Intestinal colonization of vancomycin-resistant Enterococcus in children admitted to Mofid children's hospital intensive care unit at admission and at discharge.
Children
Enterococcus spp.
Intensive care units
VRE
Vancomycin
Journal
Molecular biology reports
ISSN: 1573-4978
Titre abrégé: Mol Biol Rep
Pays: Netherlands
ID NLM: 0403234
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
08
07
2022
accepted:
08
12
2022
medline:
29
3
2023
pubmed:
30
1
2023
entrez:
29
1
2023
Statut:
ppublish
Résumé
This study aimed to investigate the frequency of intestinal colonization by vancomycin-resistant Enterococcus (VRE) carrying vanA and vanB genes in patients at ICU admission and at discharge from ICU in Mofid children's Hospital, Tehran, Iran. Sampling was performed using rectal swabs and vancomycin susceptibility testing for Enterococcus spp. was carried out using a minimum inhibitory concentration (MIC) assay on Muller Hinton Agar (MHA) medium using an E-test kit. The molecular detection of VRE isolates was performed by the PCR method using the vanA and vanB resistance genes. A total of 234 and 186 non-duplicate rectal swab samples were collected from patients at ICU admission and at discharge from ICU, respectively. Enterococcus spp. was detected in 34.6% (n = 81/234) of rectal swab samples collected from patients at ICU admission, of which 44.4% (n = 36/81) were VRE isolates. In contrast, the prevalence of Enterococcus spp. and VRE isolates among patients at discharge from ICU was 17.7% (n = 33/186) and 57.6% (n = 19/33), respectively. Out of 19 VRE isolated from patients at ICU admission, 4 (21%) and 1 (5.3%) contained vanA and vanB genes, respectively. In contrast, out of 36 VRE isolated from patients at discharge from ICU, 11 (30.5%) were positive for the vanA gene. Results revealed that the prevalence of Enterococcus spp. among patients at ICU admission was high. However, VRE was frequently isolated from patients who were hospitalized for several days in ICUs. The implementation of proper infection control strategies and the use of suitable protocols to guide the appropriate prescribing of antibiotics are necessary.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to investigate the frequency of intestinal colonization by vancomycin-resistant Enterococcus (VRE) carrying vanA and vanB genes in patients at ICU admission and at discharge from ICU in Mofid children's Hospital, Tehran, Iran.
METHOD
METHODS
Sampling was performed using rectal swabs and vancomycin susceptibility testing for Enterococcus spp. was carried out using a minimum inhibitory concentration (MIC) assay on Muller Hinton Agar (MHA) medium using an E-test kit. The molecular detection of VRE isolates was performed by the PCR method using the vanA and vanB resistance genes.
RESULTS
RESULTS
A total of 234 and 186 non-duplicate rectal swab samples were collected from patients at ICU admission and at discharge from ICU, respectively. Enterococcus spp. was detected in 34.6% (n = 81/234) of rectal swab samples collected from patients at ICU admission, of which 44.4% (n = 36/81) were VRE isolates. In contrast, the prevalence of Enterococcus spp. and VRE isolates among patients at discharge from ICU was 17.7% (n = 33/186) and 57.6% (n = 19/33), respectively. Out of 19 VRE isolated from patients at ICU admission, 4 (21%) and 1 (5.3%) contained vanA and vanB genes, respectively. In contrast, out of 36 VRE isolated from patients at discharge from ICU, 11 (30.5%) were positive for the vanA gene.
CONCLUSION
CONCLUSIONS
Results revealed that the prevalence of Enterococcus spp. among patients at ICU admission was high. However, VRE was frequently isolated from patients who were hospitalized for several days in ICUs. The implementation of proper infection control strategies and the use of suitable protocols to guide the appropriate prescribing of antibiotics are necessary.
