Antimicrobial Resistance Patterns of Common Gram-Negative Microorganisms Isolated from Patients with Lower Respiratory Tract Infections in a Teaching Hospital in Vietnam.

This cross-sectional study investigated the antimicrobial resistance (AMR) patterns of gram-negative pathogens isolated from 4,789 hospitalized patients with lower respiratory tract infections (LRTIs). Of the collected specimens, 1,325 (27.7%) tested positive for gram-negative bacteria. Acinetobacter baumannii (38.6%), Pseudomonas aeruginosa (33.5%), Klebsiella pneumoniae (18.7%), Escherichia coli (5.6%), and Klebsiella aerogenes (3.5%) were the most prevalent isolates. AMR analysis revealed high resistance rates (79.9%-100%) of A. baumannii isolates to multiple classes of antibiotics except amikacin, trimethoprim/sulfamethoxazole, and colistin. P. aeruginosa displayed low resistance to colistin (< 10%) but high resistance to other antibiotics. K. pneumoniae displayed high resistance rates of 90.0%-100.0% to most penicillins, whereas resistance rates were notably lower for colistin (7.1%) and amikacin (16.7%). K. aerogenes exhibited high resistance to various antibiotics and sensitivity to amikacin (95.1%), ampicillin (100.0%), and colistin (100.0%). E. coli isolates exhibited resistance to ampicillin (96.9%) and maximum sensitivity to several antibiotics. Our study identified significant AMR trends and highlighted the prevalence of multidrug-resistant strains (93.6% for K. aerogenes and 69.1%-92.4% for other isolates). These findings emphasize the urgent need for appropriate antibiotic management practices to combat AMR in gram-negative pathogens associated with LRTIs.

Antimicrobial Resistance Patterns of Staphylococcus Aureus Isolated at a General Hospital in Vietnam Between 2014 and 2021.

Purpose: Staphylococcus aureus is a commensal bacteria species that can cause various illnesses, from mild skin infections to severe diseases, such as bacteremia. The distribution and antimicrobial resistance (AMR) pattern of S. aureus varies by population, time, geographic location, and hospital wards. In this study, we elucidated the epidemiology and AMR patterns of S. aureus isolated from a general hospital in Vietnam. Methods: This was a cross-sectional study. Data on all S. aureus infections from 2014 to 2021 were collected from the Microbiology department of Military Hospital 103, Vietnam. Only the first isolation from each kind of specimen from a particular patient was analyzed using the Cochran-Armitage and chi-square tests. Results: A total of 1130 individuals were diagnosed as S. aureus infection. Among them, 1087 strains were tested for AMR features. Most patients with S. aureus infection were in the age group of 41-65 years (39.82%). S. aureus isolates were predominant in the surgery wards, and pus specimens were the most common source of isolates (50.62%). S. aureus was most resistant to azithromycin (82.28%), erythromycin (82.82%), and clindamycin (82.32%) and least resistant to teicoplanin (0.0%), tigecycline (0.16%), quinupristin-dalfopristin (0.43%), linezolid (0.62%), and vancomycin (2.92%). Methicillin-resistant S. aureus (MRSA) and multidrug-resistant (MDR) S. aureus were prevalent, accounting for 73.02% and 60.90% of the total strains respectively, and the strains isolated from the intensive care unit (ICU) had the highest percentage of multidrug resistance (77.78%) among the wards. Conclusion: These findings highlight the urgent need for continuous AMR surveillance and updated treatment guidelines, particularly considering high resistance in MRSA, MDR strains, and ICU isolates. Future research focusing on specific resistant populations and potential intervention strategies is crucial to combat this rising threat.

A decade of human metapneumovirus in hospitalized children with acute respiratory infection: molecular epidemiology in central Vietnam, 2007-2017.

