Fecal Colonization Rate of Carbapenem-resistant Enterobacterales among Volunteers in a Community of Raroeng Subdistrict, Wang Nam Khiao District, Nakhon Ratchasima Province, Thailand

Carbapenem-resistant Enterobacterales (CRE) have emerged as an important global public health problem due to their ability to cause high morbidity and mortality rates. CRE have the potential to spread not only in hospital settings but also in the community. Based on our knowledge, no investigation has been conducted of CRE presence among people in Raroeng Subdistrict, Wang Nam Khiao District, Nakhon Ratchasima Province, Thailand. This study aimed to clarify the CRE colonization status among volunteers in the community. This cross-sectional study was conducted in March 2023. A total of 121 fecal samples were obtained from the volunteers participating in this study. CRE screening, identification and characterization were performed using culture methods, matrix-assisted laser desorption-ionization-time of flight mass spectrometry (MALDI-TOF MS) and phenotypic and genotypic assays for carbapenemase production. Our results revealed that the fecal colonization rate of CRE was 1.65% (n=2). CRE isolates were identified as Klebsiella pneumoniae. Carbapenemase types were revealed as class B metallo-beta-lactamase and class D serine-carbapenemase, produced by blaNDM and blaOXA-48, respectively. Additional antimicrobial resistant genes including beta-lactam resistant genes (blaCTX-M, blaSHV, blaTEM) and an aminoglycoside resistant gene (aac(6’)-Ib), were also found among the CRE isolates. No significant potential factors related to CRE colonization rate were identified. Our study indicated that CRE colonization in this community is worrisome. Surveillance of CRE colonization and strict implementation of infection control practices are required to restrict the spread of CRE in communities.