BACKGROUND:Evidence on the effectiveness of pneumococcal conjugate vaccines (PCVs) in Vietnam remains limited, despite the availability of 10-valent (PCV10) and 13-valent (PCV13) conjugate vaccines in the private sector since 2014 and 2019. We evaluated the effectiveness of PCVs against invasive pneumococcal disease (IPD) among Vietnamese children prior to national introduction. METHODS:We conducted a matched case-control study between February 2022 and January 2025 in southern Vietnam. Cases were children aged 2-59 months hospitalized with culture-confirmed IPD from normally sterile sites at three tertiary pediatric hospitals. Four age- and neighborhood-matched community controls were enrolled per case. Vaccine effectiveness (VE) was estimated using conditional logistic regression as (1 - adjusted odds ratio) × 100%. RESULTS:We enrolled 72 IPD cases and 288 matched controls; 37.5% of cases had received ≥1 PCV dose. The most frequent clinical syndromes were meningitis (36.1%) and pneumonia-associated sepsis (30.6%). Serotype 19A predominated (26.4%), followed by 6A (13.9%) and 19F (11.1%); 77.8% of cases were caused by serotypes included in PCV13. For vaccine-type IPD (VT-IPD), adjusted VE of PCV10 against PCV10-type IPD was 86.3% (95% CI, 13.3-97.9) for ≥1 dose and 89.5% (95% CI, 16.1-98.7) for ≥2 doses; VE of PCV13 against PCV13-type IPD was similarly high. Against all-serotype IPD, adjusted VE was 65.1% (95% CI, 21.8-84.4) for ≥1 PCV10 dose and 84.4% (95% CI, 20.0-97.0) for ≥1 PCV13 dose. No significant effectiveness was observed against non-PCV10-type IPD. VE was highest against serotype 6 A and declined with increasing time since vaccination. CONCLUSIONS:This first Vietnamese evidence demonstrates that PCV10 and PCV13 provide substantial protection against VT-IPD and overall IPD in young children despite low vaccine coverage. The predominance of serotype 19A and waning protection over time emphasize the importance of selecting 19A-containing formulations and booster schedules to inform timely national PCV introduction in Vietnam.

Introduction: Surveillance for Rickettsia spp. is necessary given the recent emergence and re-emergence of various rickettsioses in Vietnam. However, data on their circulation in off-host arthropods from natural environments remain limited. This study aimed to investigate the presence and distribution of Rickettsia species in ticks and fleas collected from the environment in Hanoi and Phu Tho provinces, northern Vietnam, between September and December 2021. Methodology: The ticks and fleas were collected using dragging, light traps, and carbon dioxide traps. Arthropods were identified morphologically and screened for Rickettsia species using real-time PCR targeting the 17kDa antigen gene. Positive samples were further analyzed using species-specific real-time PCR assays and multilocus sequence typing (MLST) for confirmation and phylogenetic analysis. Results: A total of 758 arthropods were collected, including 748 ticks (747 larval ticks grouped into 101 pools and 1 adult tick) and 10 fleas. The minimum field infection rate (MFIR) of Rickettsia spp. in ticks was 2.94% (22/748), while the prevalence in fleas was 50% (5/10). Rickettsia felis was detected in 9 larval tick pools and 2 individual fleas by species-specific real-time PCR and MLST. No other Rickettsia species were identified. Conclusions: This study provides the first evidence of Rickettsia spp. in off-host ticks and fleas from the natural environment in Vietnam. These findings indicate a potential risk of environmental exposure to Rickettsia and emphasize the need for integrated vector surveillance strategies.

Vietnam has committed to ending the AIDS epidemic by 2030 through the 95–95–95 targets. Men who have sex with men (MSM) remain a key population driving new infections. This study assessed progress toward national HIV targets among MSM and identified factors associated with HIV status awareness. Data were obtained from the HIV Sentinel Surveillance Plus Behavioral Surveys (HSS+) conducted from 2015 to 2020 in six provinces. Proportions of HIV-positive MSM who knew their HIV status, received antiretroviral therapy (ART), and achieved viral suppression were estimated. Temporal trends were analyzed using the Cochran–Armitage trend test, and correlates of HIV status awareness were examined using multivariable logistic regression. Among 4712 MSM, 471 (10.0

