Intestinal colonization of vancomycin-resistant Enterococcus in children admitted to Mofid children’s hospital intensive care unit at admission and at discharge

Alebouyeh, Masoud; Shirvani, Fariba; Hassanzadeh, Romina; Azimi, Taher; Ghandchi, Ghazale; Abdollahi, Nafiseh; Gholinejad, Zari; Behzad, Azita; Sheikhi, Zahra; Fallah, Fatemeh; Azimi, Leila; Karimi, Abdollah; Armin, Shahnaz; Ghanaie, Roxana Mansour; Tabatabaei, Sedigheh Rafiei; Fahimzad, Seyed Alireza

doi:10.1007/s11033-022-08196-1

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…In the current study, 32.7% (36/110) of children with gastroenteritis had Enterococcus species. In a similar study conducted in Iran, Alebouyeh et al [23] found the percentage of Enterococcus species isolated from rectal swabs to be 34.6% which comes in accordance with our results. A study from Iraq (2019) found that 48.3% of children with diarrhoea were infected with Enterococci [3].…”

Section: Discussionsupporting

confidence: 92%

“…The three VRE strains isolated were multi drug resistant, two of them were E. faecium and the other one was E. avium. Vancomycin resistance was found at 44.4% and 46.4%, respectively, by Alebouyeh et al [23] and Dahmoshi et al [3], which was more than our values. Vancomycin resistance was reported to be 17.1% according to a study by So et al [25], although no Vancomycin resistant Enterococci were observed, according to Jannati et al [26].…”

Section: Resistancecontrasting

confidence: 69%

“…Healthcare workers can also spread these organisms from one patient to another. This highlights the urgent need for effective measures to control the spread of these pathogens [23].…”

Section: Resistancementioning

confidence: 99%

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Multidrug resistant Enterococci as a community acquired infection in diarrheal cases of children

Abd El Hamid,

Mohamed Nafadi,

Hasanein

et al. 2023

Microbes and Infectious Diseases

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Background and Objectives: Enterococci causes many serious and life-threatening infections. Enterococci may be the cause of diarrhea in children. Multidrug-resistant (MDR) Enterococci limits treatment options. So, the aim of our study was to detect the frequency and the antibiotic resistance profile, both phenotypically and genotypically, of MDR Enterococci isolated from the stools of children suffering from gastroenteritis who needed hospitalization. Materials and Methods: Enterococci were isolated from stool samples from children. One hundred ten (110) infants (in patients) with typical signs of gastroenteritis (nausea, vomiting, abdominal pain, diarrhea). The Vitek 2 Compact System is used for identification and antimicrobial susceptibility testing. Drug resistance genes (ermB, aph(3′)IIIa, and tetM) and virulence genes (esp) were identified using molecular techniques. Results: Thirty-six isolates of Enterococci were diagnosed phenotypically by routine lab examination and Vitek2 followed by genotypic characterization by multiplex PCR for three resistant genes: ermB (100%), aph(3′)IIIa (63.9%) and tetM (91.7%) and one virulence gene (esp (25%)). The frequency of Enterococci among studied patients was 32.7% (36/110). Most of the Enterococci isolated from stool were Enterococcus faecuim (86.1%). MDR Enterococci was found to be 94.4% (34/36) in total isolates. Conclusion: MDR Enterococci was isolated in community acquired diarrhea in young aged (less than 24 months) children. More than one resistance gene: ermB, aph(3′)IIIa, tetM and virulence gene (esp) were detected in isolates. The presence of MDR strains is risky at a young age as it limits treatment options. Drug-resistant genes may be transmitted to a child through a carrier mother or cross infection from the hospital.

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Section: Discussionsupporting

confidence: 92%

Section: Resistancecontrasting

confidence: 69%

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Multidrug resistant Enterococci as a community acquired infection in diarrheal cases of children

Abd El Hamid,

Mohamed Nafadi,

Hasanein

et al. 2023

Microbes and Infectious Diseases

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“…In a recent study in our hospital, intestinal carriage and endogenous transmission of Enterococcus spp. to the bloodstream was established in children at oncology and BMT wards [31,32]. Increased permeability of the intestine through the administration of chemotherapeutic drugs and infection control issues are assumed as risk factors for Enterococcus spp.…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 pandemic on bloodstream infections in pediatrics and alteration in antimicrobial resistance phenotypes, 2020-2022

