Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children

Karaaslan Ayşe; Ulger Toprak Nurver; Akkoç Gülşen; Akgül Öncü; Kepenekli Kadayifci Eda; Öcal Demir Sevliya; Yakut Nurhayat; Atıcı Serkan; Soysal Ahmet; Bakır Mustafa; Söyletir Güner

doi:https://dx.doi.org/10.5222/j.child.2017.169

Research Article

DOI :10.5222/j.child.2017.169 IUP :10.5222/j.child.2017.169 Full Text (PDF)

Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children

Ayşe Karaaslan, Nurver Ulger Toprak, Gülşen Akkoç, Öncü Akgül, Eda Kepenekli Kadayifci, Sevliya Öcal Demir, Nurhayat Yakut, Serkan Atıcı, Ahmet Soysal, Mustafa Bakır, Güner Söyletir

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.

Keywords: Bacteroides fragilis group, carbapenem nonsusceptible, children

DOI :10.5222/j.child.2017.169 IUP :10.5222/j.child.2017.169 Full Text (PDF)

Hastanede Yatan Çocukların Rektal Sürüntülerinde Karbapenem Duyarlı Olmayan Bacteroides fragilis Grup Bakteri Taraması

Ayşe Karaaslan, Nurver Ulger Toprak, Gülşen Akkoç, Öncü Akgül, Eda Kepenekli Kadayifci, Sevliya Öcal Demir, Nurhayat Yakut, Serkan Atıcı, Ahmet Soysal, Mustafa Bakır, Güner Söyletir

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.

Keywords: Bacteroides fragilis grup, karbapenem hassas olmama, çocuklar

References

1. 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 google scholar
2. 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 google scholar
3. 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 google scholar
4. Nagy E, Urbán E, Nord CE, et al. Antimicrobial susceptibility 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 google scholar
5. Liu CY, Huang YT, Liao CH, Yen LC, Lin HY, Hsueh PR. Increasing trends in antimicrobial resistance among clinically important anaerobes and Bacteroides fragilis isolates causing nosocomial infections: emerging resistance to carbapenems. Antimicrob Agents Chemother 2008;52:3161-8. https://doi.org/10.1128/AAC.00355-08 google scholar
6. Goldstein EJ. Anaerobic bacteremia. Clin Infect Dis 1996; 23:97-101. https://doi.org/10.1093/clinids/23.Supplement_1.S97 google scholar
7. 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 A. Karaaslan ve ark., Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children 173 google scholar
8. The European Committee on Antimicrobial Susceptibility Testing (EUCAST). http://www.eucast. org/fileadmin/src/media/EUCASTfiles/Resistance_ mechanisms/EUCASTdetection_of_resistance_mechanisms_v1.0_20131211.pdf google scholar
9. 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 google scholar
10. Nguyen MH, Yu VL, Morris AJ, et al. Antimicrobial resistance and clinical outcome of Bacteroides bacteremia: findings of a multicenter prospective observational trial. Clin Infect Dis 2000;30:870-6. https://doi.org/10.1086/313805 google scholar
11. 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 google scholar
12. 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 google scholar
13. 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 google scholar
14. Edwards R, Hawkyard CV, Garvey MT, Greenwood D. Prevalence and degree of expression of the carbapenemase 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 google scholar
15. Toprak NU, Uzunkaya OD, Sóki J, Soyletir G. Susceptibility profiles and resistance genes for carbapenems (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 google scholar
16. 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 google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format

EXPORT

APA

Karaaslan, A., Ulger Toprak, N., Akkoç, G., Akgül, Ö., Kepenekli Kadayifci, E., Öcal Demir, S., Yakut, N., Atıcı, S., Soysal, A., Bakır, M., & Söyletir, G. (2017). Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children. Journal of Child, 17(4), 169-173. https://doi.org/10.5222/j.child.2017.169

AMA

Karaaslan A, Ulger Toprak N, Akkoç G, Akgül Ö, Kepenekli Kadayifci E, Öcal Demir S, Yakut N, Atıcı S, Soysal A, Bakır M, Söyletir G. Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children. Journal of Child. 2017;17(4):169-173. https://doi.org/10.5222/j.child.2017.169

ABNT

Karaaslan, A.; Ulger Toprak, N.; Akkoç, G.; Akgül, Ö.; Kepenekli Kadayifci, E.; Öcal Demir, S.; Yakut, N.; Atıcı, S.; Soysal, A.; Bakır, M.; Söyletir, G. Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children. Journal of Child, [Publisher Location], v. 17, n. 4, p. 169-173, 2017.