Identifiants
pubmed: 36710317
doi: 10.1007/s11033-022-08196-1
pii: 10.1007/s11033-022-08196-1
doi:
Substances chimiques
Vancomycin
6Q205EH1VU
Anti-Bacterial Agents
0
Bacterial Proteins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3271-3281Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Kaya A, Kaya SY, Balkan II, Bayramlar OF, Mete B, Saltoglu N et al (2021) Risk factors for development of vancomycin-resistant enterococcal bacteremia among VRE colonizers. Wiener klinische Wochenschrift 133(9):478–483. https://doi.org/10.1007/s00508-020-01733-7 . https://pubmed.ncbi.nlm.nih.gov/32910333/
doi: 10.1007/s00508-020-01733-7
pubmed: 32910333
Ayobami O, Willrich N, Reuss A, Eckmanns T, Markwart R (2020) The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections. Emerg Microbes Infections 9(1):1180–1193. https://doi.org/10.1080/22221751.2020.1769500 . https://pubmed.ncbi.nlm.nih.gov/32498615/
doi: 10.1080/22221751.2020.1769500
Shirvani F, Behzad A, Abdollahi N, Mohkam M, Sharifian M, Esfandiar N et al (2021) Frequency and co-colonization of vancomycin-resistant Enterococci and Candida in ICU-hospitalized children. New Microbes and New Infections 41:100881. https://doi.org/10.1016/j.nmni.2021.100881 . https://pubmed.ncbi.nlm.nih.gov/34026230/
doi: 10.1016/j.nmni.2021.100881
pubmed: 34026230
pmcid: 8121691
Moosavian M, Ghadri H, Samli Z (2018) Molecular detection of vanA and vanB genes among vancomycin-resistant enterococci in ICU-hospitalized patients in Ahvaz in southwest of Iran. Infect drug Resist 11:2269. https://doi.org/10.2147/IDR.S177886 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245376/
doi: 10.2147/IDR.S177886
pubmed: 30532561
pmcid: 6245376
Ashagrie D, Genet C, Abera B (2021) Vancomycin-resistant enterococci and coagulase-negative staphylococci prevalence among patients attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia. PLoS ONE 16(4):e0249823. https://doi.org/10.1371/journal.pone.0249823 . https://pubmed.ncbi.nlm.nih.gov/33831089/
doi: 10.1371/journal.pone.0249823
pubmed: 33831089
pmcid: 8031390
Janjusevic A, Cirkovic I, Minic R, Stevanovic G, Soldatovic I, Mihaljevic B et al (2022) Predictors of vancomycin-resistant Enterococcus spp. Intestinal carriage among high-risk patients in University Hospitals in Serbia. Antibiotics 11(9):1228. https://doi.org/10.3390/antibiotics11091228 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495008/
doi: 10.3390/antibiotics11091228
pubmed: 36140006
pmcid: 9495008
Shiadeh SMJ, Azimi L, Azimi T, Pourmohammad A, Goudarzi M, Chaboki BG et al (2020) Upregulation of efrAB efflux pump among Enterococcus faecalis ST480, ST847 in Iran. Acta Microbiol Immunol Hung 67(3):187–192. https://doi.org/10.1556/030.2020.01173 . https://pubmed.ncbi.nlm.nih.gov/32986605/
doi: 10.1556/030.2020.01173
pubmed: 32986605
Beale JW, Durward-Diioia M (2022) Clinical considerations in the Approach to Vancomycin-Resistant Enterococci: a narrative review. Int J Med Students 10(2):202–209. https://doi.org/10.5195/ijms.2022.1010 . https://www.ijms.info/IJMS/article/view/1010
doi: 10.5195/ijms.2022.1010
Tacconelli E, Magrini N, Kahlmeter G, Singh N (2017) Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. World Health Organization. ;27:318 – 27. https://doi.org/10.1016/S1473-3099(17)30753-3 . https://pubmed.ncbi.nlm.nih.gov/29276051/
Davarci PZ, Turkmen FM, Davarci I, Engin DO (2020) The investigation of related factors for vancomycin resistant enterococcus colonization of inpatients at internal medicine service. https://www.annalsmedres.org/index.php/aomr/article/view/554
Axelrad JE, Lebwohl B, Cuaresma E, Cadwell K, Green PH, Freedberg DE (2018) Gut colonization with vancomycin-resistant Enterococcus and risk for subsequent enteric infection. Gut Pathogens 10(1):1–9. https://gutpathogens.biomedcentral.com/articles/ https://doi.org/10.1186/s13099-018-0259-4
doi: 10.1186/s13099-018-0259-4
Belga S, Chiang D, Kabbani D, Abraldes JG, Cervera C (2019) The direct and indirect effects of vancomycin-resistant enterococci colonization in liver transplant candidates and recipients. Expert Rev Anti-infective Therapy 17(5):363–373. https://doi.org/10.1080/14787210.2019.1607297 . https://pubmed.ncbi.nlm.nih.gov/30977692/
doi: 10.1080/14787210.2019.1607297
pubmed: 30977692
