Abstract
Nosocomial pneumonia remains an important cause of mortality and morbidity worldwide. Surveillance programs play an important role in the identification of common etiologic agents and local patterns of antimicrobial resistance. In this study we determined the frequency and antimicrobial susceptibility of pathogens isolated from patients with nosocomial pneumonia during 2009 to 2011. A total of 642 bacteria were isolated from 516 suspected samples. Acinetobacter baumannii (21.1%, n = 136), was the commonest isolated pathogen followed by Pseudomonas aeruginosa (17.4%, n = 112), Staphylococcus aureus (15.8%, n = 102) and enterococci (8.4% n = 54). The most effective therapeutic agents against A. baumannii were polymyxin B (95.5% susceptible), ceftriaxone/tazobactam (72% susceptible) and levofloxacin (52.9% susceptible). Polymixin B (89.2% susceptible), ceftriaxone/tazobactam (89.2% susceptible) and piperacillin-tazobactam (80.3% susceptible) were found to be the most active agents against P. aeruginosa. Extended-spectrum beta-lactamases were detected among isolates of K. pneumoniae (45.4%) and E. coli (20.3%). Overall, the prevalence of methicillin-resistant S. aureus and vancomycin resistant enterococci were 80.4% and 40.7% respectively. Linezolid was found to be the most active antibiotic against these pathogens. The etiology of 50% of the nosocomial infection cases was polymicrobial. The combination of ceftriaxone/tazobactam seems to be beneficial agent against multidrug-resistant Gram-negative bacilli isolated form respiratory tract infections. The results of our study can be used for guiding appropriate empiric therapy in this geographic region.
Highlights
Nosocomial pneumonia remains an important cause of mortality and morbidity worldwide
In summary, we observed a high prevalence of multidrug-resistant non-fermentative Gram-negative bacilli, methicillin-resistant S. aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended-spectrum beta-lactamases (ESBL)-producing isolates
Co-ordinated multidisciplinary approaches are required to prevent and control infections caused by these antibioticresistant bacteria
Summary
Nosocomial pneumonia remains an important cause of mortality and morbidity worldwide. Methodology: In this study we determined the frequency and antimicrobial susceptibility of pathogens isolated from patients with nosocomial pneumonia during 2009 to 2011. Acinetobacter baumannii (21.1%, n = 136), was the commonest isolated pathogen followed by Pseudomonas aeruginosa (17.4%, n = 112), Staphylococcus aureus (15.8%, n = 102) and enterococci (8.4% n = 54). Conclusions: The combination of ceftriaxone/tazobactam seems to be beneficial agent against multidrug-resistant Gram-negative bacilli isolated form respiratory tract infections. Awareness of local prevalence of causative microorganisms and drug susceptibility patterns is critical for the proper formulation of initial empiric therapy prescription of antibiotics [2]. The objective of the present study was to investigate the prevalence and antimicrobial resistance patterns of bacterial pathogens isolated from patients with NP over a period of three years (2009 to 2011) in Tehran hospitals
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