title: Clonal spread of vancomycin resistance Enterococcus faecalis in an Iranian referral pediatrics center.
abstract: Vancomycin-resistant enterococci (VRE) represent as an immediate threat to public health. Since few active compounds are available for VRE infections, rapid identification of these isolates are essential. In the absence of any report on the genetic relatedness of Enterococcus faecalis especially Vancomycin-resistant E. faecalis (VREF) isolates in Iran, we undertook this study to characterize these isolates using random amplification of polymorphic DNA (RAPD-PCR) genotyping method. In this study, E. faecalis strains isolated from various samples collected from different wards of Children Medical Hospital (Tehran, Iran). These isolates were identified by standard laboratory procedures and tested for antimicrobial resistance to vancomycin and teicoplanin. The genetic similarity of the strains was investigated by amplification of the RAPD-PCR. In our study among 91 E. faecalis isolates, 15 (16%) were identified as VREF. The similarity pattern built for E. faecalis isolates by RAPD-PCR, demonstrated the presence of four distinct clusters (A, B, C, D). It is of interest to note that 100% of VREF isolates belonged to Clusters A, indicating that there may have occurred horizontal transmission of the same strain between patients. In conclusion, rapid spread of VREF from a clonal origin calls for implementation of careful isolation and infection control measures. Therefore, environmental control by routine disinfection of patient area as well as screening of high risk patients and isolation of colonized patients should be imposed in order to diminish risk of acquiring nosocomial VRE.
authors.affiliation: Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Pourakbari
authors.affiliation: Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Mahmoudi
authors.affiliation: Department of Pediatric Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: M Kamali
authors.initials: MK
authors.lastname: Aghdam
authors.affiliation: Department of Pediatric Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Sabouni
authors.affiliation: Department of Pediatric Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Eshaghi
authors.affiliation: Department of Pathobiology, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Alizadeh
authors.affiliation: Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Mamishi
mesh_terms: D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D013293:Enterococcus faecalis / Q000187:drug effects* / Q000235:genetics*; D005260:Female; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000235:genetics* / Q000382:microbiology*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007492:Iran; D008297:Male; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction / Q000379:methods; D020713:Vancomycin Resistance / Q000235:genetics*