Fallah,

Karimi,

Azimi

et al. 2024

Preprint

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Background: Alteration in the etiology of bloodstream infection (BSI) and antimicrobial resistance (AMR) following the COVID-19 pandemic is not well known in children. This study aimed to investigate these changes during 2 years in Tehran, Iran. Methods Children under 18 years old with suspected bacteremia/fungemia who had positive BACTEC blood cultures were included. Characterization of the isolates, antimicrobial susceptibility testing, and detection of multidrug-resistant (MDR) phenotypes were done based on standard protocols. Statistical analysis was done to measure the correlation of COVID-19 infection with BSI and AMR. Results Out of 13,345 COVID-19 tests and 4,194 BACTEC blood culture requests, bacteremia/fungemia were confirmed in 10.34% of the patients who requested both tests simultaneously. The COVID-19 infection was confirmed in 25.3% of the patients with bacteremia/fungemia. The infection with Gram-negative bacteria, Gram-positive bacteria (GPB), and fungi was detected in 59.3%, 32.3%, and 8.31% of the cases, respectively. Pseudomonasspp. (21.3%), Klebsiella spp. (20.2%), CNS (15.8%), Acinetobacterspp. (9.6%), S. aureus (8%), and Enterococcus spp. (5%) were among the common isolates. In the case of BSI with GPB, a significant difference was measured among different hospital wards (p-value= 0.01). Moreover, a negative correlation was shown between the CNS bacteremia and COVID-19 infection (p-value= 0.029). Candida spp. and non-Candidayeasts were detected in 6.7% and 13.4% of the cases, respectively. Results of antibiotic susceptibility testing showed the highest frequency of resistance to azithromycin and oxacillin among CNS, azithromycin, tetracycline, and oxacillin among S. aureus, and tetracycline and trimethoprim/sulfamethoxazole among Enterococcus. Methicillin-resistance phenotype in the S. aureus (MRSA) and coagulase-negative Staphylococcusspp. (MR-CNS) was detected in 40% and 61.5% of the strains, respectively and the Enterococci were resistant to vancomycin in 33.3% of the isolates. Conclusion A decline in the trend of BSI by GPB and an increase in AMR was shown in children during the COVID-19 pandemic. The rise in antibiotic resistance could be described by the overuse of antibiotics in COVID-19 patients, while the difference in types of medical interventions may explain the difference in the etiology of BSI among the hospital wards.

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“…Variation in the prevalence of toxigenic K. oxytoca among studies can be due to the use of different sample types and types of detection methods. 4 , 27 In most cases, K. oxytoca strains with toxin‐production ability are found in stool samples. Studies have revealed that K. oxytoca strains isolated from other samples such as blood or other infections such as respiratory tract infections cannot produce toxins.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and antimicrobial resistance of toxin‐producing Klebsiella oxytoca clinical isolates from children admitted to the oncology chemotherapy center in Mofid Children's Hospital in Tehran, Iran: A cross‐sectional study

Sabzivand,

Nazari,

Shirvani

et al. 2024

Health Science Reports

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Background and AimsKlebsiella oxytoca (K. oxytoca) is the second bacterial cause of nosocomial infections in the general population after K. pneumoniae. This study surveyed the frequency of cytotoxin‐producing strains of K. oxytoca and their antibiotic susceptibility profile in a cohort of children admitted to a referral hospital with different malignancies.MethodsThe Stool samples of children admitted to the Cancer Chemotherapy Unit of the Mofid Children's Hospital, Tehran, Iran were analyzed using conventional biochemical tests and polymerase chain reaction targeting the pehX gene to identify K. oxytoca. The antibiotic susceptibility profile of isolated K. oxytoca against commonly prescribed antibiotics used in treating infection at the facility was determined using the Kirby–Bauer disk diffusion technique. Also, the prevalence of genes encoding toxins among K. oxytoca was identified by PCR assay.ResultsThe Stool samples of 280 participants were taken for the study of which 38 samples [(55.3% (21/38) 42 males and 44.7% (17/38) females)] tested positive for various Klebsiella spp. Out of this, K. oxytoca was identified in 2.5% (7/280) stools using cultures and conventional biochemical tests. Also, the stools of 2.9% (8/280) of the participants tested positive for K. oxytoca using PCR assay. Using PCR, (2/7) of the K. oxytoca isolates tested positive for the npsA and npsB genes and were identified as toxigenic K. oxytoca strains.ConclusionThe prevalence of toxin‐producing K. oxytoca strains in stool samples of children diagnosed with cancer in Iran is relatively low. Most of the K. oxytoca isolates were susceptible to tested antibiotics. Globally, active surveillance of toxigenic K. oxytoca strains in patients with different malignancies or immunocompromised patients is recommended in healthcare settings.

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Intestinal colonization of vancomycin-resistant Enterococcus in children admitted to Mofid children’s hospital intensive care unit at admission and at discharge

Cited by 6 publications

References 23 publications

Multidrug resistant Enterococci as a community acquired infection in diarrheal cases of children

Multidrug resistant Enterococci as a community acquired infection in diarrheal cases of children

The impact of COVID-19 pandemic on bloodstream infections in pediatrics and alteration in antimicrobial resistance phenotypes, 2020-2022

Epidemiology and antimicrobial resistance of toxin‐producing Klebsiella oxytoca clinical isolates from children admitted to the oncology chemotherapy center in Mofid Children's Hospital in Tehran, Iran: A cross‐sectional study

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