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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

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Abstract

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

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

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

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.

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Data availability

All relevant data are within the manuscript and its Supporting Information files.

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Acknowledgements

We thank the scientists and personnel of the Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran, for their collaboration.

Funding

This research did not receive any specific grant from funding agencies in public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Masoud Alebouyeh, Fariba Shirvani, Ghazale Ghandchi, Nafiseh Abdollahi, Zari Gholinejad, Fatemeh Fallah, Leila Azimi, Abdollah Karimi, Shahnaz Armin, Roxana Mansour Ghanaie, Sedigheh Rafiei Tabatabaei & Seyed Alireza Fahimzad

  2. Department of Microbiology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran

    Romina Hassanzadeh

  3. Department of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Taher Azimi

  4. Pediatric Intensivist, Assistant professor of SBMU, Mofid Children Hospital, Tehran, Iran

    Azita Behzad

  5. Pediatric Nurse of PICU, Shahid Beheshti University of Medical Sciences, Mofid Children Hospital, Tehran, Iran

    Zahra Sheikhi

Authors
  1. Masoud Alebouyeh
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Contributions

Fariba Shirvani, Masoud Alebouyeh, Fatemeh Fallah, Leila Azimi, and Abdollah Karimi: Conceptualization; Data curation; Formal analysis; and Writing – original draft. Fariba Shirvani, Romina Hassanzadeh, Ghazale Ghandchi, Shahnaz Armin, Seyed Alireza Fahimzad, Sedigheh Rafiei Tabatabaei, Zari Gholinejad: Conceptualization; Methodology; Project administration; and Writing – original draft. Azita Behzad, Taher Azimi, Nafiseh Abdollahi, Fariba Shirvani, Masoud Alebouyeh, Zahra Sheikhi, Fatemeh Fallah, and Roxana Mansour Ghanaie: Data curation; Formal analysis; Writing – original draft; and Writing – review & editing. Ghazale Ghandchi, Taher Azimi, Seyed Alireza Fahimzad, and Romina Hassanzadeh: Language editing.

Corresponding author

Correspondence to Fariba Shirvani.

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All of the authors declare that there are no commercial, personal, political, and any other potential conflicting interests related to the submitted manuscript.

Ethical approval

The study was approved by the Ethics Committee of the Pediatric Infectious Diseases Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran (IR. SBMU. RICH. REC. 1398.001).

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Alebouyeh, M., Shirvani, F., Hassanzadeh, R. et al. Intestinal colonization of vancomycin-resistant Enterococcus in children admitted to Mofid children’s hospital intensive care unit at admission and at discharge. Mol Biol Rep 50, 3271–3281 (2023). https://doi.org/10.1007/s11033-022-08196-1

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