Alebouyeh Masoud, Shirvani Fariba, Hassanzadeh Romina, Azimi Taher, Ghandchi Ghazale, Abdollahi Nafiseh, Gholinejad Zari, Behzad Azita, Sheikhi Zahra, Fallah Fatemeh, Azimi Leila, Karimi Abdollah, Armin Shahnaz, Ghanaie Roxana Mansour, Tabatabaei Sedigheh Rafiei, Fahimzad Seyed Alireza
Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Microbiology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran.
Mol Biol Rep. 2023 Apr;50(4):3271-3281. doi: 10.1007/s11033-022-08196-1. Epub 2023 Jan 30.
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.
本研究旨在调查伊朗德黑兰莫菲德儿童医院重症监护病房（ICU）入院时和出院时携带vanA和vanB基因的耐万古霉素肠球菌（VRE）在患者肠道定植的频率。
采用直肠拭子进行采样，并使用E-test试剂盒在Muller Hinton琼脂（MHA）培养基上通过最低抑菌浓度（MIC）测定法对肠球菌属进行万古霉素敏感性测试。使用vanA和vanB耐药基因通过PCR方法对VRE分离株进行分子检测。
分别从ICU入院患者和ICU出院患者中收集了234份和186份无重复的直肠拭子样本。从ICU入院患者的直肠拭子样本中检测到肠球菌属的比例为34.6%（n = 81/234），其中44.4%（n = 36/81）为VRE分离株。相比之下，ICU出院患者中肠球菌属和VRE分离株的患病率分别为17.7%（n = 33/186）和57.6%（n = 19/33）。从ICU入院患者中分离出的19株VRE中，分别有4株（21%）和1株（5.3%）含有vanA和vanB基因。相比之下，从ICU出院患者中分离出的36株VRE中，11株（30.5%）的vanA基因呈阳性。
结果显示，ICU入院患者中肠球菌属的患病率较高。然而，VRE经常从在ICU住院数天的患者中分离出来。实施适当的感染控制策略以及使用合适的方案来指导抗生素的合理处方是必要的。
