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Prevalence and Resistance Profiles of Pediatric Enterococcal Isolates: A Five-Year Update from Children's Medical

Bahram Nikmanesh1, Sajjad Yazdansetad2, Mona Konkori3

  • 1Department of Medical Laboratory Sciences School of Allied Medical Sciences Tehran University of Medical Sciences, Tehran, Iran.

The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Medicale
|August 7, 2024
PubMed

Insights

This study found high rates of high-level gentamicin-resistant (HLGR) and vancomycin-resistant enterococci (VRE) in pediatric patients in Tehran. Vancomycin remains effective, but linezolid-resistant VRE emerged, necessitating infection control.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatric Medicine

Background:

  • Enterococci are significant nosocomial pathogens, particularly in pediatric populations.
  • High-level gentamicin resistance (HLGR) and vancomycin resistance (VRE) are growing concerns globally.
  • Understanding the prevalence and resistance profiles of enterococci is crucial for effective treatment and infection control.

Purpose of the Study:

  • To determine the frequency of HLGR and VRE in pediatric patients.
  • To analyze the antibiotic resistance patterns of enterococcal species.
  • To investigate the prevalence of linezolid-resistant VRE in this population.

Main Methods:

  • A cross-sectional study involving 404 enterococcal isolates from pediatric patients over five years (March 2016-March 2021).
  • Antimicrobial susceptibility testing performed using standard Clinical Laboratories Standards Institute (CLSI) guidelines.
  • Isolates were analyzed for resistance to gentamicin, vancomycin, ampicillin, penicillin, and linezolid.

Main Results:

  • 87.4% of isolates were high-level gentamicin-resistant (HLGR), and 49.3% were vancomycin-resistant enterococci (VRE).
  • Inpatient isolates showed twice the resistance rates to ampicillin, penicillin, and vancomycin compared to outpatients.
  • 2% of VRE isolates were not susceptible to linezolid; nitrofurantoin demonstrated high activity (92.5% susceptibility) in urine isolates.

Conclusions:

  • This study reports the highest range of VRE in Iranian pediatric patients.
  • Despite HLGR predominance, vancomycin remains effective against these strains, but linezolid-resistant VRE is a significant finding.
  • Effective infection control measures are vital to prevent the spread of vancomycin and linezolid resistance in enterococci.
Abstract

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