Screening of rectal swabs for carbapenem non-susceptible Bacteroides fragilis group bacteria in hospitalized children

Abstract

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.