Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-04-30T15:04:51.430Z Has data issue: false hasContentIssue false

SG-APSIC1080: Surveillance and control efforts for carbapenemase-producing gram-negative bacteria at a high-burden tertiary-care healthcare facility in Ho Chi Minh City, Vietnam

Published online by Cambridge University Press:  16 March 2023

Tuan Huynh
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Lan Pham
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Loan Luong
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Tuan Le
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Khanh Lě
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Duyen Bui
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Truc Ta
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Thoa Trinh
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Yen Nguyen
Affiliation:
University Medical Center, Ho Chi Minh City, Vietnam
Diep Bui
Affiliation:
University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
Nga Vo
Affiliation:
University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
Nga Nguyen
Affiliation:
PATH, Hanoi, Vietnam
Bao Nguyen
Affiliation:
University Medical Center and University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
Binh Truong
Affiliation:
University Medical Center and University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Objectives: In Vietnam, although surveillance and control of multidrug-resistant organisms is a national priority, information on the burden of these pathogens remains scarce. At the University Medical Center in Ho Chi Minh City, we assessed the proportion of carbapanemase-producing carbapenem-resistant organisms (CP-CRO) and evaluated an intervention package to prevent transmission of carbapenemase-producing carbapenem-resistant Enterobacterieacea (CP-CRE) in the intensive care unit (ICU). Methods: All gram-negative isolates collected between November 2018 to April 2019 were tested for carbapenem resistance using the disc-diffusion method. Carbapenem-resistant bacteria, defined as meropenem resistant, were tested for phenotypic carbapenemase-production using the Becton Dickinson Phoenix CPO Detect assay. An intervention package, including placement of patients in cohorts, enhanced barrier precautions, enhanced discharge environmental cleaning, and CP-CRE rectal screening, was implemented from July 2019 through December 2020. During this period, all ICU patients were screened on admission, and negative patients were rescreened every 2 days or 7 days until discharge, death, or CRE-positive result. Admission prevalence and incidence of CP-CRE transmission was calculated among CP-CRE infected or colonized patients. Results: Among 599 gram-negative isolates collected, 108 were carbapenem-resistant isolates, of which 107 (99%) were CP-CRO by the phenotypic method. Most CP-CRO were Acinetobacter baumannii (42%) and Klebsiella pneumoniae (36%). Of 1,206 patients, 433 (35.9%) were already colonized or infected with CP-CRE before admission to the ICU. The incidence rate (cases per 100 risk days) of CP-CRE colonization or infection during ICU treatment decreased from 11.5 before the intervention to 2.9 after the implementation of the intervention package. The average number of days to change from a negative to positive screening result in the intervention phase was 7.4, compared with 4.9 days during preintervention phase. Conclusions: Nearly all CROs isolated from our ICU are carbapenemase-producing CROs, with high presence on admission as well as new acquisition during an ICU stay. An intervention package containing enhanced infection control measures was effective in reducing CP-CRE transmission.

Type
Multidrug-Resistant (MDR) Organisms
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America