ObjectivesACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network) integrates antimicrobial resistance (AMR) surveillance with clinical data in hospitals across low- and middle-income countries. We describe ACORN2 data from Viet Nam and compare findings with existing national surveillance data.MethodsHospitalised patients receiving intravenous antibiotics were enrolled from selected wards in three national hospitals. Infections were classified as community-acquired (CAI), healthcare-associated (HCAI), or hospital-acquired (HAI). Microbiological data were deduplicated to the first isolate per species per infection episode. Pathogen distribution and resistance patterns were analysed by hospital, infection origin, and sample type.ResultsAmong 5,449 infection episodes, 2,817 were CAI, 1,615 HCAI, and 1,017 HAI. Escherichia coli and Staphylococcus aureus predominated in sterile samples, while Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae were most frequent in non-sterile samples. A. baumannii and P. aeruginosa were common in HCAI and HAI. Resistance to third-generation cephalosporins and carbapenems was markedly higher in HCAI and HAI than CAI, with widespread carbapenem resistance in A. baumannii. Overall AMR levels exceeded those reported in previous national surveillance data.ConclusionACORN2 demonstrates a high burden of AMR in Viet Nam, particularly in healthcare- and hospital-acquired infections, underscoring the value of clinically oriented surveillance to inform treatment and stewardship policies.