Human metapneumovirus (hMPV) can cause severe acute respiratory infection (ARI). We aimed to clarify the clinical and molecular epidemiological features of hMPV. We conducted an ARI surveillance targeting hospitalized children aged 1 month to 14 years in Nha Trang, Vietnam. Nasopharyngeal swabs were tested for respiratory viruses with PCR. We described the clinical characteristics of hMPV patients in comparison with those with respiratory syncytial virus (RSV) and those with neither RSV nor hMPV, and among different hMPV genotypes. Among 8822 patients, 278 (3.2%) were hMPV positive, with a median age of 21.0 months (interquartile range: 12.7-32.5). Among single virus-positive patients, hMPV cases were older than patients with RSV (p < 0.001) and without RSV (p = 0.003). The proportions of clinical pneumonia and wheezing in hMPV patients resembled those in RSV patients but were higher than in non-RSV non-hMPV patients. Seventy percent (n = 195) were genotyped (A2b: n = 40, 20.5%; A2c: n = 99, 50.8%; B1: n = 37, 19%; and B2: n = 19, 9.7%). The wheezing frequency was higher in A2b patients (76.7%) than in those with other genotypes (p = 0.033). In conclusion, we found a moderate variation in clinical features among hMPV patients with various genotypes. No seasonality was observed, and the multiple genotype co-circulation was evident.

Performance of wet scrubbers to remove VOCs from rubber emissions.

Poor performance of wet scrubbers in rubber processing plants due to breakthrough of specific volatile organic compounds (VOCs) causes odour impact events. The performance of wet scrubbers in the rubber drying process to remove VOCs was investigated in order to determine the responsible odorants. VOC emissions originating at the inlet and outlet of wet scrubbers were quantified using gas chromatography-mass spectrometry/olfactometry (GC-MS/O). Critical VOCs were identified alongside seasonal and daily variations of those VOCs. Altogether, 80 VOCs were detected in rubber emissions with 16 classified as critical VOCs based on their chemical concentration, high odour activity value (OAV) and unpleasant odour. Volatile fatty acids (VFAs) were the dominant VOCs with seasonal variations affecting emission composition. Results demonstrated the ineffectiveness of the wet scrubbers to mitigate odorous VOCs whereas the removal of some VOCs could be improved based on their polarity and solubility. It was found that there is a correlation between the wet scrubber performance and VFAs concentration in the emissions. The findings demonstrated that combining quantitative and sensory analyses improved accuracy in identifying odorous VOCs, which can cause odour annoyance from rubber processing. A VOC identification framework was proposed using both analyses approaches.

Occurrence and risk assessment of trace organic contaminants and metals in anaerobically co-digested sludge.

Anaerobic co-digestion of sludge increases biogas production and maintains anaerobic digestion stability. However, it is unclear whether the addition of co-substrates may increase the concentration of trace organic contaminants (TrOCs) and metals, limiting potential resource recovery opportunities when applied to agricultural land. This study explored the occurrence of 20 TrOCs and 18 metals in wastewater sludge anaerobically co-digested with beverage rejects (cola, beer and juice) and food wastes. TrOCs results showed that cola reject caused an accumulation of caffeine in final digestate. Bisphenol A also significantly increased in food waste co-digestion when compared with the mono-digestion (control). No significant difference in TrOCs was observed in the juice reject co-digestion. Analysis of the metal composition revealed a significant increase in Cr and Al in juice reject co-digested sludge. While restaurant food waste increased concentrations of K and Ca, both of which may be beneficial when applied to land. All metals in this study were below the maximum permissible concentrations specified for agricultural land use in Australia. Environmental risk assessment of sludge when used as soil fertiliser, showed that caffeine, diuron, triclocarban, triclosan, Cu and Zn exhibited high risks, with the largest risk quotient (RQ) posed by caffeine. Estrone and naproxen implied medium risks, and ibuprofen implied a high risk except for the co-digestion using cola reject (RQ = 0.9, medium risk). The results emphasise the importance for wastewater utility operators to understand the impact of co-substrate selection on the quality of sludge to minimise environmental risk from the use of biosolids on agricultural land.

Identification of volatile sulfur odorants emitted from ageing wastewater biosolids.

