Prevalence of carbapenem resistance and its association with antibiotic use in humans and animals in the Mekong Delta of Vietnam

Southeast Asia is considered to be a hotspot for antimicrobial resistance; however there are very little data on prevalence of carbapenem resistance carriage in non-hospitalised human individuals and in animals. Carbapenem resistance, particularly associated with Enterobacteriaceae (CRE) Escherichia coli (CRE) and Klebsiella pneumoniae (CRK) as well as with Acinetobacter baumannii (CRAB) has been recognized as emerging threats worldwide. We investigated 400 farms in the Mekong Delta of Vietnam and collected samples (rectal swabs, faecal swabs) from humans (n=652), chickens (N=237), ducks (N=150) and pigs (N=143) to investigate carriage and further characterize phenotypically and genotypically CRE, CRK and CRAB. CRE was identified in humans (n=4), pigs (n=1); CRAB was isolated from chickens (n=4) and ducks (n=1); CRK was isolated from a human also colonized with CRE. In humans, the prevalence of CRE was higher among human individuals that had used antimicrobials within 90 days of the sampling date than those that had not (4.2% vs. 0.2%, p=0.005).