Molecular characterization and antimicrobial resistance of carbapenem-resistant Klebsiella pneumoniae and Escherichia coli at Cho Ray Hospital, Vietnam

Due to limited treatment options, the infection of carbapenem-resistant Enterobacterales (CRE), particularly Escherichia coli and Klebsiella pneumoniae, emerges as a critically imminent global health threat. This study aimed to investigate the prevalence and molecular characteristics of carbapenemase genes in CRE isolated from Cho Ray Hospital, and to assess their associated antimicrobial resistance profiles. A cross-sectional study was conducted on 160 non-duplicate CRE isolates collected from various clinical specimens at Cho Ray Hospital. Carbapenemase production was detected phenotypically using the modified carbapenem inactivation method and genotypically confirmed by multiplex real-time PCR targeting blaOXA, blaNDM, blaKPC, blaVIM, and blaIMP. K. pneumoniae accounted for 80.6% of isolates, while E. coli comprised 19.4%. The co-occurrence of blaOXA and blaNDM was the most common pattern (46.5% in K. pneumoniae). Notably, blaKPC was found in 17.8% of K. pneumoniae but not in E. coli. Colistin resistance was significantly higher in blaKPC isolates (30.4%) than blaNDM isolates (3.2%). The study highlights the high prevalence of dual carbapenemase gene carriage and the emergence of blaKPC at Cho Ray Hospital. These findings emphasize the importance of localized molecular surveillance and targeted infection control strategies in Vietnamese tertiary care settings.