Volatile sulfur compounds (VSCs) are important sources of unpleasant odours in biosolid emissions. However, the study of VSCs may be limited by complications in their gas phase measurements due to reactivity, transformations and varying reported odour detection thresholds. A range of methods were used to quantitatively analyse VSCs in wastewater biosolid emissions. VSCs were identified in aged biosolid emissions by gas chromatography (GC) with a sulfur chemiluminescence detector (SCD) and mass spectrometry coupled with olfactory detection port (MS/O). In total, 10 VSC's were identified with two volatile organic sulfur compounds (VOSCs), allyl methyl sulfide and methyl propyl sulfide being reported for the first time in biosolid emissions. The emission patterns of different VSCs varied as the biosolids aged. Initially, the median concentrations of H2S, dimethyl sulfide (DMS), dimethyl trisulfide (DMTS), methanethiol (MeSH) and ethanethiol (EtSH) were orders of magnitude greater than their reported odour detection threshold, suggesting they would contribute to the odorous impact of the biosolids. The maximum H2S value was equal to 59.9 × 103 µg/m3 and was at least one magnitude higher compared to VOSCs, such as dimethyl disulfide (DMDS) (3.8×103 µg/m3), DMS (4.53 × 103 µg/m3), EtSH (2.83 × 103 µg/m3) and MeSH (3.25 × 103 µg/m3). Among the identified VSCs, H2S was the prominent odorant in terms of the magnitude and the frequency of detection, both initially as well as throughout storage. However, DMTS should be considered as a high priority or key odorant due to its odour activity value (OAV) and frequency of detection (sensorially detected in more than 75% of samples, with an OAVs higher than 1).

Differences in clinical severity of respiratory viral infections in hospitalized children.

It is uncertain whether clinical severity of an infection varies by pathogen or by multiple infections. Using hospital-based surveillance in children, we investigate the range of clinical severity for patients singly, multiply, and not infected with a group of commonly circulating viruses in Nha Trang, Vietnam. RT-PCR was performed to detect 13 respiratory viruses in nasopharyngeal samples from enrolled patients. We apply a novel clinical severity score and examine associations with the odds of being severe and differences in raw severity scores. We find no difference in severity between 0-, 1-, and 2-concurrent infections and little differences in severity between specific viruses. We find RSV and HMPV infections to be associated with 2- and 1.5-fold increase in odds of being severe, respectively, and that infection with ADV is consistently associated with lower risk of severity. Clinically, based on the results here, if RSV or HMPV virus is suspected, PCR testing for confirmatory diagnosis and for detection of multiple coinfecting viruses would be fruitful to assess whether a patient's disease course is going to be severe.

Cigarette smoke induces endoplasmic reticulum stress and suppresses efferocytosis through the activation of RhoA.

Impaired efferocytosis is a key mechanism of inflammatory lung diseases, including chronic obstructive pulmonary disease and cystic fibrosis. Cigarette smoking activates RhoA and impairs efferocytosis in alveolar macrophages, but the mechanism has not been fully elucidated. We investigated the role of endoplasmic reticulum (ER) stress induced by cigarette smoking in the disruption of efferocytosis. Both tunicamycin (10 µg/ml) and thapsigargin (0.1 and 1 µM), which are ER stress inducers, suppressed efferocytosis in J774 cells, and a Rho-associated coiled-coil-forming kinase (ROCK) inhibitor (Y27632) reversed this effect. We validated the effect of tunicamycin on efferocytosis in experiments using RAW264.7 cells. Then, we investigated the role of the unfolded protein response (UPR) in efferocytosis impaired by ER stress. A PERK inhibitor (GSK2606414) restored the efferocytosis that had been impaired by TM, and an eIF2α dephosphorylation inhibitor (salubrinal) suppressed efferocytosis. Cigarette smoke extract (CSE) induced ER stress in J774 macrophages and RhoA activation in J774 cells, and the CSE-induced ROCK activity was successfully reversed by GSK2606414 and tauroursodeoxycholic acid. Finally, we confirmed that ER stress suppresses efferocytosis in murine alveolar macrophages and that GSK2606414 could rescue this process. These data suggest that cigarette smoke-induced ER stress and the UPR play crucial roles in RhoA activation and suppression of efferocytosis in the lung.

Comparison of mass transfer parameters inside a USEPA flux hood for two VOCs.

Odorous emissions from area sources at wastewater treatment plants have become an environmental issue due to negative impacts on neighboring communities causing annoyance. Enclosure devices (such as dynamic flux chambers) have been used as direct methods to estimate area source emission rates from liquid-gas surfaces. Previously, model compounds have provided information about the internal mass transfer behavior of these sampling devices and the parameters estimated for certain model compounds that can be adapted for other compounds with similar liquid-gas partitioning properties. Acetic acid and butyric acid (both gas-phase-controlled compounds) were compared in order to assess the validity of adapting results from one compound to another. Mass transfer parameters for acetic acid and butyric acid were determined for a USEPA flux hood using a sweep air flow rate of 5 L/min. Mass transfer rates estimated for butyric acid, using the mass transfer parameters of acetic acid, were of the same order of magnitude as the experimental butyric acid mass transfer rates.

