Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children
Abstract
Objective: The aim of this study was to investigate the carbapenem resistance profiles and risk factors for colonization with carbapenem-resistant Bacteroides group CR-B in pediatric patients hospitalized in a tertiary university hospital in Turkey.Material and Methods: A prospective case-control study was performed. Rectal swab specimens n=1361 were collected from 680 hospitalized pediatric patients. All anaerobic colonies isolated from selective medium were identified using MALDI-TOF Vitek MS, bioMérieux automated system and antibiotic susceptibility testing for meropenem by e-test. The presence of the cfiA gene was investigated by PCR method.Results: A total of 1361 rectal swab specimens were collected from all 680 hospitalized children. During the screening period 80 Bacteroides fragilis group BFG microorganisms with a MIC>0.125 mg/L 12% were isolated from rectal swab specimens of 680 patients. Seven different BFG species were recovered, the main species were B.fragilis n=29; 36% , B.ovatus n=16; 20% , B.vulgatus n=13; 16% , P.distasonis n=12; 15% , B.theoiotomicron n=5; 6% , B.uniformis n=4; 5% and B.caccae n=1; 1% . The presence of cfiA gene was detected in 25 31% isolates, while 29 36% isolates were not susceptible to meropenem MIC>2 mg/L . Conclusion: The high carriage rate in our hospitalized children for carbapenem-non-susceptible Bacteroides fragilis group creates a great risk for serious infections and mortality and deserves significant attention
References
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- https://doi.org/10.1128/CMR.00008-07
- Snydman dr, Jacobus nV, mcdermott lA, et al. Lessons learned from the anaerobe survey: historical perspective and review of the most recent data (2005- 2007). Clin Infect Dis 2010;50:26-33.
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- liu cy, huang yt, liao ch, yen lc, lin hy, Hsueh pR. Increasing trends in antimicrobial resis- tance among clinically important anaerobes and Bacteroides fragilis isolates causing nosocomial infec- tions: emerging resistance to carbapenems. Antimicrob Agents Chemother 2008;52:3161-8.
- https://doi.org/10.1128/AAC.00355-08
- Goldstein eJ. Anaerobic bacteremia. Clin Infect Dis 1996; 23:97-101.
- https://doi.org/10.1093/clinids/23.Supplement_1.S97
- Khushi payne tdJ, fosberry A, reading c. Production of metal dependent b-lactamases by clinical strains of Bacteroides fragilis isolated before 1987. J Antimicrob Chemother 1996;37:345-50.
- https://doi.org/10.1093/jac/37.2.345
- The European Committee on Antimicrobial Susceptibility Testing (EUCAST). http://www.eucast. org/fileadmin/src/media/EUCASTfiles/Resistance_ mechanisms/EUCASTdetection_of_resistance_mecha- nisms_v1.0_20131211.pdf
- Kato n, yamazoe K, han cG, ohtsubo e. New insertion sequence elements in the upstream region of cfiA in imipenem-resistant Bacteroides fragilis strains. Antimicrob Agents Chemother 2003;47:979-85.
- https://doi.org/10.1128/AAC.47.3.979-985.2003
- nguyen mh, yu Vl, morris AJ, et al. Antimicrobial resistance and clinical outcome of Bacteroides bacter- emia: findings of a multicenter prospective observa- tional trial. Clin Infect Dis 2000;30:870-6.
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- fernández-canigia l, litterio m, legaria mc, et al. Anaerobe Surveillance Team. First national survey of antibiotic susceptibility of the Bacteroides fragilis group: emerging resistance to carbapenems in Argentina. Antimicrob Agents Chemother 2012;56:1309-14.
- https://doi.org/10.1128/AAC.05622-11
- podglajen I, Breuil J, casin I, collatz e. Genotypic identification of two groups within the species Bacteroides fragilis by ribotyping and by analysis of PCR-generated fragment patterns and insertion sequence content. J Bacteriol 1995;177:5270-5.