Hiện nay, công nghệ giải trình tự thế hệ mới đã có những bước tiến vượt bậc, trở thành công cụ quan trọng trong nghiên cứu y sinh. Giải trình tự thế hệ thứ 3 ứng dụng công nghệ Oxford Nanopore (ONT) với ưu điểm giải trình tự đoạn dài, chi phí thấp, và có thể thực hiện nghiên cứu ngay tại chỗ, đặc biệt ở những khu vực có nguồn lực hạn chế đã mở ra nhiều cơ hội mới trong nghiên cứu và giám sát bệnh mới nổi và tái nổi, đặc biệt là vi rút Dengue (DENV). Viện Pasteur TP. HCM đã tích lũy được nhiều kinh nghiệm và thành công trong việc xây dựng và áp dụng giải trình tự ONT để giám sát dữ liệu SARS-CoV-2. Dựa trên những thành tựu đó, chúng tôi triển khai nghiên cứu xây dựng quy trình giải trình tự toàn bộ hệ gen DENV bằng mồi đặc hiệu, sử dụng công nghệ ONT. Quy trình bao gồm các bước thiết kế mồi, tách chiết RNA, chuẩn bị thư viện, giải trình tự trên thiết bị MinION Mk1C và phân tích kết quả bằng các phần mềm tin sinh học. Quy trình đã được đánh giá sơ bộ và kết quả bước đầu cho thấy trình tự của 16 mẫu nghiên cứu có độ phủ ngang từ 79% đến 99% hệ gen DENV với độ phủ sâu từ 59X đến 28295X.

BACKGROUND Ciprofloxacin resistant Klebsiella pneumoniae is common or emerging in many geographies, and knowledge of local resistance rates is important for empirical therapy. Whilst there are known K. pneumoniae ciprofloxacin resistance determinants, there is a lack of systematic data on the effect of determinants, alone and in combination, and there are no publicly accessible tools for predicting resistance from whole genome sequence data. METHODS The KlebNET-GSP AMR Genotype-Phenotype Group aggregated a matched genotype-phenotype dataset of n=12,167 K. pneumoniae species complex ( Kp SC) isolates from 27 countries between 2001-2021. We developed a rules-based classifier to predict ciprofloxacin resistance by categorizing the number of quinolone resistance determining regions mutations in gyrA and parC , the number of plasmid-mediated quinolone resistance genes, and the presence/absence of aac(6ʹ)-Ib-cr (which can acetylate ciprofloxacin). Predictive performance was assessed using the discovery dataset, for which we re-phenotyped discrepant isolates; and validated using externally contributed datasets (n=7,030 Kp SC isolates). RESULTS The rules-based classifier predicted R vs S/I with categorical agreement, sensitivity, and specificity >96%, and major/very major error rates <4%. Performance was similar across diverse Kp SC sources (human, animal, other), species, and intra-species lineages. External validation of the classifier yielded overall 93.12% categorical agreement [95% confidence interval (CI), 92.50-93.74%], 8.65% major errors [95% CI, 7.34-9.97%], and 6.20% very major errors [95% CI, 5.51-6.90%]. We implemented the classifier in Kleborate, a command-line tool that is integrated into the Pathogenwatch web platform. Using this to assess the global distribution of ciprofloxacin resistance determinants in Kp SC genomes available in Pathogenwatch (n=31,319, from 109 countries between years 2000-2023), we observed a significant positive association between national quinolone consumption rates and predicted ciprofloxacin resistance (R2=0.20, p=0.004). CONCLUSIONS Ciprofloxacin resistance phenotypes can be reasonably predicted from genotypes, which is sufficient for informing surveillance. However, unexplained resistance remains and accuracy is insufficient for clinical applications. We demonstrate the value of aggregating genotype-phenotype data to explore resistance mechanisms and develop predictors, but highlight complexities in combining phenotype data from different assays and standards. ### Competing Interest Statement The authors have declared no competing interest. Bill & Melinda Gates Foundation, INV025280, INV077266 Wellcome Trust, 226432/Z/22/Z European Union‘s Horizon 2020 Research and Innovation Programme, 773830 Trond Mohn Foundation, TMF2019TMT03 SARA project (Surveillance of Antimicrobial Resistance in Africa, through a grant from the French Ministry of Europe and Foreign Affairs within the Fonds de solidarité pour les projets innovants (FSPI) Academy of Medical Sciences Health Foundation UK Vietnam MRC Newton Fund, MR/N029399/1 RG83380 National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, NIHR207397

This report presents the genome sequence of Bacillus subtilis strain Eramic25, isolated from the fecal sample of a healthy adult in Vietnam. Genome analysis confirms its safety and reveals genes associated with probiotic characteristics, supporting its potential application in functional foods and human health.

