The rate of transmission possibility of KPC and NDM-1 producing Klebsiella pneumoniae in ICU: the need for strengthened infection control measures.

OBJECTIVE: This study aims to characterize the rate of two specific resistance genes (KPC and NDM-1) and determine the route of transmission between the sites to implement infection control measures effectively. PATIENTS AND METHODS: This study was carried out at Viet Duc hospital in Vietnam. Bacterial isolates (Klebsiella pneumoniae) were collected between January 2018 and June 2019. Bacterial strains and antimicrobial susceptibility testing were performed in the VITEK 2 system. RESULTS: A total of 100 samples from 25 patients were taken. From each patient, we collected 4 samples from 4 sites. 25 isolated strains resisted 100% to amoxicillin/acid clavulanic, piperacillin/Tazobactam, and antibiotics in the cephalosporine group. Particularly in the carbapenem group, they resisted 100% to ertapenem, 96% to imipenem, and eropenem (rest was intermediate level). They have 76% sensitivity to aminoglycosides, 76% to amikacin, 60% to gentamycin, and 60% to tigecycline. Klebsiella pneumoniae carbapenemase (KPC) (+) was 24% and NDM-1 (+) was 28%. There was no case in all four sites. Positive-KPC strains were mainly in two sites (4/6 = 66.67%) and positive-NDM-1 strains were mainly in three sites (4/7 = 57.14%). Negative to both KPC and NDM-1 strains were in one site (4/12 = 33.3%) and two sites (6/12 = 50%). CONCLUSIONS: The rate of KPC and NDM-1 was 24% and 28%. In accordance with high antibiotic resistance rates to common antibiotics used in Vietnam, the high rate of transmission possibility between the sites contributed to strengthen the implementation of infection control measures in the ICU setting.

Assessment of morphological and hemodynamic changes in adult atrial septal defect before and after percutaneous trans-catheter closure: the initial result in Vietnamese patient.

OBJECTIVE: This study aimed to evaluate the change of morphology and hemodynamics in a relatively large number of patients with atrial septal defect (ASD) and provide the initial result in Vietnamese patients. PATIENTS AND METHODS: This longitudinal, prospective case-control study was done at the Vietnam National Heart Institute from January 2012 to December 2017. The participants were divided into two groups: the ASD group, which included patients with ASDs, and the control group, which included healthy individuals or individuals without cardiac-related disorders. RESULTS: There were 94 participants in the ASD group and 83 participants in the control group. Most patients with ASDs in the study group were female, and the average age was 38.65 ± 14.8. The success rate of the ASD group was 98.9%. The right ventricle morphology and function showed right ventricular diameter, pulmonary trunk gradually decreased, FAC and ET increased, IVCT and IVRT decreased, and Tei index gradually decreased after each examination. Morphology and function of the left ventricle after ASD closure showed that the left ventricular diameter gradually increased, and EF% in 3 months after ASD closure increased statistically significantly. IVCT, IVRT, and LV Tei index decreased, and ET increased statistically significantly. After six months from ASD closure, the proportion of patients with NYHA I was 90.3%, with no patient with NYHA IV, and pulmonary vascular resistance gradually decreased. CONCLUSIONS: Percutaneous trans-catheter closure in Vietnamese adult atrial septal defect was an effective technique. Ventricle morphological and hemodynamic abnormalities following closure recovered statistical significance over time, particularly in the left ventricle.