Clinical and microbiological profile of Enterococcus faecium infections in Mexican pediatric patients of a third-level hospital.

This study analyzed the prevalence and antimicrobial resistance patterns of Enterococcus faecium (Efm) infections within a tertiary pediatric hospital in Mexico, highlighting the critical need to understand the epidemiology of this opportunistic pathogen in vulnerable pediatric populations. The primary objective is to elucidate the current landscape of Efm infections in children, including prevalent resistance profiles, which will enable the development of efficient control strategies and optimize empirical treatment regimens. A retrospective analysis of clinical isolates of Efm collected over 7 years (2018-2024) was conducted, encompassing detailed microbiological data, including species identification, antimicrobial susceptibility testing, and patient demographics. Antimicrobial susceptibility testing was performed using the VITEK 2 automated system and interpreted according to CLSI guidelines. Also, the isolates were typified using RAPD. This study's results revealed a significant prevalence of Efm infections among hospitalized children, particularly those in intensive care units and oncology wards. Many isolates were resistant to multiple antibiotics, including vancomycin, aminoglycosides, and beta-lactams, posing significant therapeutic challenges. Finally, the isolates could be grouped into five RAPD types, supporting the idea that the strains have a genetic relationship. This study demonstrates the impact of Efm infections on the pediatric population in a third-level hospital. The high incidence of XDR strains (85%), although only 40% of the isolates are vancomycin-resistant, exposes a serious menace that Efm represents. Additionally, the correlation identified between certain antibiotic resistance patterns may be important for empirical treatment.