Identification of VOCs from natural rubber by different headspace techniques coupled using GC-MS.

Different extraction procedures were evaluated to assess their potential for measuring volatile organic compounds (VOCs) from raw rubber materials. Four headspace sampling techniques (SHS, DHS, HS-SPME and µ-CTE) were studied. Each method was firstly optimised to ensure their reliability in performance. Passive sampling was also compared as a rapid identification of background VOCs. 352 VOCs were identified, 71 from passive sampling and 281 from active headspace sampling, with 62 not previously reported (hexanenitrile, octanone, decanal, indole, aniline, anisole, alpha-pinene as well as pentanol and butanol). The volatiles belonged to a broad range of chemical classes (ketones, aldehydes, aromatics, acids, alkanes, alcohol and cyclic) with their thermal effects (lower boiling points) greatly affecting their abundance at a higher temperature. Micro-chamber (µ-CTE) was found to be the most suitability for routine assessments due to its operational efficiency (rapidity, simplicity and repeatability), identifying 115 compounds from both temperatures (30 °C and 60 °C). Whereas, HS-SPME a widely applied headspace technique, only identified 75 compounds and DHS identified 74 VOCs and SHS only 17 VOCs. Regardless of the extraction technique, the highest extraction efficiency corresponded to aromatics and acids, and the lowest compound extraction were aldehyde and hydrocarbon. The interaction between techniques and temperature for all chemical groups were evaluated using two-way ANOVA (p-value is 0.000197) explaining the highly significant interactions between factors.

Quantification of VOCs and the development of odour wheels for rubber processing.

The impacts of rubber variations (clonal, seasonal, and pre-treatment) were investigated to assess changes in the composition of volatile organic compounds (VOCs) emitted during rubber processing. VOC emissions from 14 different rubber types were evaluated by headspace micro-chamber (µ-TEC) extraction coupled with gas chromatography-mass spectrometry (GC-MS). Headspace extracted at 120 °C, which is equivalent to the drying temperature during rubber processing, revealed a significant number of odorants in terms of concentrations as well as odorant type. Volatile fatty acids (VFAs) such as acetic, propanoic, butanoic, pentanoic and hexanoic acids, were frequently detected at concentrations greater than their odour detection thresholds. Other odorous compounds including trimethylamine, p-cresol, butanone, indole, and phenol, were also detected. Emissions collected at ambient conditions represent odorants released during material storage (or maturation) and were dominated by benzene derivatives followed by ketones, aldehydes, esters, and acids. Emission composition during storage appeared to be governed by specific rubber properties such as protein and rubber moisture content. Seasonal variations revealed greater impacts on the concentration of VOCs for all studied clones, compared to pre-treatment variations, suggesting that the VOCs composition was seasonally dependent and may represents the 'potential' emissions from rubber as they are processed. A combination of sensorial and analytical measurements were used to produce odour wheels which may be used as tool to identify key malodours in onsite rubber processing. The linking of odours and odorants can facilitate communication between receptors (the public) and plant operators inorder to minimise odour impact and develop effective abatement and on-site management practices.

Influenza B associated paediatric acute respiratory infection hospitalization in central vietnam.

