High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease

Tran, Dien Minh; Larsson, Mattias; Olson, Linus; Hoang, Ngoc Thi Bich; Le, Ngai Kien; Khu, Dung T.K.; Nguyen, Hung D.; Vu, Tam Van; Trinh, Tinh H; Le, Thinh Quoc; Phan, Phuong Thi Thanh; Nguyen, Binh G.; Pham, Nhung Hong Thi; Bang, Hong Rong; Nguyen, Tuan Van; Nguyen, Phuong Lan Tran; Le, Nhan Duc; Huynh, Tuan; Thư, Le Thi Anh; Thanh, Tran Chi; Berglund, Björn; Nilsson, Lennart; Bornefall, Elin; Song, Lê Hữu; Hanberger, Håkan

doi:10.1016/j.jinf.2019.05.013

Cited by 67 publications

(49 citation statements)

References 33 publications

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“…A previous study from our hospital has reported a prevalence of 14.3% of VRE carriage among hospitalized patients, identified invasive devices and duration of antimicrobial treatment as risk factors, and found that VRE carriage was not an independent predictor of mortality (12). Similar studies from other regions have reported VRE carriage rates ranging from 2 to 37% (13-15), while prevalence rates for CRGN rectal carriage ranged from 5.3 to 52% (16)(17)(18). At the same time, there is an increased risk of carbapenem-resistant enterobacteriaceae (CRE) infection and mortality in patients who test positive for carriage of CRE (19,20).…”

Section: Introductionsupporting

confidence: 57%

Gastrointestinal Carriage of Vancomycin-Resistant Enterococci and Carbapenem-Resistant Gram-Negative Bacteria in an Endemic Setting: Prevalence, Risk Factors, and Outcomes

Vasilakopoulou

Karakosta

Vourli

et al. 2020

Front. Public Health

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Background: Gastrointestinal carriage of vancomycin-resistant enterococci (VRE) and carbapenem-resistant Gram-negative bacteria (CRGN) constitutes a major public health concern as it may be followed by clinical infection development or lead to intra-hospital dissemination. Detection of carriers and implementation of infection control measures are essential in every hospital. In this study we determined the point prevalence of VRE and CRGN in the fecal flora of the inpatients of a tertiary university hospital in Greece. We determined risk factors for carriage and examined the impact of carriage on hospital outcomes. Materials/Methods: A point prevalence study of VRE/CRGN rectal carriage of inpatients was conducted on March 2018. Specimens were selectively cultured for VRE/CRGN, microorganisms were biochemically identified, submitted to antibiotic susceptibility testing, and tested for carbapenemase production. Data on potential risk factors and hospital outcomes were collected at the time of culture and until hospital discharge. Multivariable logistic and linear regression models were used, adjusting for confounders.Results: Four hundred ninety-one patients were enrolled in the study. Of them, 64 (13.0%) were positive for VRE carriage, 40 (8.2%) for CRGN, and 10 patients (2.1%) for both VRE and CRGN. VRE carriage was independently associated with age over 65 years (adjusted OR: 2.4 [95%CI: 1.3, 4.5]) and length of stay (LOS) before rectal sampling (OR: 1.1 [95%CI: 1.0, 1.1]). Carriage of CRGN was associated with 11 days increase of LOS after rectal sampling (β-coef: 11.4 [95%CI: 1.6, 21.2]), with a 3.5-fold increased risk of acquiring a resistant pathogen after rectal swabbing (RR: 3.5 [95%CI 1.2, 9.9]) and with a 6-fold increased risk of mortality (RR: 6.1 [95%CI: 2.1, 17.9]), after adjusting for sex, age, and comorbidity index. Vasilakopoulou et al. Gastrointestinal Carriage: Prevalence, Risk-Factors, Outcomes Conclusions: High prevalence rates were found for VRE and CRGN carriage among the inpatients of our hospital. Prolonged hospitalization and age were independent risk factors for VRE carriage, while CRGN carriage was associated with increased risk of acquiring a resistant pathogen, prolonged hospital stay, and increased mortality.

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Section: Introductionsupporting

confidence: 57%

Gastrointestinal Carriage of Vancomycin-Resistant Enterococci and Carbapenem-Resistant Gram-Negative Bacteria in an Endemic Setting: Prevalence, Risk Factors, and Outcomes

Vasilakopoulou

Karakosta

Vourli

et al. 2020

Front. Public Health

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“…Indeed, the acquirement of CRE infections is highly related to certain risk factors, such as: being transferred between hospitals or from long-term care centers; a long stay in the hospital, especially in an intensive care unit; having a surgical operation; transplantation; antibiotics usage; central venous catheter presence; having diabetes mellitus [ 35 , 36 ]. In this study, the majority of CRE isolates were from patients in the in the neonatal unit (40.3%), followed by the plastic surgical unit (14.1%), urology-gy-nephrology unit (11.1%), pediatric reanimation unit (13%), medical-surgical resuscitations (11.1%) and finally the medicine unit (10.1%).…”

