Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in context
Summary: Background: Antimicrobial resistance (AMR) is a silent pandemic causing 1.27 million deaths in 2019, disproportionately affecting low- and middle-income countries, but resistance among commensal microbiota and the determinants of carriage have not been widely reported. This cross-sectional...
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2025-01-01
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| Series: | The Lancet Regional Health. Western Pacific |
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| author | Max van Wijk Hoang Huy Tran Bich Ngoc Thi Vu Costanza Tacoli Tu Cam Thi Nguyen Quynh Dieu Pham Thương Hong Thi Nguyen Trang Thu Nguyen Hien Anh Thi Nguyen Tung Son Trinh Thai Duy Pham Huong Kieu Thi Tran Dung Tien Viet Vu Duc Anh Dang Tien Dac Tran Duong Thanh Nguyen H. Rogier van Doorn Thomas Kesteman Sonia Lewycka |
| author_facet | Max van Wijk Hoang Huy Tran Bich Ngoc Thi Vu Costanza Tacoli Tu Cam Thi Nguyen Quynh Dieu Pham Thương Hong Thi Nguyen Trang Thu Nguyen Hien Anh Thi Nguyen Tung Son Trinh Thai Duy Pham Huong Kieu Thi Tran Dung Tien Viet Vu Duc Anh Dang Tien Dac Tran Duong Thanh Nguyen H. Rogier van Doorn Thomas Kesteman Sonia Lewycka |
| author_sort | Max van Wijk |
| collection | DOAJ |
| description | Summary: Background: Antimicrobial resistance (AMR) is a silent pandemic causing 1.27 million deaths in 2019, disproportionately affecting low- and middle-income countries, but resistance among commensal microbiota and the determinants of carriage have not been widely reported. This cross-sectional household study aimed to determine the prevalence of carbapenem-resistant (CRE) and third-generation cephalosporin-resistant Enterobacterales (C3GRE) in a rural community in Ha Nam northern Vietnam, as well as the socio-demographic, behavioural, and environmental determinants of carriage. Methods: 1502 individuals across 324 households were surveyed between July 2018 and April 2019. Faecal samples were cultured on meropenem and ceftazidime supplemented media to identify CRE and C3GRE, respectively. Logistic regression models were used to explore risk factors for CRE and C3GRE carriage compared to susceptible strains. Findings: Colonisation with C3GRE and CRE was 94.0% (95% Confidence Interval (CI) 93.5%–94.4%) and 1.9% (1.6%–2.2%), respectively. The CRE prevalence was too low to explore determinants. Antibiotic use in the last month (adjusted OR 1.22 [95% CI 0.45–3.31]) and recent illness (aOR 1.48 [0.34–6.51]) were not associated with C3GRE carriage. Variables associated with C3GRE carriage were high-income (OR 0.29 [0.12–0.74]), worse sanitary conditions (aOR 4.35 [1.07–17.43]), and frequent beef consumption (aOR 6.56 [2.16–19.98]). A protective association between C3GRE carriage and animal husbandry was observed in children under 5-years (aOR 0.27 [0.09–0.84]). For participants 5-years and older, chicken consumption was associated with increased likelihood of C3GRE carriage (aOR 3.45 [1.45–8.22]), while a protective association was observed for regular tofu (aOR 0.32 [0.14–0.74]) and fermented food consumption (aOR 0.55 [0.31–0.96]). Interpretation: In this high-prevalence setting, colonisation with C3GRE was not associated with individual antibiotic use, while environmental exposures, including food and sanitary conditions, were associated with C3GRE colonisation. Further research is required to understand the mechanisms behind these associations. Funding: This work was supported by Oxford University Clinical Research Unit internal grants in Vietnam from the Wellcome Trust Africa Asia Programme core grants (2015-2022—106680/Z/14/Z, and 2022-2029—225167/Z/22/Z). |
| format | Article |
| id | doaj-art-95d207bbc7ac46d598486067644b0be7 |
| institution | Kabale University |
| issn | 2666-6065 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj-art-95d207bbc7ac46d598486067644b0be72025-01-14T04:12:38ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652025-01-0154101281Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in contextMax van Wijk0Hoang Huy Tran1Bich Ngoc Thi Vu2Costanza Tacoli3Tu Cam Thi Nguyen4Quynh Dieu Pham5Thương Hong Thi Nguyen6Trang Thu Nguyen7Hien Anh Thi Nguyen8Tung Son Trinh9Thai Duy Pham10Huong Kieu Thi Tran11Dung Tien Viet Vu12Duc Anh Dang13Tien Dac Tran14Duong Thanh Nguyen15H. Rogier van Doorn16Thomas Kesteman17Sonia Lewycka18Oxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, Vietnam; Faculty of Pharmacy – University of Tours, 31 Avenue Monge, 37200, Tours, FranceNational Institute of Hygiene and Epidemiology (NIHE), 1 Yec Xanh, Hanoi, Pham Dinh Ho, Hai Ba Trung, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, VietnamFaculty of Pharmacy – University of Tours, 31 Avenue Monge, 37200, Tours, FranceFaculty of Pharmacy – University of Tours, 31 Avenue Monge, 37200, Tours, FranceNational Institute of Hygiene and Epidemiology (NIHE), 1 Yec Xanh, Hanoi, Pham Dinh Ho, Hai Ba Trung, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, VietnamNational Institute of Hygiene and Epidemiology (NIHE), 1 Yec Xanh, Hanoi, Pham