Detection and Antimicrobial Susceptibility of Carbapenem-Resistant Organisms Isolated in the Center of Care and Protection of Orphan Children, Vietnam.

Abstract

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 Acinetobacter baumannii, 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.