Microbiology
Samaneh Salarvand; Alireza Abdollahi; Pegah Afarinesh Khaki; Mahsa Norouzi Shadehi; Mohammad Taghi Beigh Mohammadi; Seyed Amir Miratashi Yazdi; Elham Nazar
Abstract
Background & Objective: Antibiotic resistance, especially in the form of multidrug-resistant (MDR), is a big problem, especially in intensive care units (ICUs). This study aimed to evaluate antibiotic resistance and MDR patterns among patients hospitalized in the ICUs in one of the large referral ...
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Background & Objective: Antibiotic resistance, especially in the form of multidrug-resistant (MDR), is a big problem, especially in intensive care units (ICUs). This study aimed to evaluate antibiotic resistance and MDR patterns among patients hospitalized in the ICUs in one of the large referral centers in Iran.Methods: The present study was conducted at Imam Khomeini Hospital in Tehran (a great referral hospital), which admits critically ill patients requiring ICU services. To determine the rate of positive cultures for resistant strains, the patient’s blood specimens were sent to the laboratory of the hospital for inoculation on proper culture media within 2 hours of extraction. Antimicrobial susceptibility tests were done using the Bauer–Kirby disk diffusion method.Results: A total of 1,755 samples were collected from the patients to assess microbial strains and antibiotic resistance. The most common microbial strains detected in the cultures extracted from peripheral blood samples were Klebsiella pneumonia (22.1%), Staphylococcus epidermidis (7.9%) and another coagulase-negative Staphylococcus (15.0%). The antibiogram test showed antibiotic resistance in 1,509 cases, leading to a resistance prevalence rate of 85.9%. The most common antimicrobial resistance observed was against cotrimoxazole (61.7%), ciprofloxacin (51.3%), imipenem (50.0%), and ampicillin (49.6%). The rate of MDR was found to be 96.3%.Conclusion: In Iran’s ICUs, a significantly high level of antibiotic resistance may be seen especially the MDR pattern, which indicates the need to change the pattern of prescribing and managing these drugs in ICU centers.
Maryam Amini; Ali Davati; Mahdieh Golestanifard
Volume 7, Issue 4 , September 2012, , Pages 241-245
Abstract
Background and Objective:Acinetobacter spp.a Gram-negative coccobacillus is increasingly reported as important cause of nosocomial infections. Multi-drug resistance (MDR) ofAcinetobacterspp., raises concerns over our ability to treat serious infections with these organisms. The aim of this study was ...
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Background and Objective:Acinetobacter spp.a Gram-negative coccobacillus is increasingly reported as important cause of nosocomial infections. Multi-drug resistance (MDR) ofAcinetobacterspp., raises concerns over our ability to treat serious infections with these organisms. The aim of this study was to determine the frequency and associated risk factors for infections with MDR Acinetobacter spp. in ICU patients ofShahid Mostafa Khomeini Hospital, Tehran, Iran.
Patients and Methods:This descriptive-analytical andcross-sectional study was designed in 3 years period from April 2008 to March 2010 on 130 patients. For bacteriological analysis, sputum, blood, urine and wound specimens were used from patients within >48 hr after admission. Patient’s clinical and epidemiologic data were collected, from recordedfile, and correlated to Acinetobacter spp. infection. The data were analyzed using SPSS16 statistical software,chi-square, and Mann-Whitney test.
Results: The frequency of Acinetobacterspp. infection separately by years was 21.5%, 30.8% and 47.7% in 2008, 2009, 2010, respectively. All isolateswere resistant to carbnicillin, piperacillin, cefotaxime and cephalotin, 99.2% to ciprofloxacin, cotrimoxazole and chloramphenicol, 97.7% to imipenem, 95.4% to tetracycline and 91.5% to gentamicin. The highest sensitivity was to amikacin 14.6%.
Conclusion:Nosocomialinfections with Acinetobacter spp. during the three years, was a growing trend, and all isolates were MDR and highest susceptibility was to Amikacin. Most important risk factors wereincorrect diagnosis, inappropriate usage, doses, andtime of antibiotic therapy, inappropriate formulation of some antibiotics.