BACKGROUND:The escalating antibiotic resistance in Helicobacter pylori (H. pylori) has become a significant concern in the management of infections. This study aimed to investigate the mutations associated with levofloxacin resistance in H. pylori isolated from southern Vietnam. METHODS:Levofloxacin-resistant H. pylori strains were isolated from peptic ulcer patients and DNA sequencing of DNA gyrase (gyrA and gyrB) genes was performed. RESULTS:We found that 97 % of resistant isolates bearing at least one mutation in GyrA and 32.3 % had a simultaneous mutation in GyrB. Additionally, we identified three previously known mutations, G85C (1.5 %), N87 (34.3 %), and D91 (14.9 %), within the quinolone-resistance-determining region (QRDR) region of GyrA, which confer resistance through natural transformation and were the most prevalent in our study. Notably, we demonstrated a mutation (A88V MIC 4 μg/mL) in GyrA and four novel mutations (E422R MIC 16 μg/mL, A426G MIC 32 μg/mL, S429E MIC 4 μg/mL, and P443A MIC 4 μg/mL) in GyrB, belonging to the QRDR. Additionally, several mutations outside the QRDR were observed, including R190K (16.4 %), P219A/G (13.4 %), L45F (9 %), P220E (6 %), Y28I (4.5 %), A27L (3 %) in GyrA, and S457A (7.5 %), A382F (5.9 %), L389F (4.5 %), D412R (1.5 %), L460P (1.5 %), I482V (1.5 %), and L518E (1.5 %) that have not been documented in any previous studies and were not functionally validated. CONCLUSION:These results highlight the high genetic diversity and prevalence of levofloxacin-resistant H. pylori strains in southern Vietnam and provide valuable insights into levofloxacin resistance mechanisms for future diagnostic and treatment advancements.

BACKGROUND:Streptococcus pneumoniae is a major cause of morbidity and mortality in children. This study investigates the clinical features, cerebrospinal fluid (CSF) findings, serotype distribution, and antibiotic resistance patterns in Vietnamese children aged 1-59 months with pneumococcal meningitis (PM). METHODS:This retrospective study (2012-2023) was conducted at two tertiary pediatric hospitals in Ho Chi Minh City. CSF samples from probable bacterial meningitis (PBM) cases were analyzed using biochemistry, culture, and real-time polymerase chain reaction (rt-PCR). Serotyping and antibiotic-resistance genes were identified using quadriplex rt-PCR. RESULTS:Among 2922 PBM cases, 155 (5.3 %) were confirmed as PM. Of these, 58.7 % occurred in children under one year and 62.6 % during the rainy season. Fever (98.1 %) and vomiting (67.7 %) were the most common symptoms. Infants under 12 months frequently exhibited nonspecific signs like convulsions (48.4 %) and bulging fontanels (34.1 %), while older children displayed classic symptoms such as neck stiffness (32.4 %) and behavioral changes (26.5 %). CSF analysis revealed turbid appearance, WBC ≥ 100 cells/mm³ (85.2 %), and protein ≥ 1 g/L (60.0 %) (p < 0.05). Severe outcomes were noted in 17.4 % of PM cases, with a 3.2 % fatality rate. The 13-valent pneumococcal conjugate vaccine (PCV13) serotypes caused 81.3 % of confirmed cases, predominantly serotypes 6 A/B (34.8 %) and 19 F (20.0 %). Among 137 isolates tested, high prevalence rates were observed for the pbp2b (68.6 %), mef(A)/erm(B) (93.4 %), and tetM (92.0 %) resistance genes. Additionally, 61.3 % of isolates showed multiple resistance genes, particularly in serotypes 6 A/B, 23 F, 9 V, and 13. Antibiotic resistance in non-PCV13 serotypes increased over time. CONCLUSIONS:PM in Vietnamese children presents age-specific clinical presentations and is predominantly caused by highly resistant PCV13 serotypes. The rising resistance in non-PCV13 serotypes poses a formidable challenge in managing pneumococcal infections. These findings emphasize the urgent need for PCV introduction in the national immunization program and ongoing resistance surveillance.