Section: Discussionmentioning

confidence: 99%

Dissemination of Carbapenemases (OXA-48, NDM and VIM) Producing Enterobacteriaceae Isolated from the Mohamed VI University Hospital in Marrakech, Morocco

et al. 2021

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The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) represent a major clinical problem and raise serious health concerns. The present study aimed to investigate and ascertain the occurrence of CRE among hospitalized patients of Mohamed VI University Hospital, Marrakech, Morocco. Biological samples were collected over a one-year period (2018). The bacterial isolates were identified by MALDI-TOF-MS. Antibiotic susceptibility testing was performed using disc diffusion and Etest. The modified Hodge test and combined disc diffusion test were used for phenotypic detection. CRE hydrolyzing enzyme encoding genes: blaOXA-48, blaKPC, blaIMP, blaVIM, and blaNDM were characterized by PCR and DNA sequencing. In total, 131 non-duplicate CRE clinical strains resistant to Ertapenem were isolated out of 1603 initial Enterobacteriaceae. Klebsiella pneumoniae was the most common species (59%), followed by Enterobacter cloacae (24%), E. coli (10%), Citrobacter freundii (3%), Klebsiellaoxycota (2%), Serratia marcescens (1%), and Citrobacter braakii (1%). Of these, 56.49%, 21.37%, 15.27%, 3.38%, and 3.05% were collected from blood, urine, pus, catheters and respiratory samples, respectively. Approximately 85.5% (112/131) of the isolates were carbapenemase producers (40 blaOXA-48, 27 blaNDM, 38 blaOXA-48 + blaNDM and 7 blaVIM). All metallo-β-lactamases isolates were NDM-1 and VIM-1 producers. This is the first documentation of blaOXA-48 genes from C. freundii and C. braakii in Morocco.

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“…The mcr-1 gene can be transmitted through the plasmid to colistin-sensitive strains. [33][34][35][36] Another concern is the emergence of colistin resistance during therapy among KPCproducing strains of P. aeruginosa in Switzerland, 37 USA, 38 and Australia. 8 As the main benefit of this study was to develop an HRMA assay to detect low levels KPC-producing, ESBL producing simultaneously, and CRPA strains, we next selected the KPC/IMP/mprA primer set1 and TEM/ SHV/mcr-1 primers set2 combination for a multiplex assay assessment.…”

Section: Dovepressmentioning

confidence: 99%

<p>Prevalence and Molecular Typing of Colistin-Resistant <em>Pseudomonas aeruginosa</em> (CRPA) Among β-Lactamase-Producing Isolates: A Study Based on High-Resolution Melting Curve Analysis Method</p>

Tahmasebi¹,

Dehbashi²,

Arabestani³

2020

IDR

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Background: The frequency and production of β-lactamase enzymes may be different in colistin-resistant Pseudomonas aeruginosa (CRPA) strains compared to susceptible strains. The purpose of this study was to investigate the relationship between colistin resistance and β-lactamase enzymes in different Sequence Types (ST) of P. aeruginosa. Methods: A total of 101 P. aeruginosa isolates were collected from different samples. The antimicrobial susceptibilities of the bacterial isolates were examined by disk diffusion and MIC E-test methods. Also, real-time PCR and high-resolution melting curve analysis (HRMA) assay were performed to detect the resistance genes. Results: Out of the 101 P. aeruginosa isolates, four isolates (3.96%) were resistant to colistin. Also, 39 isolates (38.61%) were considered as MDR, and eight isolates (7.92%) were considered as XDR. Further, 25 (24.75%) and 26 isolates (25.74%) were produced ESBL and carbapenemase enzymes, respectively. According to HRMA results, four isolates (3.96%) were positive for pmrA, three isolates (2.97%) were positive for mcr-1, 25 isolates (24.75%) were positive for blaTEM, 24 isolates (23.76%) were positive for blaSHV, 26 isolates (25.75%) were positive for blaKPC, and 23 isolates (22.77%) were positive for blaIMP genes. Furthermore, ST108 and ST250 showed the highest distribution in P. aeruginosa isolates. Also, ST217, ST1078, and ST3340 were reported as novel types in CRPA strains. Conclusion: Concerns about the prevalence of CRPA strains should be taken seriously. Also, our results showed that the mcr-1 gene plays a vital role in the distribution of ESBL and KPC-producing P. aeruginosa strains.

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High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease

Abstract: http://creativecommons.org/licenses/by-nc-nd/4.0/ ) 116 D.M. Tran, M. Larsson and L. Olson et al. / Journal of Infection 79 (2019) 115-122 Conclusion: These data indicate that there is an epidemic spread of CRE in Vietnamese hospitals with rapid transmission to hospitalised patients.

Cited by 67 publications

References 33 publications

Gastrointestinal Carriage of Vancomycin-Resistant Enterococci and Carbapenem-Resistant Gram-Negative Bacteria in an Endemic Setting: Prevalence, Risk Factors, and Outcomes

Gastrointestinal Carriage of Vancomycin-Resistant Enterococci and Carbapenem-Resistant Gram-Negative Bacteria in an Endemic Setting: Prevalence, Risk Factors, and Outcomes

Dissemination of Carbapenemases (OXA-48, NDM and VIM) Producing Enterobacteriaceae Isolated from the Mohamed VI University Hospital in Marrakech, Morocco

<p>Prevalence and Molecular Typing of Colistin-Resistant <em>Pseudomonas aeruginosa</em> (CRPA) Among β-Lactamase-Producing Isolates: A Study Based on High-Resolution Melting Curve Analysis Method</p>

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