- https://doi.org/10.1128/jb.177.18.5270-5275.1995
- Soki J, urban e, Szoke I, fodor e, nagy e. Prevalence of the carbapenemase gene (cfiA) among clinical and normal flora isolates of Bacteroides species in Hungary. J Med Microbiol 2000;49:427-30.
- https://doi.org/10.1099/0022-1317-49-5-427
- edwards r, hawkyard cV, Garvey mt, Greenwood d. Prevalence and degree of expression of the carbap- enemase gene (cfiA) among clinical isolates of Bacteroides fragilis in Nottingham, UK. J Antimicrob Chemother 1999;43:273-6.
- https://doi.org/10.1093/jac/43.2.273
- toprak nu, uzunkaya od, Sóki J, Soyletir G. Susceptibility profiles and resistance genes for carbap- enems (cfiA) and metronidazole (nim) among Bacteroides species in a Turkish University Hospital. Anaerobe 2012;18:169-71.
- https://doi.org/10.1016/j.anaerobe.2011.10.004
- livermore dm, Woodford n. Carbapenemases: a problem in waiting? Curr Opin Microbiol 2000;3:489- 95.
- https://doi.org/10.1016/S1369-5274(00)00128-4
Hastanede Yatan Çocukların Rektal Sürüntülerinde Karbapenem Duyarlı Olmayan Bacteroides fragilis Grup Bakteri Taraması
Abstract
Amaç: Bu çalışmanın amacı, Türkiye’de üçüncü düzey bir üniversite hastanesinde yatmakta olan çocuk hastalarda karbapenem dirençli Bacteroides grup KD-B bakteriler ile kolonizasyon için risk faktörlerini ve karbapenem direnç profilini araştırmaktı.Gereç ve Yöntem: Prospektif vaka-kontrol çalışması uygulandı. Hastanede yatmakta olan 680 çocuk hastadan 1361 rektal swab toplandı. Selektif mediumdan izole edilen tüm anaerobik kolonilere identifikasyon için MALDI-TOF Vitek MS, bioMérieux otomatize sistem ve meropenem duyarlılığı için e-test uygulandı. cfiA geni PCR yöntemiyle araştırıldı.Bulgular: Hastanede yatmakta olan 680 çocuk hastadan 1361 rektal swab toplandı. Tarama süresince MIC>0.125 mg/L olan 80 Bacteroides fragilis group BFG bakteri izole edildi. Yedi farklı tür BFG saptandı, sıklık sırasına göre şöyleydi: B.fragilis n=29; %36 , B.ovatus n=16; %20 , B.vulgatus n=13; %16 , P.distasonis n=12; %15 , B.theoiotomicron n=5; %6 , B.uniformis n=4; %5 ve B.caccae n=1; %1 . 25 izolatda %31 cfiA geni saptanırken, meropeneme hassas olmama MIC>2 mg/L 29 izolatda %36 belirlendi.Sonuç: Çalışmamızda, hastanede yatan çocuklarda karbapenem hassas olmayan Bacteroides fragilis grup bakteriler ile kolonizasyon oranları yüksek bulunmuştur ki, bu durum ciddi enfeksiyonların oluşması, artmış mortalite açısından önemlidir ve dikkate alınmalıdır
References
- Wexler hm. Bacteroides: the good, the bad, and the nitty-gritty. Clin Microbiol Rev 2007;20:593-621.
- https://doi.org/10.1128/CMR.00008-07
- Snydman dr, Jacobus nV, mcdermott lA, et al. Lessons learned from the anaerobe survey: historical perspective and review of the most recent data (2005- 2007). Clin Infect Dis 2010;50:26-33.
- https://doi.org/10.1086/647940
- Goldstein eJ, finegold Sm, harrell lJ, et al. National survey on the susceptibility of Bacteroides fragilis group: report and analysis of trends in the United States from 1997 to 2004. Antimicrob Agents Chemother 2007;51:1649-55.
