Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern Iran
Background: Infections caused by antimicrobial-resistant bacteria are associated with increased mortality and health care costs. Enterococci have been recognized as a clinically important pathogen in hospitalized patients. Vancomycin-resistant enterococci (VRE) infections cause significant morbidity...
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| Format: | Article |
| Language: | English |
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Shiraz University of Medical Sciences
2016-10-01
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| Series: | International Journal of Organ Transplantation Medicine |
| Subjects: | |
| Online Access: | http://www.ijotm.com/ojs/index.php/IJOTM/article/view/291 |
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| author | M Kaveh A Bazargani M Ramzi H Sedigh Ebrahim-Saraie H Heidari |
| author_facet | M Kaveh A Bazargani M Ramzi H Sedigh Ebrahim-Saraie H Heidari |
| author_sort | M Kaveh |
| collection | DOAJ |
| description | Background: Infections caused by antimicrobial-resistant bacteria are associated with increased mortality and health care costs. Enterococci have been recognized as a clinically important pathogen in hospitalized patients. Vancomycin-resistant enterococci (VRE) infections cause significant morbidity and mortality among patients undergoing transplantation.
Objective: To identify epidemiology of VRE colonization and related risk factors among patients with hematological malignancies after hematopoietic stem cell transplantation (HSCT).
Methods: This cross-sectional study was performed on 42 patients who underwent bone-marrow transplantation between July 2013 and March 2014. A stool sample was taken from each patient 3–5 days after transplantation and cultured on appropriate media. Suspected colonies of enterococci were detected to species level by their culture characteristics, biochemical reactions and molecular features. VRE were confirmed via phenotypic and genotypic methods.
Results: VRE were detected in 14 (33%) of studied samples. 10 (71%) of the detected VRE isolates were identified as high level vancomycin-resistant E. faecium with minimum inhibitory concentration (MIC) of ≥256 μg/mL of vancomycin; 3 isolates were E. galinarum and 1 was E. casseliflavus with an MIC of 8–16 μg/mL. VanA was dominant phenotype and all VRE isolates with high-level of vancomycin resistance had vanA gene. VRE isolation was mostly observed in patients with acute lymphoblastic leukemia (ALL) than other diseases. Moreover, antibiotic prophylaxis and hospitalization were independent risk factors for acquisition of VRE after transplantation.
Conclusion: We found high level of vancomycin-resistance in E. faecium isolates obtained from HSCT patients. The vancomycin-resistant isolates of E. faecium had vanA and/or simultaneously vanB genes. |
| first_indexed | 2024-12-10T08:11:50Z |
| format | Article |
| id | doaj.art-f73dbe09479245e2bbfbe03067dbfc1e |
| institution | Directory Open Access Journal |
| issn | 2008-6482 2008-6490 |
| language | English |
| last_indexed | 2024-12-10T08:11:50Z |
| publishDate | 2016-10-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | International Journal of Organ Transplantation Medicine |
| spelling | doaj.art-f73dbe09479245e2bbfbe03067dbfc1e2022-12-22T01:56:34ZengShiraz University of Medical SciencesInternational Journal of Organ Transplantation Medicine2008-64822008-64902016-10-0174225Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern IranM Kaveh0A Bazargani1M Ramzi2H Sedigh Ebrahim-Saraie3H Heidari4Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranHematology Research Center, Department of Hematology-Oncology and Stem Cell Transplantation, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranBackground: Infections caused by antimicrobial-resistant bacteria are associated with increased mortality and health care costs. Enterococci have been recognized as a clinically important pathogen in hospitalized patients. Vancomycin-resistant enterococci (VRE) infections cause significant morbidity and mortality among patients undergoing transplantation. Objective: To identify epidemiology of VRE colonization and related risk factors among patients with hematological malignancies after hematopoietic stem cell transplantation (HSCT). Methods: This cross-sectional study was performed on 42 patients who underwent bone-marrow transplantation between July 2013 and March 2014. A stool sample was taken from each patient 3–5 days after transplantation and cultured on appropriate media. Suspected colonies of enterococci were detected to species level by their culture characteristics, biochemical reactions and molecular features. VRE were confirmed via phenotypic and genotypic methods. Results: VRE were detected in 14 (33%) of studied samples. 10 (71%) of the detected VRE isolates were identified as high level vancomycin-resistant E. faecium with minimum inhibitory concentration (MIC) of ≥256 μg/mL of vancomycin; 3 isolates were E. galinarum and 1 was E. casseliflavus with an MIC of 8–16 μg/mL. VanA was dominant phenotype and all VRE isolates with high-level of vancomycin resistance had vanA gene. VRE isolation was mostly observed in patients with acute lymphoblastic leukemia (ALL) than other diseases. Moreover, antibiotic prophylaxis and hospitalization were independent risk factors for acquisition of VRE after transplantation. Conclusion: We found high level of vancomycin-resistance in E. faecium isolates obtained from HSCT patients. The vancomycin-resistant isolates of E. faecium had vanA and/or simultaneously vanB genes.http://www.ijotm.com/ojs/index.php/IJOTM/article/view/291EnterococcusVancomycinRisk factorsColonizationStem cell transplant |
| spellingShingle | M Kaveh A Bazargani M Ramzi H Sedigh Ebrahim-Saraie H Heidari Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern Iran International Journal of Organ Transplantation Medicine Enterococcus Vancomycin Risk factors Colonization Stem cell transplant |
| title | Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern Iran |
| title_full | Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern Iran |
| title_fullStr | Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern Iran |
| title_full_unstemmed | Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern Iran |
| title_short | Colonization Rate and Risk Factors of Vancomycin- Resistant Enterococci among Patients Received Hematopoietic Stem Cell Transplantation in Shiraz, Southern Iran |
| title_sort | colonization rate and risk factors of vancomycin resistant enterococci among patients received hematopoietic stem cell transplantation in shiraz southern iran |
| topic | Enterococcus Vancomycin Risk factors Colonization Stem cell transplant |
| url | http://www.ijotm.com/ojs/index.php/IJOTM/article/view/291 |
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