Abstract
Treatment of nosocomial infections is becoming difficult due to the increasing trend of antibiotics resistance. Current knowledge on antibiotic resistance pattern is essential for appropriate therapy. We aimed to evaluate antibiotic resistance profiles in nosocomial bloodstream and urinary tract pathogens. A total of 129 blood stream and 300 urinary tract positive samples were obtained from patients referring to Besat hospital over a two-year period (2009 and 2010). Antibiotic sensitivity was ascertained using the Kirby-Bauer disk diffusion technique according to CLSI guidelines. Patient's data such as gender and age were recorded. The ratio of gram-negative to gram-positive bacteria in BSIs was 1.6 : 1. The most prevalent BSI pathogen was Coagulase-Negative Staphylococci (CoNS). The highest resistance rate of CoNS was against penicillin (91.1%) followed by ampicillin (75.6%), and the lowest rate was against vancomycin (4.4%). Escherichia coli was the most prevalent pathogen isolated from urinary tract infections (UTIs). Ratio of gram-negative to gram-positive bacteria was 3.2 : 1. The highest resistance rate of E. coli isolates was against nalidixic acid (57.7%). The present study showed that CoNS and E. coli are the most common causative agents of nosocomial BSIs and UTIs, and control of infection needs to be addressed in both antibiotic prescription and general hygiene.
Highlights
Nosocomial or hospital-acquired infections are defined as infections which are acquired during the hospital stay
Coagulase-Negative Staphylococci (CoNS) (34.8%) and E. coli (29.4%) were the most prevalent microorganisms isolated from nosocomial bloodstream infection (BSI) patients followed by K. pneumoniae (11%), Acinetobacter spp. (8.5%), Enterobacter spp. (7%), S. aureus (3.9%), P. aeruginosa (3.9%), and Proteus vulgaris (1.5%)
The highest resistance rate of the CoNS was against penicillin (91.1%) followed by ampicillin (75.6%), and the lowest rate was against
Summary
Nosocomial or hospital-acquired infections are defined as infections which are acquired during the hospital stay. The most frequent types of nosocomial infections are urinary tract infection (UTI), surgical-wound infection, pneumonia, and bloodstream infection (BSI) [3]. The common bacterial pathogens present in the BSIs and UTIs are Staphylococcus aureus, Coagulase-Negative Staphylococci (CoNS), Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter spp., Enterococcus spp., and Acinetobacter spp. As the result of extensive uses of antimicrobial agents, nosocomial pathogens have shifted away from treatable bacteria towards more resistant bacteria. This change is important problem for nosocomial infection control and prevention [7]. Area-specific monitoring studies aimed to gain knowledge about type of pathogens and antimicrobial resistance patterns can optimize treatment and decrease mortality rates [8, 9].
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