Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 18 1 2026 02 14 32 40 Do Phong Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam Vu Vinh Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam Dang Van Department of Infection Control, E Hospital, Hanoi, Vietnam Tran Hieu Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam Tran Huong Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam Le Thuong Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam Le Duc Department of Intensive Care Unit, E Hospital, Hanoi, Vietnam Nguyen Huong Medical Check-up Clinic, E Hospital, Hanoi, Vietnam 2025 10 15 2025 12 18 Background and Objectives: This study aimed to describe the burden, pathogen distribution, antimicrobial resistance patterns, and selected clinical outcomes of intensive care unit (ICU)-acquired Gram-negative bacteria (GNB) infections in Vietnam, with exploratory comparative analyses of outcomes. Materials and Methods: A retrospective descriptive study with comparative analyses was conducted among 102 adult patients with culture-confirmed ICU-acquired GNB infections at E Hospital, Hanoi. Demographic, clinical, microbiological, and outcome data were extracted from medical records. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute guidelines. Comparisons between outcome groups were assessed using chi-square test, with effect sizes quantified using Cramer’s V. Results: Pneumonia was the predominant infection (70.5%), followed by urinary tract (15.2%) and bloodstream infections (10.6%). GNB accounted for 68.3% of all hospital-acquired infections (HAIs), with Acinetobacter baumannii (43.4%), Pseudomonas aeruginosa (24.8%), and Klebsiella pneumoniae (13.9%) being the most frequent pathogens. The predominant pathogens exhibited extensive resistance to β-lactams, cephalosporins, and carbapenems. Susceptibility was largely retained only to colistin, tigecycline, and amikacin. Mechanical ventilation was significantly associated with death or a severe clinical outcome (p = 0.03; Cramer’s V = 0.21). Conclusion: GNB dominate ICU-acquired infections in Vietnam and demonstrate alarming antimicrobial resistance, underscoring the urgent need for strengthened infection control and antimicrobial stewardship. https://ijm.tums.ac.ir/index.php/ijm/article/view/5861 https://ijm.tums.ac.ir/index.php/ijm/article/download/5861/1859