Introduction: Recent reports indicate the emergence of community-acquired pneumonia associated with K64-Klebsiella pneumoniae. Here, we identify the capsular types and sequence type of invasive and commensal K. pneumoniae isolates from Vietnam. Methods: We included 93 K. pneumoniae isolates from patients hospitalized at the National Hospital for Tropical Diseases, Hanoi between 2007 and 2011; and 110 commensal isolates from throat swabs from healthy volunteers living in rural and urban Hanoi in 2012. We determined sequence types (STs) by multi-locus sequence typing (MLST) and capsule typing for seven K types by PCR. Antibiotic susceptibility testing was performed using disk diffusion. Results: The most common detected capsule types were K1 (39/203, 19.2%, mainly ST23) and K2 (31/203, 15.3%, multiple STs: ST65, ST86, ST380). We found significantly more K2 isolates among invasive in comparison to commensal isolates (22.6% vs 9%, p = 0.01) but no significant difference was observed between invasive and commensal K1 isolates (14.5% vs 24.7%, p = 0.075). K64 with varying sequence types were predominantly seen among invasive K. pneumoniae (8 vs. 3) and were isolated from sepsis and meningitis patients. Among K64 isolates, one was carbapenem-resistant with ST799. Conclusion: Our study confirms that capsule type K64 K. pneumoniae is associated with community-acquired invasive infections in Vietnam. Research is needed to unravel the mechanisms of virulence of capsule type K64 in both community and hospital settings.

Introduction Recent reports indicate the emergence of community-acquired pneumonia associated with K64- Klebsiella pneumoniae (K. pneumoniae). Here, we identify the capsular types and sequence type of invasive and commensal K. pneumoniae isolates from Vietnam. Methods We included 93 K. pneumoniae isolates from patients hospitalized at the National Hospital for Tropical Diseases, Hanoi between 2007 and 2011; and 110 commensal isolates from throat swabs from healthy volunteers living in rural and urban Hanoi in 2012. We determined sequence types (STs) by multi-locus sequence typing (MLST) and capsule typing for seven K types by PCR. Antibiotic susceptibility testing was performed using disk diffusion. Results The most common detected capsule types were K1 (39/203, 19.2%, mainly ST23) and K2 (31/203, 15.3%, multiple STs: ST65, ST86, ST380). We found significantly more K2 isolates among invasive in comparison to commensal isolates (22.6% vs 9%, p = 0.01) but no significant difference was observed between invasive and commensal K1 isolates (14.5% vs 24.7%, p = 0.075). K64 with varying sequence types were predominantly seen among invasive K. pneumoniae (8 vs. 3) and were isolated from sepsis and meningitis patients. Among K64 isolates, one was carbapenem-resistant with ST799. Conclusion Our study confirms that capsule type K64 K. pneumoniae is associated with community-acquired invasive infections in Vietnam. Research is needed to unravel the mechanisms of virulence of capsule type K64 in both community and hospital settings.

Dengue virus (DENV) poses a major global health concern, with over 6.5 million cases and 7300 deaths reported in 2023. Accurate serological assays are essential for tracking infection history, evaluating disease severity, and guiding vaccination strategies. However, existing assays are limited in their specificity, sensitivity, and cross-reactivity. Using optical modulation biosensing (OMB) technology and non-structural protein 1 (NS1) antigens from DENV-1–3, we developed highly sensitive and quantitative serotype-specific anti-DENV NS1 IgG serological assays. The OMB-based assays offered a wide dynamic range (~4-log), low detection limits (~400 ng/L), fast turnaround (1.5 h), and a simplified workflow. Using samples from endemic (Vietnam) and non-endemic (Israel) regions, we assessed intra-DENV and inter-Flavivirus cross-reactivity. Each assay detected DENV infection with a 100% sensitivity for the corresponding serotype and 64% to 90% for other serotypes. Cross-reactivity with Zika, Japanese encephalitis, and West Nile viruses ranged from 21% to 65%, reflecting NS1 antigen conservation. Our study provides valuable insights into the cross-reactivity of DENV NS1 antigens widely used in research and highlights the potential of OMB-based assays for quantitative and epidemiological studies. Ongoing efforts should aim to minimize cross-reactivity while maintaining sensitivity and explore integration with complementary platforms for improved diagnostic precision.

