{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:48:38Z","timestamp":1792086518573,"version":"4.4.0"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>The global surge of carbapenem-resistant Enterobacteriaceae (CRE) poses a critical threat to patient safety in intensive care units (ICUs). In low- and middle-income countries, routine CRE surveillance is often limited by the lack of microbiology laboratory infrastructure and trained personnel in peripheral healthcare facilities, resulting in reliance on empirical broad-spectrum antibiotic therapy and limited capacity to detect silent transmission. This study evaluated the operational feasibility, safety, and phenotypic agreement of a decentralized, laboratory-independent bedside CRE screening protocol using pre-formulated selective chromogenic agar and a low-cost portable incubator. Dual rectal swabs were collected from 220 ICU patients at Viet Tiep Hospital, Vietnam. One sample was processed using standard centralized laboratory procedures as the reference method, while the parallel sample was processed at the bedside by frontline nursing staff, including direct plate inoculation and point-of-care incubation. Diagnostic agreement, inter-reader reliability, procedural contamination, and operational feasibility were assessed. Gastrointestinal CRE carriage was identified in 26 of 220 patients (11.8%), with the KESC group accounting for 76.9% of positive cases. The bedside protocol demonstrated 100% phenotypic concordance with standard laboratory cultures, with 100% sensitivity, specificity, positive predictive value, and negative predictive value. Blinded assessment showed complete inter-reader agreement (\u03ba\u2009=\u20091.0). No environmental cross-contamination was detected on CRE-negative plates (0.0%; 95% CI: 0\u20134.1%). The decentralized bedside screening model, costing less than US$1 per test, demonstrated high diagnostic agreement and operational feasibility when performed by frontline nursing staff in a non-sterile ICU environment. This approach may provide an affordable alternative for CRE surveillance in resource-limited healthcare facilities where centralized microbiology laboratory infrastructure is unavailable.<\/jats:p>","DOI":"10.1371\/journal.pgph.0007479","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:28:41Z","timestamp":1792085321000},"page":"e0007479","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bedside screening of carbapenem-resistant Enterobacteriaceae using selective agar plates: A low-cost, laboratory-independent approach for rural healthcare facilities"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8010-4031","authenticated-orcid":true,"given":"The Anh","family":"Ngo","sequence":"first","affiliation":[{"name":"Viet Tiep Hospital","place":["Hai Phong, Viet Nam"],"department":["Department of Infectious Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hieu Thi","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Viet Tiep Hospital","place":["Hai Phong, Viet Nam"],"department":["Department of Infectious Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6699-2071","authenticated-orcid":true,"given":"Nhung Ngoc","family":"Hoang","sequence":"additional","affiliation":[{"name":"HUTECH University","place":["Ho Chi Minh city, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-9611","authenticated-orcid":true,"given":"Thanh Duc","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Hanoi University of Public Health","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6582-4471","authenticated-orcid":true,"given":"Thanh Chi","family":"Tran","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy","place":["Ho Chi Minh city, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"pgph.0007479.ref001","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s13756-019-0654-8","article-title":"Antimicrobial resistance in the asia pacific region: A meeting report","volume":"8","author":"ELY Yam","year":"2019","journal-title":"Antimicrob Resist Infect Control"},{"issue":"3","key":"pgph.0007479.ref002","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"A-P Magiorakos","year":"2012","journal-title":"Clin Microbiol Infect"},{"issue":"2","key":"pgph.0007479.ref003","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jinf.2019.05.013","article-title":"High prevalence of colonisation with carbapenem-resistant Enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease","volume":"79","author":"DM Tran","year":"2019","journal-title":"J Infect"},{"key":"pgph.0007479.ref004","unstructured":"Hardy Diagnostics. 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