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Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children

Objective: Carbapenem-resistant Enterobacteriaceae (CRE) infection is life-threatening, especially for immunocompromised children. The source tracking of CRE could prevent bacteremia during hospitalization. In this study, the intestinal colonization of CRE and their translocation to blood were inves...

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Autores principales: Almasian Tehrani, Nasim, Azimi, Leila, Armin, Shahnaz, Soleimani, Neda, Fallah, Fatemeh, Karimi, Abdollah, Shamsian, Bibi Shahin, Nazari, Shiva, Alebouyeh, Masoud
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10458169/
https://www.ncbi.nlm.nih.gov/pubmed/37624340
http://dx.doi.org/10.3390/tropicalmed8080402
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author Almasian Tehrani, Nasim
Azimi, Leila
Armin, Shahnaz
Soleimani, Neda
Fallah, Fatemeh
Karimi, Abdollah
Shamsian, Bibi Shahin
Nazari, Shiva
Alebouyeh, Masoud
author_facet Almasian Tehrani, Nasim
Azimi, Leila
Armin, Shahnaz
Soleimani, Neda
Fallah, Fatemeh
Karimi, Abdollah
Shamsian, Bibi Shahin
Nazari, Shiva
Alebouyeh, Masoud
author_sort Almasian Tehrani, Nasim
collection PubMed
description Objective: Carbapenem-resistant Enterobacteriaceae (CRE) infection is life-threatening, especially for immunocompromised children. The source tracking of CRE could prevent bacteremia during hospitalization. In this study, the intestinal colonization of CRE and their translocation to blood were investigated. Methods: Stool samples from immunocompromised pediatric patients were collected after admission, and secondary stool and blood samples were collected in case of fever. After CRE phonotypic detection, the OXA-48, NDM-1, VIM, IMP, and KPC genes were detected by PCR. Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) was used to determine the phylogenic relatedness of the blood and fecal isolates. Results: Bacteremia was recorded in 71.4% of the patients. Enterobacteriaceae spp. were recorded in 100% of the stool samples and 31% of the blood samples. The correlation between the length of stay (LOS), days of fever, chemotherapy regimens, and death rate was significant (p-value ≤ 0.05). OXA-48 was present in all CRE isolates in both the primary and the secondary stool samples and the blood samples. According to the phylogenetic data, 58.33% of the patients with bacteremia had identical blood and stool isolates. The death rate was 24.4% in children with CRE bacteremia. Conclusions: The primary intestinal colonization with CRE in immunocompromised pediatrics and their translocation to blood was established in this study. The implementation of infection control programs and the application of infection prevention strategies for immunocompromised children is necessary.
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spelling pubmed-104581692023-08-27 Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children Almasian Tehrani, Nasim Azimi, Leila Armin, Shahnaz Soleimani, Neda Fallah, Fatemeh Karimi, Abdollah Shamsian, Bibi Shahin Nazari, Shiva Alebouyeh, Masoud Trop Med Infect Dis Article Objective: Carbapenem-resistant Enterobacteriaceae (CRE) infection is life-threatening, especially for immunocompromised children. The source tracking of CRE could prevent bacteremia during hospitalization. In this study, the intestinal colonization of CRE and their translocation to blood were investigated. Methods: Stool samples from immunocompromised pediatric patients were collected after admission, and secondary stool and blood samples were collected in case of fever. After CRE phonotypic detection, the OXA-48, NDM-1, VIM, IMP, and KPC genes were detected by PCR. Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) was used to determine the phylogenic relatedness of the blood and fecal isolates. Results: Bacteremia was recorded in 71.4% of the patients. Enterobacteriaceae spp. were recorded in 100% of the stool samples and 31% of the blood samples. The correlation between the length of stay (LOS), days of fever, chemotherapy regimens, and death rate was significant (p-value ≤ 0.05). OXA-48 was present in all CRE isolates in both the primary and the secondary stool samples and the blood samples. According to the phylogenetic data, 58.33% of the patients with bacteremia had identical blood and stool isolates. The death rate was 24.4% in children with CRE bacteremia. Conclusions: The primary intestinal colonization with CRE in immunocompromised pediatrics and their translocation to blood was established in this study. The implementation of infection control programs and the application of infection prevention strategies for immunocompromised children is necessary. MDPI 2023-08-07 /pmc/articles/PMC10458169/ /pubmed/37624340 http://dx.doi.org/10.3390/tropicalmed8080402 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Almasian Tehrani, Nasim
Azimi, Leila
Armin, Shahnaz
Soleimani, Neda
Fallah, Fatemeh
Karimi, Abdollah
Shamsian, Bibi Shahin
Nazari, Shiva
Alebouyeh, Masoud
Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children
title Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children
title_full Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children
title_fullStr Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children
title_full_unstemmed Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children
title_short Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children
title_sort endogenous bacteremia caused by intestinal colonization of carbapenem-resistant enterobacteriaceae (cre) in immunocompromised children
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10458169/
https://www.ncbi.nlm.nih.gov/pubmed/37624340
http://dx.doi.org/10.3390/tropicalmed8080402
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