This document discusses antimicrobial resistance data from humans and animals in Vietnam. It provides data on resistance levels of various bacteria like Campylobacter, E. coli, and Salmonella found in pigs, poultry, and humans. The data indicates high levels of resistance to commonly used antibiotics. The document also discusses antimicrobial use on farms and in communities in Vietnam. It suggests interventions like improving rational antibiotic use, controlling community antibiotic use, and using diagnostics to guide treatment in animals instead of blanket use.

1. Is there a problem with
antimicrobial resistance in humans
& animals?

2. Problems with antimicrobial
resistance data
1 3
2
Clinician/Vet Microbiologist
Pharmacist

4. % Antimicrobial resistance in Camp.jejuni in pigs & poultry in
%resistance in Campylobacter coli in pigs & poultry from Dong Thap
Dong Thap Provence Feb 2012 (N =98)
Province 2012 (N = 78)
100
100
80 80
60 60
40
40
20
0 20
AMP AMC CRO CAZ Cl NA CIP OFX CN SXT DA ERY ESBL+ 0
antibiotic AMP CRO CL CIP CN DA ESBL+
% antimicrobial resistance in % antimicrobial resistance in
Campylobacter jejuni children <5 years in HCMC
Campylobacter coli children <5 years in HCM 2009-
2009-2010 (N=69)
100
2010 (N=91) 100
90
80
80 70
60
60 50
40
40 30
20
20 10
0
0
AMP AMC CRO CAZ Cl NA CIP OFX CN SXT DA E ESBL
E
NA
Cl
CN
P
DA
T
P
C
Z
X
O
CI
SX
CA
AM
OF
AM
s
CR
po
pos
BL
ES

5. % resistance in E.coli from diseased pigs Dong Thap
& Tien Giang 2005 (N = 50)
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
OFX CIP CRO CAZ AMC C CN SXT AMP
% resistance in E.coli from children with diarrheoa
(N= 204) 2011-2012 HMC
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
OFX CIP CRO CAZ AMC C CN SXT AMP

6. % resistance in E.coli March – December 2012
Amoxicilin AMC
Ceftazidine CAZ
Ceftriaxone CRO
Cloramphenicol C
Meropenem MEM
Tetracyclin TE
Trimethoprim-
sulfamethoxazole SXT
Amikacin AK
Gentamycine CN
Ciprofloxacin 5 CIP5
Ampicillin AMP
Chicken and Human data: from VIBRE
study in Tien Giang
5 Colonies / individual sample

7. Comparison antimicrobial resistance non-typhoid Salmonella
spp. from humans and animals in southern March – December
2012
human diarroheoa N = 79
70
human asymptomatic N = 92
60
animal N = 743
50
40
%
30
20
10
0
AMP AUG CRO CAZ C CIP CN OFX SXT
antibiotic

8. % antimicrobial resistance in E.coli & Salm spp from market
rats in Dong Thap Province Jan 2013 (E.coli N=532:
Salm.spp N=37)
E.coli
26 Salm.spp
24
22
20
18
16
14
%
12
10
8
6
4
2
0
AMC CAZ CRO C MEM TE SXT AK CN CIP5 AMP ESBL
% Antimicrobial resistance in S.suis in rats (S.suis N=6)
70
60
50
40
30
20
10
0
CM RD LE IMP OX ERY P TE FEP SXT VA CRO

9. Antimicrobial use in Viet Nam
Use at a farm level
Use in the community
Details of use of antimicrobials in humans within
the hospital setting
Use in veterinary situations through The Animal
Health Departments

10. Normal pig feed!
Chlotetracyline
50 mg/kg

11. Number (percentage) of chicken farms where
antimicrobials were present in the medicine cabinet
No. medium
Antimicrobial farms No. small farms Total No. of farms
groups ( N=34 ) ( N=30 ) ( N=64 )
Macrolides 13 ( 38% ) 4 (13% ) 17 ( 27% )
Penicillins 10 (29% ) 8 (27% ) 18 (28% )
Phenicols 6 ( 18% ) 1 ( 3% ) 7 ( 11% )
Quinolones 12 ( 35% ) 9 (30% ) 21 ( 33% )
Tetracyclines 13 ( 38% ) 13 (43% ) 13 (38% )
Aminoglycosids 2 ( 6% ) 4 ( 13% ) 6 ( 9% )
Sulfonamides 3 ( 9% ) none 3 ( 5% )
Polypeptides 8 ( 24% ) 11 (37% ) 19 (30% )
Lincosamides 2 ( 6% ) none 2 ( 3% )

12. Number (percentage) of households where antimicrobials were
present in the family medicine cabinet
No. of farm No. of rural No. of urban Total No. of
Antimicrobial households households households households
groups (N=24 ) (N=24 ) (N=15 ) ( N=63 )
Aminopenicillis 7 ( 29% ) 5 (21% ) 3 ( 20% ) 15 ( 24% )
Cephlasporins 10 (42% ) 20 (83% ) 6 (40% ) 36 (57% )
Lincosamides 1 ( 4% ) none 1 ( 7% ) 2 (3% )
Macrolides 5 ( 21% ) 6 ( 25% ) 4 (27% ) 15 ( 24% )
Quinolones 1 ( 4% ) 2 ( 8% ) 1 ( 7% ) 4 ( 6% )
Sulfonamides none none 1 ( 7% ) 1 ( 2% )
Tetracyclines none 1 ( 4% ) 1 ( 7% ) 2 ( 3% )

13. Interventions
Rational use of antimicrobial in hospitals
Control of antimicrobials in community
Diagnostics in veterinary medicine in Viet Nam as
opposed to blanket antimicrobial use
Changing farm practices with a view to reducing
antimicrobial resistance

15. Acknowledgements
The Microbiology Dept., • OUCRU:
HTD: Bs.Lan • Prof. J. J. Farrar
• N. V. M. Hoang
• T. T. T. Nga
Animal Health Depts. • C. T. Thuy
Tien Giang Province • P. V. Minh
• V. O. P. Linh
L. M. Khanh
• N. T. Son Chau
Dong Nai Province • OUCRU Zoonosis Group:
T. V. Quang • N. T. Hoa
Dong Thap Province • J. J. Carrique-Mas
• VIBRE:
N. B. Hien • N. V. Truong
LL
W E CO
Wellcome Trust
ME
THE
TR
UST

16. Xin Cam On !