Author/Authors :
Almasian Tehrani ، Nasim Department of Microbiology and Microbial Biotechnology - Faculty of Life Sciences and Biotechnology, Pediatric Infections Research Center, Research Institute for Children’s Health - Shahid Beheshti University , Alebouyeh ، Masoud Pediatric Infections Research Center, Research Institute for Children’s Health - Shahid Beheshti University of Medical Sciences , Armin ، Shahnaz Pediatric Infections Research Center, Research Institute for Children’s Health - Shahid Beheshti University of Medical Sciences , Soleimani ، Neda Department of Microbiology and Microbial Biotechnology - Faculty of Life Sciences and Biotechnology - Shahid Beheshti University , Karimi ، Abdollah Pediatric Infections Research Center, Research Institute for Children’s Health - Shahid Beheshti University of Medical Sciences , Shamsian ، Bibishahin Pediatric Congenital Hematologic Disorders Research Center - Shahid Beheshti University of Medical Sciences , Nazari ، Shiva Pediatric Congenital Hematologic Disorders Research Center - Shahid Beheshti University of Medical Sciences , Azimi ، Leila Pediatric Infections Research Center, Research Institute for Children’s Health - Shahid Beheshti University of Medical Sciences
Abstract :
Hospital-acquired infection with carbapenem-resistant Enterobacteriaceae (CRE) is a global concern. The adminis-tration of antibiotics among the infected and non-infected immunocompromised children with SARS-CoV-2 is associated with an increased risk of intestinal CRE colonization and bacteremia during hospitalization. Objectives: The present study aimed to detect the correlation between the intestinal colonization of carbapenemase encoding Enterobacteriaceae with SARS-CoV-2 infection and antibiotic prescription among immunocompromised children admitted to the oncology and Bone Marrow Transplantation (BMT) wards. Methods: Stool samples were collected from the immunocompromised children, and the members of Enterobacteriaceae were iso-lated using standard microbiological laboratory methods. Carbapenem resistance isolates were initially characterized by the disc di usion method according to CLSI 2021 and further confirmed by the PCR assay. SARS-CoV-2 infection was also recorded according to documented real-time PCR results. Results: In this study, 102 Enterobacteriaceae isolates were collected from the stool samples. The isolates were from Escherichia spp.(59/102, 57.8%), Klebsiella spp. (34/102, 33.3%), Enterobacter spp. (5/102, 4.9%), Citrobacter spp. (2/102, 1.9%), and Serratia spp. (2/102, 1.9%). The carbapenem resistance phenotype was detected among 42.37%, 73.52%, 40%, 50%, and 100% of Escherichia spp., Klebsiella spp., Enterobacter spp., Citrobacter spp., and Serratia spp., respectively. Moreover, blaOXA-48 (49.1%) and blaNDM-1 (29.4%), as well as blaVIM (19.6%) and blaKPC (17.6%) were common in the CRE isolates. SARS-CoV-2 infection was detected in 50% of the participants; however, it was confirmed in 65.45% (36/55) of the intestinal CRE carriers. The administration of antibiotics, mainly broad-spectrum antibiotics, had a significant correlation with the CRE colonization in both the infected and non-infected children with SARS-CoV-2 infection. Conclusions: Regardless of the COVID-19 status, prolonged hospitalization and antibiotic prescription are major risk factors asso-ciated with the CRE intestinal colonization in immunocompromised children.
Keywords :
Children , Hospital , Acquired Infections , Carbapenem Resistant Enterobacteriaceae
