876 Characterization of Enterococci Causing Catheter- Associated Urinary Tract Infections in Children in Iran

Abstract

Background and Aims Urinary tract infection is one of the most common diseases in children. Precise and untimely diagnosis and comprehensive treatment can significantly decrease late serious complications. Among microorganisms causing UTI, enterococci are one of the most prevalent reported one. Microorganisms causing UTI are resistant to most of antibiotics which lead to increasing the duration of hospitalization, morbidity, mortality and there are medical and financial implications associated with UTIs. The aim of this study was to determine enterococci prevalence, its antimicrobial resistance and its genetic diversity isolated in children. Methods Urine samples were cultured by standard loop method. The 105 CFU/ml cultures were assumed as positive. After identification of enterococci by biochemical tests, susceptibility of each isolate was assessed by disk diffusion method according to CLSI guidelines. In order to analyzing bacterial genotypic diversity, pulsed-field gel electrophoresis (PFGE) were performed using SmaI enzyme in CHEF DRIII apparatus. Results Out of 500 urine samples, 50 were positive for vancomycin resistant Enterococci. Out of 50 VRE isolates, 3 were isolated from catheter-associated urinary tract infections from neonatal intensive care unit and Pediatric ward. All of 3 VRE isolates showed a high level vancomycin resistance (MIC>=128) and harbored vanA gene. Genotyping by PFGE using SmaI enzyme revealed the presence of two types. Conclusion The prevalence of VRE catheter- associated urinary tract infections among NICU patients and Pediatric ward has been rare in Tehran. PFGE results revealed that among enterococci isolates PFGE patterns were diverse.