BACKGROUND: Influenza B is one of the major etiologies for acute respiratory infections (ARI) among children worldwide; however, its clinical-epidemiological information is limited. We aimed to investigate the hospitalization incidence and clinical-epidemiological characteristics of influenza B-associated paediatric ARIs in central Vietnam. METHODS: We collected clinical-epidemiological information and nasopharyngeal swabs from ARI children hospitalized at Khanh Hoa General Hospital, Nha Trang, Vietnam from February 2007 through June 2013. Nasopharyngeal samples were screened for 13 respiratory viruses using Multiplex-PCRs. Influenza B-confirmed cases were genotyped by Haemagglutinin gene sequencing. We analyzed the clinical-epidemiological characteristics of influenza B Lineages (Victoria/Yamagata) and WHO Groups. RESULTS: In the pre-A/H1N1pdm09 period, influenza B-associated ARI hospitalization incidence among children under five was low, ranging between 14.7 and 80.7 per 100 000 population. The incidence increased to between 51.4 and 330 in the post-A/H1N1pdm09. Influenza B ARI cases were slightly older with milder symptoms. Both Victoria and Yamagata lineages were detected before the A/H1N1pdm09 outbreak; however, Victoria lineage became predominant in 2010-2013 (84% Victoria vs 16% Yamagata). Victoria and Yamagata lineages did not differ in demographic and clinical characteristics. In Victoria lineage, Group1 ARI cases were clinically more severe compared to Group5, presenting a greater proportion of wheeze, tachypnea, and lower respiratory tract infection. CONCLUSIONS: The current results highlight the increased incidence of influenza B-related ARI hospitalization among children in central Vietnam in the post-A/H1N1pdm09 era. Furthermore, the difference in clinical severity between Victoria lineage Group1 and 5 implies the importance of influenza B genetic variation on clinical presentation.

Viral Acute Respiratory Illnesses in Young Infants Increase the Risk of Respiratory Readmission.

BACKGROUND: Respiratory viruses cause acute respiratory illness (ARI) in early childhood, but their effect on subsequent ARI admissions is not fully understood. This study aimed to determine the association between initial ARI admission because of viruses including human rhinovirus (HRV), respiratory syncytial virus (RSV), human adenovirus (HAdV) and human metapneumovirus (hMPV) and the risk of ARI readmission in children. METHODS: Clinical information and nasopharyngeal swab samples were collected from children <2 years old at their initial ARI admission in Nha Trang, Vietnam, from January 2007 to April 2012. The incidence of ARI readmission during the follow-up period (initial admission to 5 years of age) was compared between children with and without 1 of 13 respiratory viruses (influenza virus A, influenza virus B, RSV, hMPV, parainfluenza virus-1, parainfluenza virus-2, parainfluenza virus-3 and parainfluenza virus-4, HRV, human coronavirus-229E, human coronavirus-OC43, HAdV and human bocavirus) at initial admission. RESULTS: A total of 1941 children were enrolled in the study. Viruses were detected in 1254 (64.6%) children at enrollment; HRV, RSV, HAdV and hMPV were detected in 499 (25.7%), 439 (22.6%), 156 (8.0%) and 47 (2.4%) children, respectively. During the follow-up period (4572.7 person-years), 277 children were readmitted with ARI. Virus-related ARI initial admission was associated with an increased risk of ARI readmission for children who were initially admitted before 6 months of age (adjusted rate ratio, 1.6; 95% confidence interval: 1.1-2.5). HAdV (4.6; 1.8-11.9), hMPV (20.4; 6.2-66.9) and HRV (1.6; 1.0-2.4) were independently associated with the outcome. These associations were not observed for children whose initial admission occurred after 6 months of age. CONCLUSIONS: HAdV-, hMPV- and HRV-related initial ARI admissions, when occurring during early infancy, increased the risk of subsequent ARI-related readmission.

Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza pneumonia among adults aged ≥65 years in Japan.

BACKGROUND: The effectiveness of inactivated influenza vaccine (IIV) against laboratory-confirmed influenza pneumonia in older adults remains to be established. METHODS: Pneumonia patients aged ≥65 years who visited a study hospital in Chiba, Japan, were prospectively enrolled from February 2012 to January 2014. Sputum samples were collected from participants and tested for influenza virus by polymerase chain reaction assays. Influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza pneumonia was estimated by a test-negative design. RESULTS: Among a total of 814 pneumonia patients, 42 (5.2%) tested positive for influenza: 40 were positive for influenza A virus, and two were positive for influenza B virus. The IVE against laboratory-confirmed influenza pneumonia was 58.3% (95% confidence interval, 28.8-75.6%). The IVE against influenza pneumonia hospital admission, severe pneumonia, and death was 60.2% (95% CI, 22.8-79.4%), 65.5% (95% CI, 44.3-78.7%), and 71% (95% CI, -62.9% to 94.8%), respectively. In the subgroup analyses, the IVE against influenza pneumonia was higher for patients with immunosuppressive conditions (85.9%; 95% CI, 67.4-93.9%) than for those without (48.7%; 95% CI, 2.7-73%) but did not differ by patients' statin use status. CONCLUSION: IIV effectively reduces the risk of laboratory-confirmed influenza pneumonia in older adults.

