Antimicrobial Resistance Patterns of the Gram-positive Bacteria Isolated from Children with Bloodstream Infection in an Iranian Referral Hospital: A 6-year Study

Pourakbari, Babak; Mahmoudi, Shima; Moradzadeh, Mina; Mahzari, Masoumeh; Ashtiani, Mohammad Taghi Haghi; Tanzifi, Parin; Mamishi, Setareh

doi:10.2174/1871526517666170821164343

Cited by 12 publications

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“…According to several studies, the controlled consumption of antibiotics in patients suffering from bacterial infections leads to improved microorganism susceptibility, and the emergence of resistant strains are rarely observed 3,4. Among the Gram-positive bacteria, vancomycin-resistant Staphylococcus aureus (VRSA), vancomycin-resistant Enterococcus (VRE), methicillin-resistant S. aureus (MRSA) and beta-lactamase-resistant Streptococcus are considered the most important groups in terms of antibiotic resistance 5,6. Due to their importance, antibiotic consumption policies should be taken and implemented in the agenda of the infection control committees of hospitals 7.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance And Genotyping Of Gram-Positive Bacteria Causing Hospital-Acquired Infection In Patients Referring To Children’s Medical Center

Mamishi¹,

Mohammadian²,

Pourakbari³

et al. 2019

IDR

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IntroductionA serious problem affecting human society is the development of bacterial resistance. The purpose of the current study was to evaluate the antibiotic resistance of Gram-positive bacteria (GPB) and genotyping of common GPB causing hospital-acquired infections (HAIs) in patients who were referred to Children’s Medical Center during a 6-month period by random amplified polymorphic DNA (RAPD) and enterobacterial repetitive intergenic consensus sequence polymerase chain reaction (ERIC-PCR).MethodsDuring the 6-month period, antimicrobial resistance profiles of GPB isolates recovered from patients in Children’s Medical Center were determined using the Kirby–Bauer disk diffusion and MIC. Typing of common GPB was performed and the results were analyzed by gel compare software.ResultsIn this cross-sectional study, 6524 cultures were performed and 138 Ggram-positive bacteria were isolated (2%). Staphylococcus aureus strains showed the highest antibiotic penicillin resistance (96.3%). Twenty-six per cent of the strains were methicillin-resistant S. aureus (MRSA) and no resistance was found against vancomycin. All isolates of Enterococcus faecium were resistant to ciprofloxacin (100%). The resistance to vancomycin was very high (67%) and no resistance was observed to linezolid. The results of genotyping analysis of S. epidermidis strains showed the presence of two clones with a genetic relationship of over 80%. All of the S. aureus strains were in one cluster and half of the E. faecium strains were in a cluster with a genetic predilection of over 80%.ConclusionThis study indicated frequent occurrence of antimicrobial resistance, especially in Enterococcus spp. isolates. Rapid spreads of MRSA and VREF from a clonal origin require implementing careful isolation and infection control measures.

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Section: Introductionmentioning

confidence: 99%

Antibiotic Resistance And Genotyping Of Gram-Positive Bacteria Causing Hospital-Acquired Infection In Patients Referring To Children’s Medical Center

Mamishi¹,

Mohammadian²,

Pourakbari³

et al. 2019

IDR

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“…Twenty-three percent of E. faecium strains (n=3) showed resistance to vancomycin, which was lower than our previous reports. 15,16 Out of 203 strains isolated, 62 strains had nosocomial infection criteria which were: 18 E. coli, 13 K. pneumoniae, 11 E. faecium, and five B. cepacia complex. Molecular typing and phylogenetic analysis of these 62 isolates causing hospital-acquired infection revealed that E. coli strains were divided into three clusters with 70% genetic similarity ( Figure 1A).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-three percent of E. faecium strains (n=3) showed resistance to vancomycin, which was lower than our previous reports. 15 , 16 …”

Section: Resultsmentioning

confidence: 99%

Antimicrobial Resistance and Genotyping of Bacteria Isolated from Urinary Tract Infection in Children in an Iranian Referral Hospital