Mục tiêu: Nghiên cứu này nhằm đánh giá toàn diện tính an toàn trong điều kiện in vitro của chủng Bacillus subtilis Eramic 25 theo hướng dẫn của GRAS, Cơ quan Quản lý Thực phẩm và Thuốc Hoa Kỳ (FDA) và Cơ quan An toàn Thực phẩm Châu Âu (EFSA), thông qua việc phân tích khả năng kháng khuẩn, độc tính tế bào, cùng sự hiện diện của các gen kháng kháng sinh và gen độc lực liên quan đến tính an toàn của chủng. Phương pháp: Các thử nghiệm được thực hiện bao gồm đánh giá khả năng kháng khuẩn đối với vi khuẩn gây bệnh, thử nghiệm độc tính tế bào trên hai dòng tế bào Vero và HT-29, cũng như phân tích bộ gen nhằm xác định sự hiện diện của các gen độc lực và gen kháng kháng sinh.Kết quả: Chủng B. subtilis Eramic 25 không ức chế các chủng vi khuẩn gây bệnh trong thử nghiệm và không gây độc trên hai dòng tế bào Vero và HT-29. Phân tích bộ gen cũng xác nhận rằng chủng này không mang các gen mã hóa độc tố, không chứa gen gây tan máu. Các gen kháng kháng sinh không nằm trên plasmid hoặc gen nhảy, cho thấy nguy cơ lây truyền gen kháng kháng sinh là rất thấp. Kết luận: Chủng Bacillus subtilis Eramic 25 đáp ứng các tiêu chí an toàn in vitro theo hướng dẫn của GRAS, FDA và EFSA. Kết quả này cho thấy tiềm năng ứng dụng của chủng trong sản xuất probiotic, thực phẩm chức năng và các sản phẩm thực phẩm dành cho con người, đồng thời là cơ sở để tiến hành các nghiên cứu tiếp theo trên động vật và thử nghiệm lâm sàng trên người.

Mục tiêu: Xác định giá trị tiên lượng tử vong của chỉ số lactate/albumin (LAR) trên người bệnh (NB) nhiễm khuẩn huyết (NKH) điều trị tại Bệnh viện Quân y 103. Phương pháp nghiên cứu: Nghiên cứu hồi cứu, mô tả cắt ngang có so sánh, phân tích trên 81 NB ≥ 18 tuổi, chẩn đoán NKH và điều trị tại Bệnh viện Quân y 103 từ tháng 01 - 12/2024. Kết quả: Tuổi trung bình là 60,0 ± 14,5, nam giới chiếm 59,3%. Nhóm tử vong có lactate máu cao hơn (7,5 ± 2,2 mmol/L so với 4,0 ± 1,5 mmol/L; p < 0,01), albumin thấp hơn (20,0 ± 5,1 g/L so với 24,0 ± 6,8 g/L; p > 0,05) và LAR cao hơn (37,5 ± 11,1 so với 16,7 ± 7,2; p < 0,01). Trong tiên lượng tử vong, LAR cho AUC = 0,76, điểm cắt 2,2, độ nhạy 73,7%, độ đặc hiệu 71,0%. Lactate có AUC = 0,72, điểm cắt 3,8 mmol/L, độ nhạy 72,0%, đặc hiệu 68,0%. Albumin có AUC = 0,66, độ nhạy và độ đặc hiệu đều thấp hơn. Kết luận: LAR là chỉ số tiên lượng tử vong tốt hơn so với lactate hoặc albumin đơn lẻ, có thể áp dụng lâm sàng để sàng lọc nguy cơ tử vong ở NB NKH.