An Alarmingly High Proportion of HIV-1 Isolates Carrying Mutations Corresponding to Resistance to Antiretroviral Drugs among HIV-Positive High-Risk Groups in Central Vietnam: a Substudy of the National Sentinel Survey.

We studied the prevalence of HIV drug resistance among high-risk groups such as injecting drug users (IDUs), female sex workers (FSWs), and men having sex with men (MSM) in central Vietnam. We used HIV-positive blood samples from 2012-2013 sentinel surveillance surveys. Study subjects were screened for HIV infection by standardized screening assays, and the HIV-positive samples were further tested for HIV viral load and drug-resistance mutations (DRMs) by in-house assays. DRMs were identified using the Stanford University online sequence analysis tool. Their risk behaviors were also investigated. During the study period, 6,016 (high-risk) subjects were screened, and 97 tested positive for HIV infection (IDUs: n = 63, 3.0%; FSWs: n = 24, 0.9%; and MSM: n = 10, 1.0%). Ninety-two of the 97 samples (45 from 2012 and 47 from 2013) were available for further testing. HIV RNA was detected in 56 (60.9%) of the 92 samples, and drug resistance genotyping was successfully performed on 40 (71.4%) samples. All these isolates were subtype CRF01_AE, except for 1 (2.5%) IDU whose HIV belongs to subtype B. Thirteen individuals (32.5%) were carrying HIV with at least 1 DRM: 9 IDUs, 1 FSW, and 3 MSM. Thus, HIV seroprevalence among high-risk individuals in central Vietnam is low, but a high proportion of drug resistant HIV-1 isolates is observed in the high-risk group.

Molecular evolution of respiratory syncytial virus subgroup A genotype NA1 and ON1 attachment glycoprotein (G) gene in central Vietnam.

We performed molecular evolutionary analyses of the G gene C-terminal 3rd hypervariable region of RSV-A genotypes NA1 and ON1 strains from the paediatric acute respiratory infection patients in central Vietnam during the 2010-2012 study period. Time-scaled phylogenetic analyses were performed using Bayesian Markov Chain Monte Carlo (MCMC) method, and pairwise distances (p-distances) were calculated. Bayesian Skyline Plot (BSP) was constructed to analyze the time-trend relative genetic diversity of central Vietnam RSV-A strains. We also estimated the N-glycosylation sites within G gene hypervariable region. Amino acid substitutions under positive and negative selection pressure were examined using Conservative Single Likelihood Ancestor Counting (SLAC), Fixed Effects Likelihood (FEL), Internal Fixed Effects Likelihood (IFEL) and Mixed Effects Model for Episodic Diversifying Selection (MEME) models. The majority of central Vietnam ON1 strains detected in 2012 were classified into lineage 1 with few positively selected substitutions. As for the Vietnamese NA1 strains, four lineages were circulating during the study period with a few positive selection sites. Shifting patterns of the predominantly circulating NA1 lineage were observed in each year during the investigation period. Median p-distance of central Vietnam NA1 strains was wider (p-distance=0.028) than that of ON1 (p-distance=0.012). The molecular evolutionary rate of central Vietnam ON1 strains was estimated to be 2.55×10-2 (substitutions/site/year) and was faster than NA1 (7.12×10-3 (substitutions/site/year)). Interestingly, the evolutionary rates of both genotypes ON1 and NA1 strains from central Vietnam were faster than the global strains respectively. Furthermore, the shifts of N-glycosylation pattern within the G gene 3rd hypervariable region of Vietnamese NA1 strains were observed in each year. BSP analysis indicated the rapid growth of RSV-A effective population size in early 2012. These results suggested that the molecular evolution of RSV-A G gene detected in central Vietnam was fast with unique evolutionary dynamics.

Association of RSV-A ON1 genotype with Increased Pediatric Acute Lower Respiratory Tract Infection in Vietnam.

