Changing epidemiology and antimicrobial susceptibility of bloodstream infections at a Vietnamese infectious diseases hospital (2010–2020)

Bloodstream infection (BSI) poses a global health problem, with diverse organisms and rising antimicrobial resistance (AMR). Here, we characterized trends in BSI prevalence, AMR, and antibiotic use at a Vietnamese infectious diseases hospital from 2010 to 2020. Among 108,303 cultured blood samples, 8.8% were positive, yielding 7995 pathogens. Of 7553 BSI cases, 86.4% were community-acquired. BSI prevalence varied from 17 to 35 cases/1000 admissions/year, highest in HIV/hepatitis wards and patients >60. The in-hospital mortality or hospice discharge outcome was 21.3%. The top three pathogens, <i>E. coli</i> (24%)<i>, K. pneumoniae</i> (8.7%) <i>and S. aureus</i> (8.5%) exhibited increasing prevalence and multidrug resistance. Pathogens like <i>Cryptococcus neoformans</i> (8.4%), <i>Talaromyces marneffei</i> (6.7%), and <i>Salmonella enterica</i> (6.5%) declined. <i>E. coli</i> and <i>K. pneumoniae</i> were prevalent in older adults with community-acquired BSIs. Antibiotic use reached 842.6 DOT/1000 PD and significantly reduced after an antibiotic control policy. Enhanced surveillance and antimicrobial stewardship are crucial for managing BSIs in Vietnam.