The COVID-19 pandemic highlighted the urgent need for genomic surveillance to monitor viral evolution and guide public health responses, especially in limited-resource settings. This study describes the establishment and implementation of a SARS-CoV-2 genomic surveillance system by Pasteur Institute in Ho Chi Minh City (PIHCM), covering 20 provinces in southern Vietnam from January 2020 to June 2023. Nasopharyngeal swabs were systematically collected, screened by RT-PCR (Ct < 28), and sequenced using adaptable Next-Generation Sequencing technologies, including Illumina MiSeq and later Oxford Nanopore MinION, supported by international training and resources. Phylogenetic analyses tracked viral lineage dynamics across five pandemic phases. A total of 2207 genomes were sequenced, revealing temporal shifts in variant dominance, particularly Delta and Omicron variants and an average mutation count of 52,5 per sample. The data were instrumental in managing local outbreaks, informing national responses, and contributing to global databases like GISAID. This study demonstrates that adaptive genomic surveillance is both feasible and effective in resource-constrained settings. It underscores the critical role of real-time genomic data in pandemic response and advocates for sustained investment in capacity building, infrastructure and global collaboration, offering a scalable model for future preparedness in low - and middle - income countries.

BACKGROUND:DNA sequencing could become an alternative to in vitro antibiotic susceptibility testing (AST) methods for determining antibiotic resistance by detecting genetic determinants associated with decreased antibiotic susceptibility. Here, we aimed to assess and improve the accuracy of antibiotic resistance determination from Enterococcus faecium genomes for diagnosis and surveillance purposes. METHODS:In this retrospective diagnostic accuracy study, we first conducted a literature search in PubMed on Jan 14, 2021, to compile a catalogue of genes and mutations predictive of antibiotic resistance in E faecium. We then evaluated the diagnostic accuracy of this database to determine susceptibility to 12 different, clinically relevant antibiotics using a diverse population of 4382 E faecium isolates with available whole-genome sequences and in vitro culture-based AST phenotypes. Isolates were obtained from various sources in 11 countries worldwide between 2000 and 2018. We included isolates tested with broth microdilution, Vitek 2, and disc diffusion, and antibiotics with at least 50 susceptible and 50 resistant isolates. Phenotypic resistance was derived from raw minimum inhibitory concentrations and measured inhibition diameters, and harmonised primarily using the breakpoints set by the European Committee on Antimicrobial Susceptibility Testing. A bioinformatics pipeline was developed to process raw sequencing reads, identify antibiotic resistance genetic determinants, and report genotypic resistance. We used our curated database, as well as ResFinder, AMRFinderPlus, and LRE-Finder, to assess the accuracy of genotypic predictions against phenotypic resistance. FINDINGS:We curated a catalogue of 228 genetic markers involved in resistance to 12 antibiotics in E faecium. Very accurate genotypic predictions were obtained for ampicillin (sensitivity 99·7% [95% CI 99·5-99·9] and specificity 97·9% [95·8-99·0]), ciprofloxacin (98·0% [96·4-98·9] and 98·8% [95·9-99·7]), vancomycin (98·8% [98·3-99·2] and 98·8% [98·0-99·3]), and linezolid resistance (after re-testing false negatives: 100·0% [90·8-100·0] and 98·3% [97·8-98·7]). High sensitivity was obtained for tetracycline (99·5% [99·1-99·7]), teicoplanin (98·9% [98·4-99·3]), and high-level resistance to aminoglycosides (97·7% [96·6-98·4] for streptomycin and 96·8% [95·8-97·5] for gentamicin), although at lower specificity (60-90%). Sensitivity was expectedly low for daptomycin (73·6% [65·1-80·6]) and tigecycline (38·3% [27·1-51·0]), for which the genetic basis of resistance is not fully characterised. Compared with other antibiotic resistance databases and bioinformatic tools, our curated database was similarly accurate at detecting resistance to ciprofloxacin and linezolid and high-level resistance to streptomycin and gentamicin, but had better sensitivity for detecting resistance to ampicillin, tigecycline, daptomycin, and quinupristin-dalfopristin, and better specificity for ampicillin, vancomycin, teicoplanin, and tetracycline resistance. In a validation dataset of 382 isolates, similar or improved diagnostic accuracies were also achieved. INTERPRETATION:To our knowledge, this work represents the largest published evaluation to date of the accuracy of antibiotic susceptibility predictions from E faecium genomes. The results and resources will facilitate the adoption of whole-genome sequencing as a tool for the diagnosis and surveillance of antimicrobial resistance in E faecium. A complete characterisation of the genetic basis of resistance to last-line antibiotics, and the mechanisms mediating antibiotic resistance silencing, are needed to close the remaining sensitivity and specificity gaps in genotypic predictions. FUNDING:Wellcome Trust, UK Department of Health, British Society for Antimicrobial Chemotherapy, Academy of Medical Sciences and the Health Foundation, Medical Research Council Newton Fund, Vietnamese Ministry of Science and Technology, and European Society of Clinical Microbiology and Infectious Disease.