Kim HS, Kim DH, Yoon H-j, Lee WJ, Woo SH, Choi SP (2018) Factors associated with vancomycin-resistant enterococcus colonization in patients transferred to emergency departments in Korea. J Korean Med Sci 33(48). https://doi.org/10.3346/jkms.2018.33.e295 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249167/
Agarwal P, Singhal L, Gupta V, Guglani V, Chander J (2019) Vancomycin-resistant enterococci & healthcare-associated risk factors in paediatric intensive care unit. Indian J Med Res 149(1):71. https://doi.org/10.4103/ijmr.IJMR_2063_16 . https://pubmed.ncbi.nlm.nih.gov/31115379/
doi: 10.4103/ijmr.IJMR_2063_16
pubmed: 31115379
pmcid: 6507533
Dirbazian A, Rouhi S, Shakob P (2021) Detection of VanA, VanB, and VanC genes in Enterococcus Species isolated from fecal sample of patients in Qom province. Iran Appl Biology 11(43):53–62. https://sjoapb.qom.iau.ir/article_689275.html?lang=en
Regasa Dadi B, Solomon Z, Tesfaye M (2021) Vancomycin resistant enterococci and its associated factors among HIV infected patients on anti-retroviral therapy in Ethiopia. PLoS ONE 16(6):e0251727. https://doi.org/10.1371/journal.pone.0251727 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224944/
doi: 10.1371/journal.pone.0251727
pubmed: 34166383
pmcid: 8224944
Alotaibi FE, Bukhari EE (2017) Emergence of vancomycin-resistant Enterococci at a teaching hospital, Saudi Arabia. Chin Med J 130(03):340–346. https://doi.org/10.4103/0366-6999.198923 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308018/
doi: 10.4103/0366-6999.198923
pubmed: 28139519
pmcid: 5308018
Yoon YK, Lee MJ, Ju Y, Lee SE, Yang KS, Sohn JW et al (2019) Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case–control study. Ann Clin Microbiol Antimicrob 18(1):1–9. https://doi.org/10.1186/s12941-019-0327-8 . https://pubmed.ncbi.nlm.nih.gov/31601221/
doi: 10.1186/s12941-019-0327-8
Haghi F, Lohrasbi V, Zeighami H (2019) High incidence of virulence determinants, aminoglycoside and vancomycin resistance in enterococci isolated from hospitalized patients in Northwest Iran. BMC Infect Dis 19(1):1–10. https://doi.org/10.1186/s12879-019-4395-3 . https://pubmed.ncbi.nlm.nih.gov/31455296/
doi: 10.1186/s12879-019-4395-3
Arshadi M, Mahmoudi M, Motahar MS, Soltani S, Pourmand MR (2018) Virulence determinants and antimicrobial resistance patterns of vancomycin-resistant Enterococcus faecium isolated from different sources in Southwest Iran. Iranian journal of public health. ;47(2):264. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810390/
Markwart R, Willrich N, Haller S, Noll I, Koppe U, Werner G et al (2019) The rise in vancomycin-resistant Enterococcus faecium in Germany: data from the german Antimicrobial Resistance Surveillance (ARS). Antimicrob Resist Infect Control 8(1):1–11. https://doi.org/10.1186/s13756-019-0594-3 . https://pubmed.ncbi.nlm.nih.gov/31485325/
doi: 10.1186/s13756-019-0594-3
Tarafdar F, Jafari B, Azimi T (2020) Evaluating the antimicrobial resistance patterns and molecular frequency of blaoxa-48 and blaGES-2 genes in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from burn wound infection in Tehran, Iran. New Microbes and New Infections. ;37:100686. https://doi.org/10.1016/j.nmni.2020.100686 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394744/
Fallah F, Azimi T, Azimi L, Karimi A, Rahbar M, Shirdoust M et al (2020) Evaluating the antimicrobial resistance and frequency of AmpC β-lactamases blaCMY-2 gene in Gram-negative bacteria isolates collected from selected hospitals of Iran: a multicenter retrospective study. Gene Rep 21:100868. https://doi.org/10.30699/IJP.2022.538613.2716 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9508542/
doi: 10.30699/IJP.2022.538613.2716
Selim S (2022) Mechanisms of gram–positive vancomycin resistance. Biomedical Rep 16(1):1–6. https://doi.org/10.3892/br.2021.1490 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8686198/
doi: 10.3892/br.2021.1490
Azimi L, Fallah F, Karimi A, Shirdoust M, Azimi T, Sedighi I et al (2020) Survey of various carbapenem-resistant mechanisms of Acinetobacter baumannii and Pseudomonas aeruginosa isolated from clinical samples in Iran. Iran J Basic Med Sci 23(11):1396. https://doi.org/10.22038/IJBMS.2020.44853.10463 . https://pubmed.ncbi.nlm.nih.gov/33235696/
doi: 10.22038/IJBMS.2020.44853.10463
pubmed: 33235696
pmcid: 7671419