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TREATMENT OF SERIOUS BACTERIOLOGICAL INFECTIONS
CAUSED BY MULTI-RESISTANT GRAM NEGATIVE BACTERIA
Pham Thi Ngoc Thao
Cho Ray Hospital
ABSTRACT
In recent years, the outbreak of carbapenem-resistant Gram-negative bacteria
has become a global health threat. In 2017, the World Health Organization (WHO)
classified Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas
aeruginosa resistant to carbapenem antibiotics among the most deadly pathogens.
Carbapenem resistance in Gram-negative bacteria is mainly due to the
production of carbapenemase genes capable of inhibiting most β-lactam
antibiotics. These carbapenemase genes include Imipenemase metallo-β-lactamase
(IMP), Veron integron metallo-β-lactamase (VIM), New Delhi metallo-β-
lactamase_1 (NDM-1) of the Ambler B class; Klebsiella pneumoniae
carbapenemase (KPC) belongs to Ambler A class; Oxacillinase-48 (OXA-48)
belongs to Ambler D class.
At Cho Ray Hospital, according to annual microbiological report data, the
rate of carbapenem antibiotic resistance among Gram-negative bacteria is
increasing, which creates a lot of pressure for clinicians. Understanding the
genotypic rate, the distribution of genes as well as the risk factors affecting the
genotypic ability in carbapenem-resistant Gram-negative bacteria will help doctors
in choosing the proper antibiotics dosages and optimizing the use of drugs in
clinical settings.
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