- https://doi.org/10.1128/AAC.01435-06
- Nagy E, Urbán E, Nord CE, et al. Antimicrobial sus- ceptibility of Bacteroides fragilis group isolates in Europe: 20 years of experience. Clin Microbiol Infect 2011;17:371-9.
- https://doi.org/10.1111/j.1469-0691.2010.03256.x
- liu cy, huang yt, liao ch, yen lc, lin hy, Hsueh pR. Increasing trends in antimicrobial resis- tance among clinically important anaerobes and Bacteroides fragilis isolates causing nosocomial infec- tions: emerging resistance to carbapenems. Antimicrob Agents Chemother 2008;52:3161-8.
- https://doi.org/10.1128/AAC.00355-08
- Goldstein eJ. Anaerobic bacteremia. Clin Infect Dis 1996; 23:97-101.
- https://doi.org/10.1093/clinids/23.Supplement_1.S97
- Khushi payne tdJ, fosberry A, reading c. Production of metal dependent b-lactamases by clinical strains of Bacteroides fragilis isolated before 1987. J Antimicrob Chemother 1996;37:345-50.
- https://doi.org/10.1093/jac/37.2.345
- The European Committee on Antimicrobial Susceptibility Testing (EUCAST). http://www.eucast. org/fileadmin/src/media/EUCASTfiles/Resistance_ mechanisms/EUCASTdetection_of_resistance_mecha- nisms_v1.0_20131211.pdf
- Kato n, yamazoe K, han cG, ohtsubo e. New insertion sequence elements in the upstream region of cfiA in imipenem-resistant Bacteroides fragilis strains. Antimicrob Agents Chemother 2003;47:979-85.
- https://doi.org/10.1128/AAC.47.3.979-985.2003
- nguyen mh, yu Vl, morris AJ, et al. Antimicrobial resistance and clinical outcome of Bacteroides bacter- emia: findings of a multicenter prospective observa- tional trial. Clin Infect Dis 2000;30:870-6.
- https://doi.org/10.1086/313805
- fernández-canigia l, litterio m, legaria mc, et al. Anaerobe Surveillance Team. First national survey of antibiotic susceptibility of the Bacteroides fragilis group: emerging resistance to carbapenems in Argentina. Antimicrob Agents Chemother 2012;56:1309-14.
- https://doi.org/10.1128/AAC.05622-11
- podglajen I, Breuil J, casin I, collatz e. Genotypic identification of two groups within the species Bacteroides fragilis by ribotyping and by analysis of PCR-generated fragment patterns and insertion sequence content. J Bacteriol 1995;177:5270-5.
- https://doi.org/10.1128/jb.177.18.5270-5275.1995
- Soki J, urban e, Szoke I, fodor e, nagy e. Prevalence of the carbapenemase gene (cfiA) among clinical and normal flora isolates of Bacteroides species in Hungary. J Med Microbiol 2000;49:427-30.
- https://doi.org/10.1099/0022-1317-49-5-427
- edwards r, hawkyard cV, Garvey mt, Greenwood d. Prevalence and degree of expression of the carbap- enemase gene (cfiA) among clinical isolates of Bacteroides fragilis in Nottingham, UK. J Antimicrob Chemother 1999;43:273-6.
- https://doi.org/10.1093/jac/43.2.273
- toprak nu, uzunkaya od, Sóki J, Soyletir G. Susceptibility profiles and resistance genes for carbap- enems (cfiA) and metronidazole (nim) among Bacteroides species in a Turkish University Hospital. Anaerobe 2012;18:169-71.
- https://doi.org/10.1016/j.anaerobe.2011.10.004
- livermore dm, Woodford n. Carbapenemases: a problem in waiting? Curr Opin Microbiol 2000;3:489- 95.
- https://doi.org/10.1016/S1369-5274(00)00128-4
Details
| Primary Language | English |
|---|---|
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 1, 2017 |
| Published in Issue | Year 2017 |