• Logo
  • SBMUJournals

Nosocomial Infections Caused by Drug-Resistant Bacteria in a Referral University Hospital, Tehran, Iran

Mohammad Javad Nasiri, Amir Mohammad Goudarzi, Hamid Reza Aslani, Mehdi Goudarzi, Samin Zamani, Shahnaz AdinehKharrat
112

Views

PDF

Abstract

Background: The emergence of antimicrobial-resistant pathogens associated with hospital-acquired infections (HAIs) is a major public health problem worldwide. Although being drug resistance is common in some countries and rare in others, the extent of this condition is not precisely known in most parts of Iran.

Materials and Methods: Clinical specimens from patients who had been in the hospital for at least 48 hours were included in this study. The pattern of antibiotic resistance was determined by disk diffusion method as recommended by the Clinical Laboratory and Standards Institute (CLSI).

Results: Of 11164 patients that were investigated, 369 (3.3%) had nosocomial infections. The most frequently isolated organisms from all sites of infections were Acinetobacter species (14.2%), Escherichia coli (13.7%) and Pseudomonas aeruginosa (9.9%). Among the Gram-negative bacilli, Acinetobacter spp was mostly resistant to ciprofloxacin, ceftriaxon, co-trimoxazole and centamicin, while P. aeruginosa was frequently resistant to ampicillin/sulbactam (87%). Imipenem and piperacillin/tazobactam were the most active antimicrobials against gram-negative microorganisms whereas vancomycin was the antimicrobial agent most consistently active against the Gram-positive cocci.

Conclusions: This study highlights the importance of antimicrobial-resistant pathogens associated with nosocomial infection in Tehran, Iran. Using proper diagnostic criteria as well as administering more effective treatment may limit the frequency of drug-resistant bacteria associated with HAIs. 


Keywords

Hospital-acquired infection, antimicrobial-resistant pathogens, Iran

References

Asl HM. The National Nosocomial Infections Surveillance in Iran. A 4 years report. In: BMC Proceedings: BioMed Central Ltd; 2011. pp. P243.

Khalili H, Soltani R, Afhami S, Dashti-Khavidaki S, Alijani B. Antimicrobial resistance pattern of gram-negative bacteria of nosocomial origin at a teaching hospital in the Islamic Republic of Iran. EMHJ. 2012;18(2).

Tenover FC. Mechanisms of antimicrobial resistance in bacteria. The American Journal of Medicine .2006; 119(6):S3-S10.

Klavs I, Bufon LT, Skerl M, Grgic-Vitek M, Lejko ZT, Dolinsek M, et al. Prevalance of and risk factors for hospital-acquired infections in Slovenia-results of the first national survey, 2001. The Journal of Hospital Infection. 2003;54(2):149.

Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. American Journal of Infection Control. 1988;16(3):128-40.

Smith PW, Rusnak PG. Infection prevention and control in the long-term-care facility. American Journal of Infection Control. 1997;25(6):488-512.

Bayram A, Balci I. Patterns of antimicrobial resistance in a surgical intensive care unit of a university hospital in Turkey. BMC Infectious Diseases. 2006;6(1):155.

Andersen BM, Rasch M, Hochlin K, Tollefsen T, Sandvik L. Hospital-acquired infections before and after healthcare reorganization in a tertiary university hospital in Norway. Journal of Public Health. 2009;31(1):98-104.

Gordts B, Vrijens F, Hulstaert F, Devriese S, Van de Sande S. The 2007 Belgian national prevalence survey for hospital-acquired infections. Journal of Hospital Infection. 2010;75(3):163.

Van der Kooi T, Mannien J, Wille J, Van Benthem B. Prevalence of nosocomial infections in The Netherlands, 2007–2008: results of the first four national studies. Journal of Hospital Infection. 2010;75(3):168-72.

Assar S, Akhoundzadeh R, Aleali AM, Latifi SM, Salemzadeh M. Survey of nosocomial infections and causative bacteria: A hospital-based study; 2012.

Pourakbari B, Rezaizadeh G, Mahmoudi S, Mamishi S. Epidemiology of nosocomial infections in pediatric patients in an Iranian referral hospital. J Prev Med Hyg. 2012;53(4):204-6.

Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine. 2006;355(26):2725-32.

Hadaway LC. 5 Steps to preventing catheter-related bloodstream infections. Trauma; 2010.

Joshi SG, Litake GM, Satpute MG, Telang NV, Ghole VS, Niphadkar KB. Clinical and demographic features of infection caused by Acinetobacter species. Indian Journal of Medical Sciences. 2006;60(9):351




DOI: https://doi.org/10.22037/nbm.v7i2.24847