Since the initial discovery of RSV-A ON1 in Canada in 2010, ON1 has been reported worldwide, yet information regarding its clinical impact and severity has been controversial. To investigate the clinical relevance of RSV-A ON1,acute respiratory infection (ARI) cases enrolled to our population-based prospective pediatric ARI surveillance at Khanh Hoa General Hospital, Central Vietnam from January 2010 through December 2012 were studied. Clinical-epidemiological information and nasopharyngeal samples were collected. Multiplex PCR assays were performed for screening 13 respiratory viruses. RSV-positive samples were further tested for subgroups (A/B) and genotypes information by sequencing the G-glycoprotein 2nd hypervariable region. Statistical analysis was performed to evaluate the clinical-epidemiological characteristics of RSV-A ON1. A total of 1854 ARI cases were enrolled and 426 (23.0%) of them were RSV-positive. During the study period, RSV-A and B had been co-circulating. NA1 was the predominant RSV-A genotype until the appearance of ON1 in 2012. RSV-related ARI hospitalization incidence significantly increased after the emergence of ON1. Moreover, multivariate analysis revealed that risk of lower respiratory tract infection was 2.26 (95% CI: 1.37-3.72) times, and radiologically-confirmed pneumonia was 1.98 (95% CI: 1.01-3.87) times greater in ON1 compared to NA1 cases. Our result suggested that ON1 ARI cases were clinically more severe than NA1.

Impact of 2009 pandemic influenza among Vietnamese children based on a population-based prospective surveillance from 2007 to 2011.

BACKGROUND: Influenza virus is one of the major viral pathogens causing pediatric acute respiratory infection (ARI). The spread of pandemic influenza A (A(H1N1)pdm09) in 2009 around the globe had a huge impact on global health. OBJECTIVE: To investigate the impact of A(H1N1)pdm09 on pediatric ARI in Vietnam. STUDY DESIGN: An ongoing population-based prospective surveillance in central Vietnam was used. All children aged <15 years residing in Nha Trang city, enrolled to the ARI surveillance in Khanh Hoa General Hospital, from February 2007 through March 2011 were studied. Clinical data and nasopharyngeal swab samples were collected. Influenza A was detected and genotyped by multiplex polymerase chain reaction assays and sequencing. RESULTS: Among enrolled 2736 hospitalized ARI cases, 354 (13%) were positive for influenza A. Genotyping results revealed that seasonal H3N2 and H1N1 (sea-H1N1) viruses were cocirculating before A(H1N1)pdm09 appeared in July 2009. The A(H1N1)pdm09 replaced the sea-H1N1 after the pandemic. The majority of influenza A cases (90%) were aged <5 years with incidence rate of 537 (387-775) per 100 000 population. Annual incidence rates of hospitalized influenza cases for pre-, initial and post-pandemic periods among children aged <5 year were 474, 452, and 387 per 100 000, respectively. Children with A(H1N1)pdm09 were elder, visited the hospital earlier, less frequently had severe signs, and were less frequently associated with viral coinfection compared with seasonal influenza cases. CONCLUSIONS: The A(H1N1)pdm09 did not increase the influenza annual hospitalization incidence or disease severity compared with seasonal influenza among pediatric ARI cases in central Vietnam.

Incidence of radiologically-confirmed pneumonia and Haemophilus influenzae type b carriage before Haemophilus influenzae type b conjugate vaccine introduction in Central Vietnam.

OBJECTIVES: To determine the incidence of radiologically-confirmed pneumonia (RCP) and Haemophilus influenzae type b (Hib) carriage in central Vietnam as a baseline data before Hib conjugate vaccine introduction. STUDY DESIGN: In the context of ongoing population-based prospective, hospitalized acute respiratory infection surveillance study, a cross-sectional Hib carriage study was conducted among 1000 children < 5 years of age living in NhaTrang, Vietnam in June 2010, 1 month before the nationwide introduction of Hib conjugate vaccine in Vietnam. RESULTS: The incidence of RCP hospitalizations among children < 5 years of age was 3.3 per 1000 children. The highest incidence was observed among children 12-23 month age group (8.3 per 1000). Haemophilus influenzae carriage was detected in 37% of the children and Hib carriage rate was 3%. Eighty-two percent of the Haemophilus influenzae had TEM ß-lactamase resistance gene. The presence of 6 or more family members was associated with an increased rate of Hib carriage (P = .04). CONCLUSIONS: Incidence of RCP and Hib carriage in this cross-sectional survey are lower compared with other studies. Continued surveillance for invasive Hib disease and sequential Hib carriage surveys are needed to support future assessments of the impact of Hib conjugate vaccine in Vietnam.