Interpreting the phenotypes of bla SHV alleles in Klebsiella pneumoniae genomes is complex. Whilst all strains are expected to carry a chromosomal copy conferring resistance to ampicillin, they may also carry mutations in chromosomal bla SHV alleles or additional plasmid-borne bla SHV alleles that have extended-spectrum β-lactamase (ESBL) activity and/or β-lactamase inhibitor (BLI) resistance activity. In addition, the role of individual mutations/a changes is not completely documented or understood. This has led to confusion in the literature and in antimicrobial resistance (AMR) gene databases [e.g. the National Center for Biotechnology Information (NCBI) Reference Gene Catalog and the β-lactamase database (BLDB)] over the specific functionality of individual sulfhydryl variable (SHV) protein variants. Therefore, the identification of ESBL-producing strains from K. pneumoniae genome data is complicated. Here, we reviewed the experimental evidence for the expansion of SHV enzyme function associated with specific aa substitutions. We then systematically assigned SHV alleles to functional classes (WT, ESBL and BLI resistant) based on the presence of these mutations. This resulted in the re-classification of 37 SHV alleles compared with the current assignments in the NCBI's Reference Gene Catalog and/or BLDB (21 to WT, 12 to ESBL and 4 to BLI resistant). Phylogenetic and comparative genomic analyses support that (i) SHV-1 (encoded by bla SHV-1) is the ancestral chromosomal variant, (ii) ESBL- and BLI-resistant variants have evolved multiple times through parallel substitution mutations, (iii) ESBL variants are mostly mobilized to plasmids and (iv) BLI-resistant variants mostly result from mutations in chromosomal bla SHV. We used matched genome-phenotype data from the KlebNET-GSP AMR Genotype-Phenotype Group to identify 3999 K. pneumoniae isolates carrying one or more bla SHV alleles but no other acquired β-lactamases to assess genotype-phenotype relationships for bla SHV. This collection includes human, animal and environmental isolates collected between 2001 and 2021 from 24 countries. Our analysis supports that mutations at Ambler sites 238 and 179 confer ESBL activity, whilst most omega-loop substitutions do not. Our data also provide support for the WT assignment of 67 protein variants, including 8 that were noted in public databases as ESBL. These eight variants were reclassified as WT because they lack ESBL-associated mutations, and our phenotype data support susceptibility to third-generation cephalosporins (SHV-27, SHV-38, SHV-40, SHV-41, SHV-42, SHV-65, SHV-164 and SHV-187). The approach and results outlined here have been implemented in Kleborate v2.4.1 (a software tool for genotyping K. pneumoniae), whereby known and novel bla SHV alleles are classified based on causative mutations. Kleborate v2.4.1 was updated to include ten novel protein variants from the KlebNET-GSP dataset and all alleles in public databases as of November 2023. This study demonstrates the power of sharing AMR phenotypes alongside genome data to improve the understanding of resistance mechanisms.

BACKGROUND:This study aimed to measure the preferences for mental health support among health professionals, their willingness to support the mental health of colleagues and associated factors. METHOD:A descriptive cross-sectional study was performed from August to October 2022 within five hospitals located in Hanoi, Vietnam. A total of 244 health professionals participated in the study. Data on socio-economic status, health and COVID-19-related characteristics, Depression Anxiety Stress Scale (DASS-21); and preferences for mental health support services were collected by using a structured self-reported questionnaire. Multivariate logistic regression models were utilized to identify associated factors with the demand for mental support services. RESULTS:13.9%, 17.1% and 8.6% reported having at least mild depression, anxiety and stress, respectively. There 13.9% did not seek any mental health support during the COVID-19 pandemic. The most common support included talking with friends (52.9%), family (50.8%), colleagues (47.6%) and using social networks/Internet (43.5%). There 31.1% had been aware of mental health services, but only 18.0% used this service at least once. Regarding preferences, 47.3% had a demand for mental support services, and the most preferred service was providing coping skills (25.9%), followed by skills to support others against mental problems (22.2%). Major sources of support included psychiatrists (34.4%), colleagues (29.1%) and family (27.9%). The main preferred channels for support included telephone/mobile phone (35.7%) and Internet (20.9%). Only 12.3% were willing to provide mental support for colleagues during the pandemic. Age, education, perceived mental health status, ever seeking any mental service, and DASS-21 depression score were associated with demand for mental support services. CONCLUSION:This study found a lack of awareness of mental health services for health professionals, as well as moderate levels of demand for this service in this population. Raising awareness and developing tailored mental health support services are important to enhancing the mental well-being of health professionals in Vietnam to prepare for the next pandemic.

