Prevalence and risk factors for carbapenem-resistant Enterobacterales colonization in hospitalized children in a provincial hospital in Vietnam.
| Title: | Prevalence and risk factors for carbapenem-resistant Enterobacterales colonization in hospitalized children in a provincial hospital in Vietnam. |
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| Authors: | Dinh VAT; Department of Infection Control, Vietnam National Children's Hospital, Hanoi, Vietnam.; Trang NNT; The Training and Research Institute of Child Health, Hanoi, Vietnam.; Hanoi University of Public Health, Hanoi, Vietnam.; Vo ND; The Training and Research Institute of Child Health, Hanoi, Vietnam.; Bich NHT; Department of Microbiology, Vietnam National Children's Hospital, Hanoi, Vietnam.; Tran DM; Vietnam National Children's Hospital, Hanoi, Vietnam.; University of Medicine and Pharmacy - Vietnam National University, Hanoi, Vietnam.; Phuc PD; Hanoi University of Public Health, Hanoi, Vietnam.; Duc SL; Thai Binh Paediatric Hospital, Hưng Yên, Vietnam.; Dung DM; Thai Binh Paediatric Hospital, Hưng Yên, Vietnam.; Goutard F; The French Agricultural Research Centre for International Development (CIRAD), Montpellier, France.; Velavan TP; Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam.; Faculty of Medicine, Duy Tan University, Da Nang, Vietnam.; Nurjadi D; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam.; Institute of Medical Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.; Hounmanou YMG; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Jörgensen B; Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.; Training and Research Academic Collaboration (TRAC) - Sweden - Vietnam, Hanoi, Sweden.; School of Global Studies, University of Gothenburg, Gothenburg, Sweden.; Song LH; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam.; 108 Military Central Hospital, Hanoi, Vietnam.; My TN; University of Medicine and Pharmacy - Vietnam National University, Hanoi, Vietnam.; Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam.; 108 Military Central Hospital, Hanoi, Vietnam.; Loire E; The French Agricultural Research Centre for International Development (CIRAD), Montpellier, France.; Östholm Å; Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.; Nilsson LE; Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.; Phan PH; The Training and Research Institute of Child Health, Hanoi, Vietnam.; Vietnam National Children's Hospital, Hanoi, Vietnam.; Dalsgaard A; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; International Centre For Antimicrobial Resistance Solutions, Copenhagen, Denmark.; Larsson M; Training and Research Academic Collaboration (TRAC) - Sweden - Vietnam, Hanoi, Sweden.; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.; Olson L; Training and Research Academic Collaboration (TRAC) - Sweden - Vietnam, Hanoi, Sweden.; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.; Hanberger H; Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.; Training and Research Academic Collaboration (TRAC) - Sweden - Vietnam, Hanoi, Sweden. |
| Corporate Authors: | I-CRECT Consortium |
| Source: | Frontiers in cellular and infection microbiology [Front Cell Infect Microbiol] 2026 Feb 20; Vol. 16, pp. 1770367. Date of Electronic Publication: 2026 Feb 20 (Print Publication: 2026). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101585359 Publication Model: eCollection Cited Medium: Internet ISSN: 2235-2988 (Electronic) Linking ISSN: 22352988 NLM ISO Abbreviation: Front Cell Infect Microbiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Lausanne : Frontiers Media SA |
| MeSH Terms: | Enterobacteriaceae Infections*/epidemiology ; Enterobacteriaceae Infections*/microbiology ; Carbapenem-Resistant Enterobacteriaceae*/isolation & purification ; Carbapenem-Resistant Enterobacteriaceae*/drug effects ; Cross Infection*/epidemiology ; Cross Infection*/microbiology ; Carbapenems*/pharmacology; Vietnam/epidemiology ; Anti-Bacterial Agents/pharmacology ; Rectum/microbiology ; Humans ; Male ; Female ; Prevalence ; Risk Factors ; Child ; Child, Preschool ; Infant ; Microbial Sensitivity Tests ; Adolescent ; Hospitalization ; Infant, Newborn ; Child, Hospitalized ; Hospitals, Pediatric |
| Abstract: | Background and Aims: Carbapenem-resistant Enterobacterales (CRE) colonization is an important prerequisite to hospital-acquired infections (HAIs) caused by CRE and increased mortality. This study assessed the prevalence of, and risk factors for, CRE colonization among children admitted to a provincial pediatric hospital in a high-antimicrobial-resistance setting in Vietnam.; Methods: A point prevalence survey was conducted on 15 August 2022 at a provincial pediatric hospital in the Red River Delta. Rectal swabs were collected from 376 hospitalized children after informed consent. Samples were inoculated on chromogenic selective agar for CRE detection, and bacterial identification and antimicrobial susceptibility testing were performed using the VITEK® 2 system. Clinical and demographic data were obtained from structured questionnaires and medical records. Logistic regression analyses were used to identify risk factors associated with CRE colonization.; Results: CRE colonization was detected in 28.2% of hospitalized children. Colonization was more common among patients screened >48 hours after admission (30.8%) and hospitalization >48 hours was associated with a 2.27-fold increased risk of colonization (p = 0.026) compared with screening earlier. Prevalence increased with length of stay, reaching 40.8% among those hospitalized ≥7 days. Children ≤6 years had a colonization rate of 29.7%. The highest ward-level prevalence occurred in the Intensive Care Unit (77.8%), whereas the lowest rates were observed in trauma and nutrition wards (9.5%). Escherichia coli (40.6%), Klebsiella pneumoniae (34.4%), and Enterobacter cloacae (16.4%) were the predominant CRE species. Most isolates were resistant to 4-10 antimicrobial classes. CRE colonization was also significantly associated with sepsis at the time of assessment.; Conclusions: CRE colonization was highly prevalent among pediatric inpatients in this provincial Vietnamese hospital, particularly among young children, those hospitalized for prolonged periods, and patients in intensive care or neonatal units. These findings underscore the urgent need to strengthen infection prevention and control (IPC) strategies and to implement targeted screening approaches to assess the effect on CRE transmission of improvement of IPC.; (Copyright © 2026 Dinh, Trang, Vo, Bich, Tran, Phuc, Duc, Dung, Goutard, Velavan, Nurjadi, Hounmanou, Jörgensen, Song, My, Loire, Östholm, Nilsson, Phan, Dalsgaard, Larsson, I-CRECT Consortium, Olson and Hanberger.) |
| Competing Interests: | The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors DN, LO declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. |
| Contributed Indexing: | Investigator: H Hanberger; B Jörgensen; Å Östholm; LE Nilsson; M Larsson; L Olson; TP Velavan; SH Le; A Purgreth; MT Pham; F Goutard; E Loire; YMG Hounmanou; A Dalsgaard; PD Pham; HT Tran; NTT Nguyen; DM Tran; PH Phan; NT Hoang; VA Thi Dinh; NK Le; Keywords: CRE colonization; Carbapenem-Resistant Enterobacterales; Vietnam; hospital acquired infection; pediatric hospital; point prevalence survey |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents); 0 (Carbapenems) |
| Entry Date(s): | Date Created: 20260309 Date Completed: 20260309 Latest Revision: 20260309 |
| Update Code: | 20260309 |
| PubMed Central ID: | PMC12963313 |
| DOI: | 10.3389/fcimb.2026.1770367 |
| PMID: | 41798757 |
| Database: | MEDLINE |
Journal Article