The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit
Abstract Background This study aimed to investigate the intestinal carrier status of Enterococcus spp. among children in a pediatric intensive care unit (PICU) and reveal the role of hospitalization in the alteration of resistance phenotypes and clonal diversity of the isolates during admission and...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-023-04238-0 |
| _version_ | 1827708268478201856 |
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| author | Fariba Shirvani Romina Hassanzadeh Bahareh Attaran Ghazale Ghandchi Nafiseh Abdollahi Zari Gholinejad Zahra Sheikhi Azita Behzad Fatemeh Fallah Leila Azimi Azam Safarkhani Abdollah Karimi Alireza Mahdavi Shahnaz Armin Roxana Mansour Ghanaiee Sedigheh Rafiei Tabatabaei Seyed Alireza Fahimzad Masoud Alebouyeh |
| author_facet | Fariba Shirvani Romina Hassanzadeh Bahareh Attaran Ghazale Ghandchi Nafiseh Abdollahi Zari Gholinejad Zahra Sheikhi Azita Behzad Fatemeh Fallah Leila Azimi Azam Safarkhani Abdollah Karimi Alireza Mahdavi Shahnaz Armin Roxana Mansour Ghanaiee Sedigheh Rafiei Tabatabaei Seyed Alireza Fahimzad Masoud Alebouyeh |
| author_sort | Fariba Shirvani |
| collection | DOAJ |
| description | Abstract Background This study aimed to investigate the intestinal carrier status of Enterococcus spp. among children in a pediatric intensive care unit (PICU) and reveal the role of hospitalization in the alteration of resistance phenotypes and clonal diversity of the isolates during admission and discharge periods. Methods Two separate stool samples were collected from hospitalized patients in the pediatric intensive care unit at admission and discharge times. The culture was done, and Enterococcus species were tested for antimicrobial susceptibility and carriage of vanA-D gene subtypes. Random Amplified Polymorphic DNA (RAPD)-PCR was used for a phylogenetic study to check the homology of pairs of isolates. Results The results showed carriage of Enterococci at admission, discharge, and at both time points in 31%, 28.7%, and 40.1% of the cases, respectively. High frequencies of the fecal Enterococcus isolates with vancomycin-resistance (VR, 32.6% and 41.9%), high-level of gentamicin-resistance (HLGR, 25.6% and 27.9%), and multi-drug resistance phenotypes (MDR, 48.8% and 65.1%) were detected at admission and discharge times, respectively. Resistance to vancomycin, ampicillin, and rifampicin was higher among E. faecium, but resistance to ciprofloxacin was higher in E. faecalis isolates. The increased length of hospital stay was correlated with the carriage of resistant strains to vancomycin, ampicillin, and ciprofloxacin. While the homology of the isolates was low among different patients during hospitalization, identical (9%) and similar (21%) RAPD-PCR patterns were detected between pairs of isolates from each patient. Conclusions The high rate of intestinal carriage of VR, HLGR-, and MDR-Enterococci at admission and during hospitalization in the PICU, and the impact of increased length of hospital stay on the fecal carriage of the resistant strains show the importance of antibiotic stewardship programs to control their transmission and spread in children. |
| first_indexed | 2024-03-10T17:02:15Z |
| format | Article |
| id | doaj.art-c8666539afa143d0ab9587d224b44597 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-03-10T17:02:15Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-c8666539afa143d0ab9587d224b445972023-11-20T10:56:55ZengBMCBMC Pediatrics1471-24312023-08-012311910.1186/s12887-023-04238-0The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unitFariba Shirvani0Romina Hassanzadeh1Bahareh Attaran2Ghazale Ghandchi3Nafiseh Abdollahi4Zari Gholinejad5Zahra Sheikhi6Azita Behzad7Fatemeh Fallah8Leila Azimi9Azam Safarkhani10Abdollah Karimi11Alireza Mahdavi12Shahnaz Armin13Roxana Mansour Ghanaiee14Sedigheh Rafiei Tabatabaei15Seyed Alireza Fahimzad16Masoud Alebouyeh17Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesDepartment of Microbiology, Faculty of Biological Sciences, Alzahra UniversityDepartment of Microbiology, Faculty of Biological Sciences, Alzahra UniversityPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Intensive Care Unit, Mofid Children’s Hospital, Shahid Beheshti University of Medical SciencesPediatric Intensive Care Department, Mofid Children’s Hospital, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Intensive Care Unit, Mofid Children’s Hospital, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesAnesthesiology Research Center, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesPediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical SciencesAbstract Background This study aimed to investigate the intestinal carrier status of Enterococcus spp. among children in a pediatric intensive care unit (PICU) and reveal the role of hospitalization in the alteration of resistance phenotypes and clonal diversity of the isolates during admission and discharge periods. Methods Two separate stool samples were collected from hospitalized patients in the pediatric intensive care unit at admission and discharge times. The culture was done, and Enterococcus species were tested for antimicrobial susceptibility and carriage of vanA-D gene subtypes. Random Amplified Polymorphic DNA (RAPD)-PCR was used for a phylogenetic study to check the homology of pairs of isolates. Results The results showed carriage of Enterococci at admission, discharge, and at both time points in 31%, 28.7%, and 40.1% of the cases, respectively. High frequencies of the fecal Enterococcus isolates with vancomycin-resistance (VR, 32.6% and 41.9%), high-level of gentamicin-resistance (HLGR, 25.6% and 27.9%), and multi-drug resistance phenotypes (MDR, 48.8% and 65.1%) were detected at admission and discharge times, respectively. Resistance to vancomycin, ampicillin, and rifampicin was higher among E. faecium, but resistance to ciprofloxacin was higher in E. faecalis isolates. The increased length of hospital stay was correlated with the carriage of resistant strains to vancomycin, ampicillin, and ciprofloxacin. While the homology of the isolates was low among different patients during hospitalization, identical (9%) and similar (21%) RAPD-PCR patterns were detected between pairs of isolates from each patient. Conclusions The high rate of intestinal carriage of VR, HLGR-, and MDR-Enterococci at admission and during hospitalization in the PICU, and the impact of increased length of hospital stay on the fecal carriage of the resistant strains show the importance of antibiotic stewardship programs to control their transmission and spread in children.https://doi.org/10.1186/s12887-023-04238-0EnterococcusPediatric Intensive Care UnitCarriersMDRVREHLGR |
| spellingShingle | Fariba Shirvani Romina Hassanzadeh Bahareh Attaran Ghazale Ghandchi Nafiseh Abdollahi Zari Gholinejad Zahra Sheikhi Azita Behzad Fatemeh Fallah Leila Azimi Azam Safarkhani Abdollah Karimi Alireza Mahdavi Shahnaz Armin Roxana Mansour Ghanaiee Sedigheh Rafiei Tabatabaei Seyed Alireza Fahimzad Masoud Alebouyeh The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit BMC Pediatrics Enterococcus Pediatric Intensive Care Unit Carriers MDR VRE HLGR |
| title | The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit |
| title_full | The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit |
| title_fullStr | The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit |
| title_full_unstemmed | The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit |
| title_short | The intestinal carrier status of Enterococcus spp. in children: clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit |
| title_sort | intestinal carrier status of enterococcus spp in children clonal diversity and alterations in resistance phenotypes before and after admission to a pediatric intensive care unit |
| topic | Enterococcus Pediatric Intensive Care Unit Carriers MDR VRE HLGR |
| url | https://doi.org/10.1186/s12887-023-04238-0 |
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