BackgroundStreptococcus pneumoniae is the most common bacterium that causes community-acquired pneumonia (CAP) in children. The rate of S. pneumoniae resistance to antibiotics is increasing, particularly in patients with severe CAP. Therefore, the level of antibiotic resistance of S. pneumoniae causing severe CAP in Vietnamese children requires regular monitoring.MethodsThis was a cross-sectional descriptive study. Nasopharyngeal aspiration specimens from children were cultured, isolated, and examined for S. pneumoniae. Bacterial strains were assessed for antimicrobial susceptibility, and the minimum inhibitory concentration (MIC) was determined.ResultsEighty-nine strains of S. pneumoniae were isolated from 239 children with severe CAP. The majority of isolates were completely non-susceptible to penicillin (1.1% intermediate, 98.9% resistant) and highly resistant to erythromycin (96.6%) and clarithromycin (88.8%); the rate of resistance to ceftriaxone was 16.9%, with the proportion of intermediate resistance at 46.0%; 100% of strains were susceptible to vancomycin and linezolid. For most antibiotics, MIC50 and MIC90 were equal to the resistance threshold according to the Clinical and Laboratory Standards Institute 2021; penicillin had an eight-fold increase in MIC90 (64 mg/L) and ceftriaxone had a 1.5-fold increase in MIC90 (6 mg/L).ConclusionStreptococcus pneumoniae isolates described in this study were resistant to many antibiotics. Penicillin should not be the first-line antibiotic of choice, and ceftriaxone at an enhanced dose should be used instead.

Enterococcus faecalis là tác nhân gây nhiễm trùng cơ hội phổ biến ở bệnh viện và cộng đồng. Sự sẵn có của nó trong nhiều môi trường khác nhau và khả năng đề kháng với nhiều loại kháng sinh đã làm cho vai trò của E. faecalis ngày càng quan trọng hơn. Fluoroquinolone là nhóm kháng sinh được sử dụng rộng rãi trong lâm sàng, đặc biệt là trên bệnh nhân nhiễm trùng đường tiết niệu mà E. faecalis là tác nhân vi khuẩn gram dương gây bệnh thường gặp. Sự tiêu thụ fluoroquinolone trong bệnh viện, trong chăn nuôi đã tạo ra áp lực chọn lọc cho sự đề kháng, theo thực phẩm và sinh vật trung gian, ví dụ như ruồi hoàn toàn có thể đươc lan truyền. 466 chủng E. faecalis từ các mẫu phân người, phân gà, ruồi và thực phẩm chợ được phân lập. Tỷ lệ kháng ciprofloxacin 19,5%, kháng levofloxacin 17,6%. Thử nghiệm tính nhạy cảm của các chủng kháng fluoroquinolone với các kháng sinh khác cho thấy tỷ lệ kháng cao với macrolide, phenicol, tetracylin (> 90%), kháng aminoglycosid mức độ cao (27,5% - 53,9%) và kháng linezolid (63,7%). Nhạy cảm tốt với penicillin và ampicillin. Gen liên quan sự đề kháng là gyrA (có mặt trong 14,4% chủng kháng ciprofloxacin, 18,5% chủng kháng levofloxacin), emeA, ermA, ermB, cat, fexA, tetM, tetL và tetK. 100% chủng kháng linezolid mang optrA, không tìm thấy poxtA. Các gen aac(6′)-Ie/aph(2′′)-Ia, aph(3′)-IIIa, ant(6’)-Ia xuất hiện trong các chủng kháng aminoglycosid mức độ cao. emeA, gen quy định cơ chế kháng bơm đẩy có mặt rộng rãi trên các chủng E. faecalis phân lập được nhưng không có mối liên hệ có ý nghĩa thống kê đối với mức độ kháng fluoroquinolone.