Nikmanesh Bahram, Yazdansetad Sajjad, Konkori Mona, Sadredinamin Mehrzad, Ghalavand Zohreh, Nojookambari Neda Yousefi
Department of Medical Laboratory Sciences School of Allied Medical Sciences Tehran University of Medical Sciences, Tehran, Iran.
Department of Biology Faculty of Basic Sciences Imam Hossein Comprehensive University, Tehran, Iran.
Can J Infect Dis Med Microbiol. 2024 Jul 30;2024:5529598. doi: 10.1155/2024/5529598. eCollection 2024.
In this study, attempts were made to evaluate the frequency of high-level gentamicin-resistant (HLGR) and vancomycin-resistant enterococci (VRE) and the prevalence and antibiotic resistance profile of enterococcal species isolated from pediatric patients referred to Children's Medical Center Hospital, Tehran, over five years.
A total of 404 enterococcal isolates from different patients referred to the Children's Medical Center between March 2016 and March 2021 were included in this cross-sectional study. Antimicrobial susceptibility testing was performed using standard methods according to the guidelines of the Clinical Laboratories Standards Institute (CLSI).
Approximately one-third of the enterococcal strains were isolated from urology and intensive care units. 17.3% of the isolates were obtained from outpatient sources. However, 82.7% of the isolates were sourced from inpatient settings. We found that the rates of resistance to ampicillin, penicillin, and vancomycin were twice as high in inpatients as in outpatients. Of the total isolates, 87.4% and 49.3% were identified as HLGR and VRE, respectively. In addition, we identified 2% of the VRE isolates that were not susceptible to linezolid. Nitrofurantoin showed excellent activity against enterococcal isolates in the urine, with a susceptibility rate of 92.5%.
The present study reports the highest range of VRE isolated from pediatric patients in Iran. Despite the predominance of HLGR enterococci in our region, vancomycin remains effective against such strains. This study is among the few to demonstrate the incidence of linezolid-insensitive VRE in pediatric patients. Therefore, it is important to evaluate effective infection control measures to prevent linezolid and vancomycin resistance in enterococci.
在本研究中，我们试图评估高水平庆大霉素耐药（HLGR）和耐万古霉素肠球菌（VRE）的频率，以及在五年期间转诊至德黑兰儿童医学中心医院的儿科患者中分离出的肠球菌种类的流行情况和抗生素耐药谱。
本横断面研究纳入了2016年3月至2021年3月期间转诊至儿童医学中心的不同患者的404株肠球菌分离株。根据临床实验室标准协会（CLSI）的指南，采用标准方法进行抗菌药物敏感性测试。
约三分之一的肠球菌菌株分离自泌尿外科和重症监护病房。17.3%的分离株来自门诊患者。然而，82.7%的分离株来自住院患者。我们发现住院患者对氨苄西林、青霉素和万古霉素的耐药率是门诊患者的两倍。在所有分离株中，分别有87.4%和49.3%被鉴定为HLGR和VRE。此外，我们鉴定出2%的VRE分离株对利奈唑胺不敏感。呋喃妥因对尿液中的肠球菌分离株显示出优异的活性，敏感率为92.5%。
本研究报告了伊朗儿科患者中分离出的VRE的最高范围。尽管我们地区HLGR肠球菌占主导地位，但万古霉素对此类菌株仍然有效。本研究是少数证明儿科患者中利奈唑胺不敏感VRE发生率的研究之一。因此，评估有效的感染控制措施以预防肠球菌对利奈唑胺和万古霉素的耐药性很重要。
