الگوهای توزیع باکتری و مقاومت آنتی بیوتیکی در عفونت های جریان خون در بیماران ICU و غیر ICU: یک مطالعه 14 ساله در یک بیمارستان ریفرال در ایران
کد: G-1071
نویسندگان: Zahra Jafarpour © ℗, Gholamreza Pouladfar, Bahman Pourabbas, Amin Abbasian, Fatemeh Ghasemi, Pejman Abbasi, Maryam Sabzehzar, Mohammad Ali Dehyadegari, Helma Nasiraei, Sara Dorostkar, Arman Maddahi
زمان بندی: زمان بندی نشده!
دانلود: دانلود پوستر
خلاصه مقاله:
خلاصه مقاله
Background: Bloodstream infections (BSIs) represent a serious and potentially life-threatening health problem with a high morbidity and mortality rate. The predominant microbial distribution in intensive care units (ICUs) and non-ICUs wards were investigated to provide more effective and appropriate treatment for patients. Methods: In this retrospective cross-sectional study, blood cultures sent to Professor Alborzi Clinical Microbiology Research Center in Nemazi Hospital between 2010 and 2024 were included. Positive cultures were analyzed for pathogen type and antibiotic susceptibility testing was performed by Kirby Bauer Disk Diffusion method, according to CLSI guidelines. Methicillin resistance Staphylococcus aureus (MRSA), was detected using cefoxitin disc. Extended-spectrum β-lactamases (ESBL) was confirmed with CLSI double disc method. Results: Over 14 years of research, we included 1,036 blood culture specimens from ICU patients suspected of BSIs and 6462 from non-ICU patients. 2137 blood cultures specimens did not provide information about the ward of origin, were excluded from the study. The major bacterial isolates in ICU wards were Stenotrophomonas maltophilia (Pma) (17%), Enterococcus spp. (14%), Acinetobacter baumannii (13%), Klebsiella (K.) pneumonia (9%), and Escherichia (E.)coli (7%), while in non-ICU wards, Pma (21%), E. coli (11%), Staphylococcus aureus (9%), Pseudomonas spp. (8%), and Enterococcus spp. (7%) were the most prevalent. MRSA was found in 73 % of ICU and 40 % of Non-ICU wards. (P-value=0.18) In ICU and Non-ICU wards, 77% and 61 % of Enterococcus sp. were found to be Vancomycin-resistant. (P-value=0.07) ESBL producers in Enterobacteriaceae were more prevalent in ICU wards (78 %) compared to Non-ICU wards (60 %). (P-value=0.08) Carbapenem resistance (CR) was found in a high percentage of Acinetobacter spp. (93 % in ICU and 69 % in Non-ICU) (P-value=0.09) and K. pneumonia (65 % in ICU and 52 % in Non-ICU). (P-value=0.07) The prevalence of CR Pseudomonas spp. was also substantial, with 40% and 28 % found in ICU and Non-ICU wards, respectively. (P-value=0.11) Conclusion: The higher resistance rates were detected in ICU wards. This information indicates that data on drug resistance monitoring in the ICU and non-ICU should be analyzed separately and provided to physicians for selecting empirical antibiotic regimens in various clinical situations.
کلمات کلیدی
Antibiotic Resistance Intensive Care Units Methicillin-Resistant Staphylococcus aureus vancomycin-resistant Enterococci extended-spectrum beta-lactamase carbapenem resistance