Chicago: Author-Date Style

Karaaslan, Ayşe, and Nurver Ulger Toprak and Gülşen Akkoç and Öncü Akgül and Eda Kepenekli Kadayifci and Sevliya Öcal Demir and Nurhayat Yakut and Serkan Atıcı and Ahmet Soysal and Mustafa Bakır and Güner Söyletir. 2017. “Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children.” Journal of Child 17, no. 4: 169-173. https://doi.org/10.5222/j.child.2017.169

Chicago: Humanities Style

Karaaslan, Ayşe, and Nurver Ulger Toprak and Gülşen Akkoç and Öncü Akgül and Eda Kepenekli Kadayifci and Sevliya Öcal Demir and Nurhayat Yakut and Serkan Atıcı and Ahmet Soysal and Mustafa Bakır and Güner Söyletir. “Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children.” Journal of Child 17, no. 4 (Apr. 2024): 169-173. https://doi.org/10.5222/j.child.2017.169

Harvard: Australian Style

Karaaslan, A & Ulger Toprak, N & Akkoç, G & Akgül, Ö & Kepenekli Kadayifci, E & Öcal Demir, S & Yakut, N & Atıcı, S & Soysal, A & Bakır, M & Söyletir, G 2017, 'Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children', Journal of Child, vol. 17, no. 4, pp. 169-173, viewed 19 Apr. 2024, https://doi.org/10.5222/j.child.2017.169

Harvard: Author-Date Style

Karaaslan, A. and Ulger Toprak, N. and Akkoç, G. and Akgül, Ö. and Kepenekli Kadayifci, E. and Öcal Demir, S. and Yakut, N. and Atıcı, S. and Soysal, A. and Bakır, M. and Söyletir, G. (2017) ‘Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children’, Journal of Child, 17(4), pp. 169-173. https://doi.org/10.5222/j.child.2017.169 (19 Apr. 2024).

MLA

Karaaslan, Ayşe, and Nurver Ulger Toprak and Gülşen Akkoç and Öncü Akgül and Eda Kepenekli Kadayifci and Sevliya Öcal Demir and Nurhayat Yakut and Serkan Atıcı and Ahmet Soysal and Mustafa Bakır and Güner Söyletir. “Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children.” Journal of Child, vol. 17, no. 4, 2017, pp. 169-173. [Database Container], https://doi.org/10.5222/j.child.2017.169

Vancouver

Karaaslan A, Ulger Toprak N, Akkoç G, Akgül Ö, Kepenekli Kadayifci E, Öcal Demir S, Yakut N, Atıcı S, Soysal A, Bakır M, Söyletir G. Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children. Journal of Child [Internet]. 19 Apr. 2024 [cited 19 Apr. 2024];17(4):169-173. Available from: https://doi.org/10.5222/j.child.2017.169 doi: 10.5222/j.child.2017.169

ISNAD

Karaaslan, Ayşe - Ulger Toprak, Nurver - Akkoç, Gülşen - Akgül, Öncü - Kepenekli Kadayifci, Eda - Öcal Demir, Sevliya - Yakut, Nurhayat - Atıcı, Serkan - Soysal, Ahmet - Bakır, Mustafa - Söyletir, Güner. “Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children”. Journal of Child 17/4 (Apr. 2024): 169-173. https://doi.org/10.5222/j.child.2017.169

Volume 17, Issue 42017, P. 169-173

TIMELINE

Submitted	23.11.2017
Accepted	26.01.2018

LICENCE

Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.

Journal of Child

Research Article

Screening of Rectal Swabs for Carbapenem Non-susceptible Bacteroides fragilis Group Bacteria in Hospitalized Children

Hastanede Yatan Çocukların Rektal Sürüntülerinde Karbapenem Duyarlı Olmayan Bacteroides fragilis Grup Bakteri Taraması

PDF View

References

Citations

EXPORT

APA

AMA

ABNT

Chicago: Author-Date Style

Chicago: Humanities Style

Harvard: Australian Style

Harvard: Author-Date Style

MLA

Vancouver

ISNAD

TIMELINE

LICENCE

SHARE