Diseases during 2024 - 2025.Methods: A cross-sectional descriptive study was conducted on 447 participants receiving counseling and PEP. Data were collected using a standardized questionnaire consisting of 15 knowledge items and 3 practice items on rabies prevention. Participants were classified as having adequate knowledge or practices if they achieved ≥ 80% of the total score.Results: The mean knowledge score was 11.37 ± 1.27/15, with 33.6% achieving adequate knowledge; the mean practice score was 2.07 ± 0.61/3, with 38.7% achieving adequate practices. Most participants correctly identified the severity and preventability of rabies (90 - 100%), but appropriate post-exposure behaviors remained limited - only 22.6% performed correct wound care, 69.3% sought medical care promptly, and 70% completed the full five-dose PEP schedule.Conclusions: Knowledge and practices on rabies prevention remain suboptimal, particularly regarding post-exposure management. Strengthening health education and expanding reliable communication channels are essential to improve public awareness and preventive behaviors against rabies.

IDENTIFICATION OF SOME PATHOGENESES AND ANTIBIOTIC RESISTANCE OF BACTERIA THAT CAUSE PNEUMONIA IN CHILDREN AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES IN 2024 - 2025

Le Thanh Huyen — 2025-12-25

Objectives: Identification of key bacterial pathogens and assessment of antimicrobial resistance patterns in pediatric pneumonia cases at the National Hospital for Tropical Diseases, 2024 - 2025.Subjects and methods: A cross-sectional descriptive study was conducted on the medical records of 221 pediatric patients (< 15 years old) diagnosed with pneumonia and admitted to the National Hospital for Tropical Diseases from January 2024 to May 2025.Results: Among 221 pediatric pneumonia cases, children under 5 years of age accounted for the majority (90.5%). The most frequently isolated bacterial pathogens were Haemophilus influenzae (34.8%), Moraxella catarrhalis (28.5%), Streptococcus pneumoniae (23.1%), and Staphylococcus aureus (7.69%).H. influenzae showed complete resistance to ampicillin, with high resistance also observed to trimethoprim/ sulfamethoxazole (83.6%) and ampicillin/sulbactam (66.7%). M. catarrhalis exhibited marked resistance to erythromycin (60.7%) and trimethoprim/sulfamethoxazole (43.1%). S. pneumoniae demonstrated complete resistance to erythromycin and near-complete resistance to clindamycin (93.9%) and tetracycline (98.0%), whereas S. aureus showed high resistance to penicillin G (85.7%) and erythromycin (78.6%).Conclusions: H. influenzae, M. catarrhalis, S. pneumoniae and S. aureus were the predominant bacterial pathogens causing pediatric pneumonia at the National Hospital for Tropical Diseases. The high levels of resistance to commonly prescribed antibiotics particularly ampicillin, erythromycin, and penicillin G are alarming. These findings highlight the urgent need for evidence-based antibiotic stewardship and continuous antimicrobial resistance surveillance to guide appropriate empirical therapy and prevent the spread of resistant bacterial strains.

RESISTANT CHARACTERISTICS OF CARBAPENEM-RESISTANT ENTEROBACTERALES INFECTIONS AT THE INTENSIVE CARE UNIT - BAC NINH GENERAL HOSPITAL NO. 1

Nguyen Thi Hue — 2025-12-25

Objectives: TTo determine resistant characteristics of carbapenem-resistant Enterobacterales (CRE) isolated from patients in the Intensive Care Unit (ICU) - Bac Ninh General Hospital No.1 in 2024.Methods: A cross-sectional descriptive study was conducted among patients treated in the ICU, from whom CRE were isolated between April 2024 and March 2025. Data were collected from medical records and microbiological results, processed using SPSS 25.0 software.Results: Among 233 pathogenic Enterobacterales isolates, 77 were CRE (33.0%). Carbapenem resistantK. pneumoniae (CRKP) and Serratia spp were the most common (each 29.9%). All CRE were multidrugresistant (MDR) or higher; 19.5% were extensively drug-resistant (XDR). CRE showed high resistance to most β-lactams, cephalosporins, quinolones, while amikacin, fosfomycin, tigecycline, and colistin retained partial activity. Carbapenemase production was found in 87.0% of isolates, mostly Ambler class D (55.8%) and class B (26.6%).Conclusions: The rate of CRE infections in the ICU was high and alarming resistance levels. Strengthening infection control, rational antibiotic management, and routine CRE surveillance are necessary.

THE PANCREATICODUODENAL RESERSION (WHIPPLE PROCEDURE) IN ELDERLY PATIENT: A CLINICAL REPORT AND LITERATURE REVIEW

Nguyen Minh Trong — 2025-12-25

The indication for surgery in cases of pancreatic or ampullary tumors in elderly patients remains a major challenge due to the technical complexity of the procedure and the high risk of complications, particularly among those over 80 years of age. However, recent studies have demonstrated that pancreaticoduodenectomy (Whipple procedure) can be performed safely in this population with careful patient selection and optimal perioperative management. We report a case of a successful pancreaticoduodenectomy in an 85-year-old patient, further supporting the feasibility and safety of this procedure in elderly individuals.