Meybodi Mohammad Masoud Emami, Foroushani Abbas Rahimi, Zolfaghari Masoome, Abdollahi Alireza, Alipour Abbas, Mohammadnejad Esmaeil, Mehrjardi Ehsan Zare, Seifi Arash
Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Microbiol. 2021 Apr;13(2):178-182. doi: 10.18502/ijm.v13i2.5978.
Antimicrobial resistance (AMR) is an increasing threat for efficient treatment of infections. Determining the epidemiology of healthcare-associated infections and causative agents in various hospital wards helps appropriate selection of antimicrobial agents.
This retrospective study was performed by analyzing antibiograms from March 2017 to March 2018 among patients admitted to the different wards of Imam Khomeini Hospital Complex in Tehran, Iran.
Among 2440 hospital acquired infections, 59.3% were Gram-negative bacilli: (n = 469, 22.2%), (n = 457, 21.7%), spp. (n = 282, 13.4%), (n = 139, 6.6%) and important Gram-positive bacteria were spp. (n = 216, 10.2%), (n = 148, 7%), (n = 118, 5.6). Generally, there was a high antimicrobial resistance in bacterial isolates in this study. Methicillin resistant (MRSA) was 56.3 % and MRSE 62.9 %. Vancomycin resistant enterococci (VRE) was 60.7%. -ESBL was 79.6% and its resistance to carbapenem was 38.4%. -ESBL was 42% and its resistance to carbapenems was 2.3%. resistance to ceftazidime was 74.4%, to fluroquinolones 63.3%, to aminoglycosides 64.8%, to piperacillin tazobactam 47.6% and to carbapenems 62.1%. resistance to ceftazidime was 98.7%, to fluroquinolones 97%, to aminoglycosides 95.9%, to ampicillin sulbactam 84%, to carbapenems 96.4% and to colistin 4%.
The study revealed an alarming rate of resistance to the commonly used antimicrobial agents used in treating HAIs. Also the relationship between AMR and some risk factors and thus taking steps towards controlling them have been shown.
抗菌药物耐药性（AMR）对感染的有效治疗构成了日益严重的威胁。确定各类医院病房中医疗保健相关感染的流行病学情况及病原体有助于合理选择抗菌药物。
本回顾性研究通过分析2017年3月至2018年3月期间入住伊朗德黑兰伊玛目霍梅尼医院综合大楼不同病房的患者的抗菌谱来进行。
在2440例医院获得性感染中，59.3%为革兰氏阴性杆菌：大肠埃希菌（n = 469，22.2%）、肺炎克雷伯菌（n = 457，21.7%）、铜绿假单胞菌属（n = 282，13.4%）、鲍曼不动杆菌（n = 139，6.6%），重要的革兰氏阳性菌为金黄色葡萄球菌（n = 216，10.2%）、表皮葡萄球菌（n = 148，7%）、粪肠球菌（n = 118，5.6%）。总体而言，本研究中的细菌分离株存在较高的抗菌药物耐药性。耐甲氧西林金黄色葡萄球菌（MRSA）为56.3%，耐甲氧西林表皮葡萄球菌（MRSE）为62.9%。耐万古霉素肠球菌（VRE）为60.7%。大肠埃希菌产超广谱β-内酰胺酶（ESBL）为79.6%，其对碳青霉烯类的耐药率为38.4%。肺炎克雷伯菌产ESBL为42%，其对碳青霉烯类的耐药率为2.3%。鲍曼不动杆菌对头孢他啶的耐药率为74.4%，对氟喹诺酮类为63.3%，对氨基糖苷类为64.8%，对哌拉西林他唑巴坦为47.6%，对碳青霉烯类为62.1%。铜绿假单胞菌对头孢他啶的耐药率为98.7%，对氟喹诺酮类为97%，对氨基糖苷类为95.9%，对氨苄西林舒巴坦为84%，对碳青霉烯类为96.4%，对黏菌素为4%。
该研究揭示了治疗医院获得性感染常用抗菌药物的耐药率令人担忧。同时还显示了AMR与一些风险因素之间的关系，并因此采取措施加以控制。
