Alteration of Enterobacteriaceae microbial composition, drug resistance pattern and resistance spectrum to broad-spectrum beta-lactams in pediatric gastrointestinal tract during hospitalization

Background and Aim : Infections caused by extended-spectrum β-lactamase (ESBLs)-producing organisms have been described as an emerging worldwide public health problem. Transmission of these pathogens from the community to hospitals and vice versa is considered as a public health threat. Although secondary infections from the hospital environment is critical for patients, administration of antibiotics in hospital settings is considered as an important risk factor for selection and enrichment of ESBLs-producing bacteria.Methods : In this study, ۷۸ pairs of fecal samples from hospitalized children in PICU ward were examined in two different time periods, <۴۸ hours and ۳-۵ days after hospitalization in Mofid Children's hospital. Bacterial isolates were identified by standard diagnostic and biochemical methods and antimicrobial susceptibility testing and ESBL phenotype were performed using DOUBLE DISK method.Results : Among the samples studied in the first and second stages, the presence of Escherichia coli, Klebsiella and Enterobacter species was detected in ۸۱.۹% and ۶۹.۴%, ۱۱.۱% and ۱۸.۱%, and ۶.۹% and ۱۲.۵%, respectively. Comparison of drug resistance patterns confirmed the highest changes in resistance to cefotaxime-clavulanic acid (from ۲۴% to ۳۴%) and the lowest to amoxicillin-clavulanic acid (From ۸۴% to ۸۲%). ESBL phenotype was detected in ۵۹% of primary isolates and ۵۱.۳% of isolates obtained afterwards. In total, ۲۸.۶% of patients did not have strains with ESBL resistance pattern.Conclusion : These findings highlight that changes in the intestinal colonization of members of the Enterobacteriaceae family and drug resistance patterns occur in the pediatric gastrointestinal tract following the hospitalization and antibiotic use.

کلیدواژه ها:

Enterobacteriaceae ، Extended-spectrum β-lactamase ، pediatric ، drug resistance