Van Kim Nguyen, Thang Tran Dang, Long Cao Thang, Ivanovitch Katiya, Baker Stephen, Noisumdaeng Pirom
Faculty of Public Health, Thammasat University, Pathum Thani, Thailand.
Hung Vuong Hospital, Ho Chi Minh City, Vietnam.
Int J Microbiol. 2025 Sep 19;2025:3147068. doi: 10.1155/ijm/3147068. eCollection 2025.
Carbapenems are critical for treating patients infected with multidrug-resistant bacteria; however, the use of carbapenems has also facilitated the selection and spreading of carbapenem-resistant organisms (CROs), occasionally reported in healthcare settings. The study examined the CRO prevalence among healthcare workers (HCWs), orphan children patients, and the environment in an orphanage healthcare facility in Vietnam. A cross-sectional study was performed by collecting rectal swabs in 20 HCWs and 67 orphan patients, as well as in 175 randomly selected environmental samples. Chromogenic CARBA agars, blood agars, and a BD Phoenix Automated Microbiology System were employed for bacterial isolation and for identification and testing of antimicrobial susceptibility. In a total of 262 samples, 36 CROs (i.e., six carbapenem-resistant Enterobacterales [CRE] and 30 non-CRE) were detected. The CRO prevalence of 30.0% (6/20), 16.4% (11/67), and 10.86% (19/175) was shown in HCWs, orphan patients, and the environment, respectively. Most CROs detected in HCWs were CREs (66.7%, 4/6). Non-CRE cases, mainly , were detected in orphan patients and in the orphanage healthcare environment. Out of 36 CRO isolates, 97.2% (35/36), 11.1% (4/36), and 13.9% (5/36) were identified as resistant to ertapenem, imipenem, and meropenem, respectively. This study was the first to show evidence-based CRO colonization with an epidemiological study in an orphanage healthcare facility in Vietnam. The finding of this study suggested that control and prevention programs, active surveillance, and routine monitoring for CROs should be implemented in healthcare establishments.
碳青霉烯类药物对于治疗多重耐药菌感染患者至关重要;然而,碳青霉烯类药物的使用也促使了耐碳青霉烯类微生物(CROs)的产生和传播,医疗机构中偶尔会报告此类情况。该研究调查了越南一家孤儿院医疗机构中医护人员(HCWs)、孤儿患者以及环境中的CROs流行情况。通过收集20名医护人员、67名孤儿患者的直肠拭子以及175份随机选取的环境样本进行了一项横断面研究。使用显色CARBA琼脂、血琼脂以及BD Phoenix自动微生物系统进行细菌分离以及抗菌药敏鉴定和测试。在总共262份样本中,检测到36株CROs(即6株耐碳青霉烯类肠杆菌科细菌[CRE]和30株非CRE)。医护人员、孤儿患者和环境中的CROs流行率分别为30.0%(6/20)、16.4%(11/67)和10.86%(19/175)。在医护人员中检测到的大多数CROs为CREs(66.7%,4/6)。非CRE病例主要在孤儿患者和孤儿院医疗环境中检测到。在36株CRO分离株中,分别有97.2%(35/36)、11.1%(4/36)和13.9%(5/36)被鉴定为对厄他培南、亚胺培南和美罗培南耐药。这项研究首次在越南一家孤儿院医疗机构中通过流行病学研究展示了基于证据的CRO定植情况。该研究结果表明,医疗机构应实施针对CROs的控制和预防计划、主动监测以及常规监测。