Dinh Ho, Hai Ba Trung, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, VietnamNational Institute of Hygiene and Epidemiology (NIHE), 1 Yec Xanh, Hanoi, Pham Dinh Ho, Hai Ba Trung, VietnamCentre for Disease Control, Ha Nam Province, Vietnam; Department of Health, Ha Nam Province, VietnamCentre for Disease Control, Ha Nam Province, VietnamOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, Vietnam; Centre of Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Roosevelt Dr, Headington, Oxford, OX3 7LG, United KingdomOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, Vietnam; Centre of Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Roosevelt Dr, Headington, Oxford, OX3 7LG, United KingdomOxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, Vietnam; Centre of Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Roosevelt Dr, Headington, Oxford, OX3 7LG, United Kingdom; Corresponding author. Oxford University Clinical Research Unit (OUCRU), National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da District, Hanoi, Viet Nam.Summary: Background: Antimicrobial resistance (AMR) is a silent pandemic causing 1.27 million deaths in 2019, disproportionately affecting low- and middle-income countries, but resistance among commensal microbiota and the determinants of carriage have not been widely reported. This cross-sectional household study aimed to determine the prevalence of carbapenem-resistant (CRE) and third-generation cephalosporin-resistant Enterobacterales (C3GRE) in a rural community in Ha Nam northern Vietnam, as well as the socio-demographic, behavioural, and environmental determinants of carriage. Methods: 1502 individuals across 324 households were surveyed between July 2018 and April 2019. Faecal samples were cultured on meropenem and ceftazidime supplemented media to identify CRE and C3GRE, respectively. Logistic regression models were used to explore risk factors for CRE and C3GRE carriage compared to susceptible strains. Findings: Colonisation with C3GRE and CRE was 94.0% (95% Confidence Interval (CI) 93.5%–94.4%) and 1.9% (1.6%–2.2%), respectively. The CRE prevalence was too low to explore determinants. Antibiotic use in the last month (adjusted OR 1.22 [95% CI 0.45–3.31]) and recent illness (aOR 1.48 [0.34–6.51]) were not associated with C3GRE carriage. Variables associated with C3GRE carriage were high-income (OR 0.29 [0.12–0.74]), worse sanitary conditions (aOR 4.35 [1.07–17.43]), and frequent beef consumption (aOR 6.56 [2.16–19.98]). A protective association between C3GRE carriage and animal husbandry was observed in children under 5-years (aOR 0.27 [0.09–0.84]). For participants 5-years and older, chicken consumption was associated with increased likelihood of C3GRE carriage (aOR 3.45 [1.45–8.22]), while a protective association was observed for regular tofu (aOR 0.32 [0.14–0.74]) and fermented food consumption (aOR 0.55 [0.31–0.96]). Interpretation: In this high-prevalence setting, colonisation with C3GRE was not associated with individual antibiotic use, while environmental exposures, including food and sanitary conditions, were associated with C3GRE colonisation. Further research is required to understand the mechanisms behind these associations. Funding: This work was supported by Oxford University Clinical Research Unit internal grants in Vietnam from the Wellcome Trust Africa Asia Programme core grants (2015-2022—106680/Z/14/Z, and 2022-2029—225167/Z/22/Z).http://www.sciencedirect.com/science/article/pii/S266660652400275XAntibioticResistanceThird-generation cephalosporinCarbapenemEnterobacteralesCommensal |
| spellingShingle | Max van Wijk Hoang Huy Tran Bich Ngoc Thi Vu Costanza Tacoli Tu Cam Thi Nguyen Quynh Dieu Pham Thương Hong Thi Nguyen Trang Thu Nguyen Hien Anh Thi Nguyen Tung Son Trinh Thai Duy Pham Huong Kieu Thi Tran Dung Tien Viet Vu Duc Anh Dang Tien Dac Tran Duong Thanh Nguyen H. Rogier van Doorn Thomas Kesteman Sonia Lewycka Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in context The Lancet Regional Health. Western Pacific Antibiotic Resistance Third-generation cephalosporin Carbapenem Enterobacterales Commensal |
| title | Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in context |
| title_full | Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in context |
| title_fullStr | Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in context |
| title_full_unstemmed | Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in context |
| title_short | Prevalence and determinants of faecal carriage of carbapenem- and third-generation cephalosporin-resistant Enterobacterales: a cross-sectional household survey in northern VietnamResearch in context |
| title_sort | prevalence and determinants of faecal carriage of carbapenem and third generation cephalosporin resistant enterobacterales a cross sectional household survey in northern vietnamresearch in context |
| topic | Antibiotic Resistance Third-generation cephalosporin Carbapenem Enterobacterales Commensal |
| url | http://www.sciencedirect.com/science/article/pii/S266660652400275X |
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