Ph.D.
Vu Thi Ngoc Bich
Oxford University Clinical Research Unit – Ha Noi
Title: Molecular epidemiology of carbapenem-resistant Escherichia coli from hospitalized patients of two provinces in the North and the South of Vietnam
Name(s): Vu Thi Ngoc Anh1, Lam Thi Ngoc Kim3, Le Quang Tho4, Pham Thi Ngoc Thu3, Phan Vu Thu Ha4, Nguyen Thi Kha Tu5, Nguyen Quoc Phuong2, Nguyen Hai Yen1, Nguyen Thi Hong Ngoc1, Lam Hong Bao Ngoc1, Le Quynh Trang1,5, Le Na8, Trieu Quoc Thuong8, To Duc Linh8, Nguyen Manh Ha8, Chau Minh Duc7, Vo Thi Hoang Dung Em7, Phan Van Be Bay7, Nguyen Thi Cam Tu7, Nguyen Kim The7, Vu Tien Viet Dung1, Tran Van Giang2, 9, Pham Ngoc Thach2, H Rogier van Doorn1,5, Vu Thi Lan Huong1 , Vu Thi Ngoc Bich1
On behalf of the ASPARNet (Evaluating Antimicrobial Stewardship strategies and capacity building through Participatory Action Research and a Network approach in Vietnam) Study Group.
1 Oxford University Clinical Research Unit – Ha Noi, Vietnam;
2 National Hospital for Tropical Diseases – Ha Noi, Vietnam;
3 Dong Thap Department of Health, Dong Thap, Vietnam;
4 Phu Tho Department of Health, Phu Tho, Vietnam;
5 Nuffield Department, Oxford University, United Kingdom;
7 Dong Thap General Hospital, Dong Thap, Vietnam;
8 Phu Tho Provincal Hospital, Phu Tho, Vietnam;
9 Hanoi Medical University, Ha Noi, Vietnam
Carbapenem-resistant Enterobacterales (CRE) are an emerging cause of healthcare-associated infections. They are difficult to treat and pose significant threats to patient safety. Carbapenem-resistant Escherichia coli (CREC) is of particular concern given its role as a gut commensal and its potential to cause subsequent infections.
Here, as part of the ASPARNet project, we isolated CREC from rectal swabs collected from inpatients (n=500) at admission and discharge and environmental samples (surface swabs and wastewater, n=136) from two provincial hospitals in Vietnam to elucidate the molecular epidemiology and the relative contributions of clonal transmission and horizontal gene transfer in this setting.
We performed whole-genome sequencing on 198 CREC isolates from 142 patients (85 at Hospital 1 and 57 at Hospital 2) and three environmental samples. CREC diversity and genomic sharing patterns were strongly structured by hospital. The predominant carbapenemase genes were blaNDM-5 (n=109), followed by blaOXA-48 (n=42) and blaOXA-181 (n=32). Pairwise single nucleotide polymorphism (SNP) analysis showed that 24/54 patients had both admission and discharge isolates that were genetically distinct (median SNP distance: 23,369 – IQR 139–46,206), suggesting potential strain acquisition during hospitalization. We identified 263 clonal sharing pairs (CPSs) (threshold ≤25 SNPs) among 128 isolates from 88 patients (65 in Hospital 1 and 23 in Hospital 2). A total of 208 (79.1%) CSPs occurred between different patients within the same hospital, predominantly in Hospital 1 (186 CSPs). A small proportion of CSPs involved patient and environmental isolates (20 CSPs, 7.6%). The largest putative transmission clusters were associated with ST405, closely related to previously reported clinical ST405 CREC isolates, and involved 17 patients across multiple wards in Hospital 1.
Overall, our findings support the existence of localized transmission networks contributing to the spread of CREC within healthcare settings and highlight the importance of ongoing surveillance and infection prevention strategies to limit transmission.
Biography of the presenting author
Vu Thi Ngoc Bich has completed his PhD in 2023 from Radboud University Medical Center and postdoctoral studies from Oxford Univesity Clinical Research Unit (OUCRU Hanoi). Her work focuses on bacterial infections and antibiotic resistance. Her research interests are Microbiome, Resistome, and AMR in resource-limited settings.
Presenting author details
Full name: Vu Thi Ngoc Bich
Contact number: +84 347986555
Email: bichvtn@oucru.org
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Session name/ number: Antimicrobial resistance and treatment/2.
Category: (Oral presentation)