{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:48:51Z","timestamp":1790113731174,"version":"4.0.1"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Clin Microbiol Antimicrob"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Lower respiratory tract infection (LRTI) remains the leading infectious cause of morbidity and mortality globally. Key bacterial pathogens include\n Acinetobacter baumannii<\/jats:italic>\n ,\n Pseudomonas aeruginosa<\/jats:italic>\n ,\n Klebsiella pneumoniae<\/jats:italic>\n ,\n Escherichia coli<\/jats:italic>\n ,\n Staphylococcus aureus<\/jats:italic>\n and\n Streptococcus pneumoniae<\/jats:italic>\n . This study examined the prevalence and antimicrobial resistance patterns of major bacterial pathogens from community- and hospital-acquired LRTIs across six major hospitals in Vietnam.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Between January 2022 and May 2023, 1000 bacterial isolates were collected through an isolate-based surveillance. Species identification and antimicrobial susceptibility testing were performed by VITEK-2\/Phoenix M50, with MICs determined by E-test or broth microdilution. Multiplex PCRs were used to detect common AMR genes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A. baumannii<\/jats:italic>\n (49.6%),\n P. aeruginosa<\/jats:italic>\n (21%),\n K. pneumoniae<\/jats:italic>\n (18.6%) were predominant, followed by\n S. aureus<\/jats:italic>\n (6.7\n %)<\/jats:italic>\n ,\n E. coli<\/jats:italic>\n (3.9%) and\n S. pneumoniae<\/jats:italic>\n (0.2%). Most isolates (94.4%) were identified from hospital-acquired cases. High prevalence of MDR and carbapenem resistance were identified in\n A. baumannii<\/jats:italic>\n (96% and 95%),\n P. aeruginosa<\/jats:italic>\n (56.7% and 57.1%), and\n K. pneumoniae<\/jats:italic>\n (78% and 69.2%), respectively. Notably, resistance to ceftazidime-avibactam was detected in\n K. pneumoniae<\/jats:italic>\n (34.3%),\n P. aeruginosa<\/jats:italic>\n (29%), and\n E. coli<\/jats:italic>\n (7.7%), while colistin resistance was found in\n K. pneumoniae<\/jats:italic>\n (18.2%) and\n A. baumannii<\/jats:italic>\n (2.8%). MRSA prevalence was 79.1%, though\n S. aureus<\/jats:italic>\n remained susceptible to vancomycin, linezolid and ceftaroline. Most\n bla<\/jats:italic>\n NDM<\/jats:sub>\n -positive\n K. pneumoniae<\/jats:italic>\n (62\/71, 87.3%),\n E. coli<\/jats:italic>\n (2\/2, 100%), and\n P. aeruginosa<\/jats:italic>\n (23\/25, 85.2%) showed resistance to ceftazidime-avibactam. Whole genome sequencing revealed that the\n bla<\/jats:italic>\n NDM<\/jats:sub>\n -positive but ceftazidime-avibactam susceptible isolates (9\n K. pneumoniae<\/jats:italic>\n and 2\n P. aeruginosa<\/jats:italic>\n ) carried truncated\n bla<\/jats:italic>\n NDM<\/jats:sub>\n . Overall, ceftazidime-avibactam was effective against\n K. pneumoniae<\/jats:italic>\n ,\n E. coli<\/jats:italic>\n , and\n P. aeruginosa<\/jats:italic>\n isolates carrying ESBL, ESBL and\n bla<\/jats:italic>\n OXA\u221248<\/jats:sub>\n , or ESBL and\n bla<\/jats:italic>\n KPC<\/jats:sub>\n . Alternatively, no detectable AMR genes were found in 35 ceftazidime-avibactam resistant\n P. aeruginosa<\/jats:italic>\n isolates.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Carbapenem-resistant Gram-negative pathogens were predominant among hospital-acquired LRTIs in Vietnam, with notable resistance to ceftazidime-avibactam and colistin. The lack of effective treatment for\n A. baumannii<\/jats:italic>\n remains a major concern. We found a strong correlation between AMR phenotype and genotype among\n K. pneumoniae<\/jats:italic>\n and\n E. coli<\/jats:italic>\n , supporting gene-based therapy to guide ceftazidime-avibactam use. However, the presence of disrupted\n bla<\/jats:italic>\n NDM<\/jats:sub>\n underscores the need to re-evaluate commercial PCR assays for carbapenemase detection.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1186\/s12941-025-00818-3","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T16:46:02Z","timestamp":1756658762000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The bacterial etiology and antimicrobial susceptibility of lower respiratory tract infections in Vietnam"],"prefix":"10.1186","volume":"24","author":[{"given":"Tran Thi Ngoc","family":"Dung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chau","family":"Vinh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham Hong","family":"Anh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vo Kim Phuong","family":"Linh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha Thanh","family":"Tuyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham Thanh","family":"Tam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Phu Huong","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Truong Thien","family":"Phu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Su Minh","family":"Tuyet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham Hong","family":"Nhung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van Dinh","family":"Trang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Thi","family":"Van","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Thi","family":"Thanh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kesteman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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