RESUMEN
BACKGROUND AND OBJECTIVES: This study was carried out with the objective of determining the genomic variability of P. aeruginosa strains isolated from patients suffering from cystic fibrosis or from environmental cultures collected from different locations in the unit they admitted. MATERIALS AND METHODS: A total of 57 clinical and environmental P. aeruginosa isolates were genotyped by enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR), and antimicrobial susceptibility testing was performed using the Clinical and Laboratory Standards Institute method. RESULTS: One predominant ERIC profile (type A) was identified in 46 strains (81% of all typed isolates) which was responsible for thirty-nine of 44 clinical isolates (89%) and 7 of 13 environmental isolates (54%). All clinical isolates were susceptible to piperacillin-tazobactam, ceftazidime and cefepime followed by ticarcillin, aztreonam, amikacin and tobramycin (96.5%). CONCLUSIONS: In our country CF patients are not segregated from other patients, and transmission of bacteria between these patients and other patients might occur in the wards via personal contact or contaminated environment. Future evaluation for policy of patient segregation is necessary and the elimination of contaminated sources and control of environmental spread and recurrent contamination risk is needed.
RESUMEN
BACKGROUND: Risk factors for colonization with vancomycin-resistant enterococci (VRE) vary by population and locale. The objective of this study was to determine the prevalence of and risk factors for VRE colonization in children with acute lymphoblastic leukemia (ALL) in Tehran. METHODS: Stools were collected from children with ALL at the Ali Asghar Children's Hospital and the Mahak Pediatric Oncology Center between March 2007 and October 2008. Demographic features and potential risk factors for VRE colonization, including duration of ALL, presence of severe neutropenia in the preceding month, receipt of antibiotics in the preceding 3 months, concurrent medical problems, days of hospitalization, and the need for intensive care since the time of diagnosis of ALL, were recorded. RESULTS: VRE was identified from stools in 33 of 130 children with ALL (25%). No clear risk factors were identified for VRE colonization in the current study, but there was a trend towards an increased prevalence in children admitted to the intensive care unit since their ALL diagnosis (p=0.07). The VanA genotype was found in 28 of the 33 stools (85%), with all other enterococci being VanB. CONCLUSIONS: The prevalence of VRE colonization in children with ALL in Tehran is high. Modifiable risk factors have not been identified. The implementation of routine surveillance for colonization and an increased emphasis on adherence to standard infection control precautions may prevent spread.