Colonisation of vancomycin-resistant Enterococci in paediatric unit of a teaching hospital in Turkey
Abstract number: p1345
Guducuoglu H., Aktas E., Begendik Comert F., Aygul K., Ozlu N., Baykal S.
Upon a first time isolation of VRE from a urine sample of a 8 month-baby followed by another sample of a 5 month-baby, we decided to perform a VRE screening in our paediatric unit. After screening, isolated VRE strains were investigated by molecular methods to detect the resistance genotypes and possible clonal relatedness.
For this reason 88 samples (rectal swabs, skin of patients, surroundings of beds, hands of patients' mothers, staff, washbowl, stethoscope, and different environmental samples) were collected from Paediatric Unit of our hospital. The identification was performed by conventional methods and confirmed by PhoenixTM NMIC/ID, Becton Dickinson, USA kits. Vancomycin resistance genotypes were determined by PCR using VanA and VanB primers. Pulsed-field gel electrophoresis (PFGE) was used to evaluate the molecular relatedness of VRE isolates.
12 VRE strains were isolated from screening samples (8 of them were from rectal swabs, 3 of them were from surroundings of the beds and one of them was from skin of a patient). All of the isolates were identified as Enterococcusfaecium. The isolated VRE strains were tested against vancomycin, teicoplanin, ampicillin, linezolid by disc diffusion method and also with PhoenixTM NMIC/ID panels. All of the strains were resistant to vancomycin, teicoplanin, ampicillin and were susceptible to linezolid by both methods. All the strains were found to be VanA genotype by PCR. According to PFGE band profiles, 2 different major PFGE band patterns (A, B) were detected. Five of the 14 isolates belonged to PFGE pattern A while 7 belonged to PFGE pattern B. There was one isolate closely related with PFGE pattern A (A1) and one isolate closely related with PFGE pattern B (B1).
After a first time isolation of VRE in our laboratory, the isolated VRE strains from the screening were important because of being the first isolation in our hospital and rarely reported incidence in our country. The detection of two major clones of VRE showed a nosocomial transmission according to contamination. Early detection of patients colonized or infected with VRE by performing survelliance cultures is an essential component of any hospital programme designed to prevent nosocomial transmission of VRE. We gave advices for the eradication of VRE to the paediatric unit like the rational use of antibiotics, education of the employees and taking serious preventions on controlling VRE colonisation.
|Session name:||XXIst ISTH Congress|
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