title: Prevalence and risk factors of early fecal carriage of Enterococcus faecalis and Staphylococcus spp and their antimicrobial resistant patterns among healthy neonates born in a hospital setting in central Saudi Arabia.
abstract: OBJECTIVE
  To investigate the prevalence, antibiotic resistant profiles, and risk factors of early fecal carriage of Enterococcus faecalis (E. faecalis) and staphylococci among 150 healthy Saudi neonates born in a hospital setting in central Saudi Arabia.
  
  
  METHODS
  This prospective study was conducted in Al-Bukayriyah General Hospital, Qassim, Saudi Arabia, between June 2012 and January 2013. The E. faecalis and Staphylococcus spp. isolates were identified manually, and Vitek2 system was used for identity confirmation at the species level and minimum inhibitory concentration-susceptibility testing.
  
  
  RESULTS
  Enterococcus faecalis (n=73) and Staphylococcus spp. (n=18) were recovered. Unlike staphylococci, E. faecalis colonization did not significantly vary from day one up to 7 days of life, regardless of the type of feeding, but it was relatively higher among vaginally versus cesarean delivery. Both Staphylococcus epidermidis (S. epidermidis) and Staphylococcus aureus (S. aureus) carriage increase as the body weight increases, and this difference was significant (p=0.025) for S. epidermidis. High-level resistance in Gentamycin among E. faecalis isolates was 25% and 11% to Streptomycin. Thirty percent of S. epidermidis were resistant to oxacillin and exhibited multidrug-resistant (MDR) patterns of 5 resistant markers, which were also observed among 2/5 (40%) of Methicillin-resistant Staphylococcus aureus isolates.
  
  
  CONCLUSIONS
  Enterococcus faecalis did not significantly vary in relation to type of delivery, age up to 7 days, and type of feeding. The neonatal fecal carriage of MDR isolates should be considered as a crucial reservoir to the further spread of antimicrobial resistance genes among hospitals, cross infections, and the community.
authors.affiliation: Department of Clinical Laboratory Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail. tkersh@ksu.edu.sa.
authors.forename: Talat A
authors.initials: TA
authors.lastname: El-Kersh
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Marie
authors.forename: Yazeed A
authors.initials: YA
authors.lastname: Al-Sheikh
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Al-Agamy
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Al Bloushy
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001724:Birth Weight; D002353:Carrier State / Q000453:epidemiology*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D013293:Enterococcus faecalis / Q000187:drug effects / Q000502:physiology; D005260:Female; D005839:Gentamicins / Q000494:pharmacology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000502:physiology; D008826:Microbial Sensitivity Tests; D010068:Oxacillin / Q000494:pharmacology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000502:physiology; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000502:physiology; D013307:Streptomycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D010068:Oxacillin; D013307:Streptomycin