Mamishi¹,

Shalchi²,

Mahmoudi³

et al. 2020

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Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood, and the increasing rate of antibiotic resistance to the commonly prescribed antimicrobial agents against it has become a major concern. The aim of this study was to determine the antibiotic resistance and genotyping of bacteria isolated from urine cultures in patients referred to the Children's Medical Center, Tehran, Iran. Methods: During the 1-year period, antimicrobial susceptibility profiles of strains isolated from patients with UTI were determined. Typing of the isolates causing nosocomial infections was performed by random amplified polymorphic DNA (RAPD) analysis, and the results were analyzed by Gelcompar II software. Results: In this study, 203 children (130 girls and 73 boys) were included. The patients' age ranged from 1 day to 16 years (IQR average=4 months to 4 years). The most frequent isolated organisms were Escherichia coli (118 isolates, 58%), followed by Klebsiella pneumoniae (30 isolates, 15%). Sixty-two strains (18 strains of E. coli, 13 strains of K. pneumoniae, 11 strains of Enterococcus faecium, and five strains of Burkholderia cepacia complex) had criteria of nosocomial infection. A high resistance rate to trimethoprim-sulfamethoxazole (69%) and cefotaxime (60%) was reported in E. coli and K. pneumoniae strains, respectively. Pseudomonas aeruginosa strains showed high sensitivity to amikacin (100%). All E. faecium strains were susceptible to trimethoprim-sulfamethoxazole (100%), and 23% of the strains were resistant to vancomycin. The analysis of RAPD-typing revealed the presence of three clusters in E. coli, two clusters in E. faecium, and one clone in K. pneumoniae. Besides, four out of five isolates of B. cepacia complex had more than 90% genetic similarity. Conclusion: The most frequent isolated pathogen was E. coli, and an increasing rate of antibiotic resistance to the commonly prescribed antimicrobial agents such as trimethoprim/ sulfamethoxazole and cephalosporins was observed. Moreover, the results of this study showed the presence of clones with ≥80% similarity in E. coli, K. pneumoniae, E. faecium, and B. cepacia complex isolates; therefore, the transmission of nosocomial infections from one patient to another or one ward to another is probable.

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“…This is similar to other reports of blood culture isolates in pediatric centers and NICUs, which report a nosocomial incidence of S epidermidis bacteremia in neonates. 11,12 Although S epidermidis is often considered a contaminant, our pediatric rates of contamination of blood cultures are monitored and tracked by the infection prevention department. Because our rates are known to be low, we anticipate that this is an accurate portrayal of causes of infection in our pediatric hospitals.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Risk Factors for Bacteremia in Pediatric and Adolescent Patients

Stover

Morrison

Collier

et al. 2019

Journal of Pharmacy Practice

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Background: Epidemiology and risk factors for bacteremia in pediatric and adolescent patients have not been fully elucidated. Objective: The purpose of this study was to identify primary causative agents of bacteremia in pediatric and adolescent patients and associated risk factors. We hypothesized that these would be different than those seen in adults. Patients and Methods: This retrospective cohort, epidemiologic evaluation included patients admitted to a tertiary referral center from January 01, 2013, to December 31, 2015. Patients <18 years old with a confirmed positive blood culture were included; the first positive culture per organism per patient was analyzed. The primary outcome was to determine the most frequent causative organisms of bacteremia; the secondary outcome was an evaluation of risk factors for acquiring staphylococcal bacteremia. Results: A total of 913 isolates were evaluated, including 92 unique organisms. The most frequently identified were Staphylococcus epidermidis (238/913, 26.1%), followed by Staphylococcus aureus (136/913, 14.9%). Methicillin resistance was observed in 60.3% of S aureus. Two hundred thirty-six patients were included in the risk factor analysis. Prematurity, previous antibiotics, and intubation/ventilation were more likely associated with S epidermidis ( P < .001, P < .001, and P = .032, respectively). Patients with a recent or previous hospitalization and those with dermatitis/eczema were statistically more likely to grow S aureus ( P < .001, P = .029, respectively). Conclusions: Although epidemiology of organisms associated with pediatric and adolescent bacteremia was similar to adults, risk factors were different than seen in that population. Further understanding of these risk factors may be helpful in developing preemptive infection control strategies in patients at risk.

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Antimicrobial Resistance Patterns of the Gram-positive Bacteria Isolated from Children with Bloodstream Infection in an Iranian Referral Hospital: A 6-year Study

Abstract: Our results emphasize the importance of a valuable guide in identifying resistance trends and selecting appropriate antibiotic.

Cited by 12 publications

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<p>Antibiotic Resistance And Genotyping Of Gram-Positive Bacteria Causing Hospital-Acquired Infection In Patients Referring To Children’s Medical Center</p>

<p>Antibiotic Resistance And Genotyping Of Gram-Positive Bacteria Causing Hospital-Acquired Infection In Patients Referring To Children’s Medical Center</p>

<p>Antimicrobial Resistance and Genotyping of Bacteria Isolated from Urinary Tract Infection in Children in an Iranian Referral Hospital</p>

Epidemiology and Risk Factors for Bacteremia in Pediatric and Adolescent Patients

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