Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Ann Clin Microbiol Antimicrob. 2022 Feb 16;21(1):6. doi: 10.1186/s12941-022-00496-5.
Nosocomial infections (NIs) could lead to considerably higher mortality rates, length of the hospital stays and costs, and represent a serious public health concern worldwide. Besides, the unreasonable use of antibiotics could lead to get resistant to different antibiotics and create limited therapeutic options, increased risks of treatment failure and poor patient management. The current study aimed to evaluate the prevalence and antimicrobial susceptibility of NIs in an Iranian referral pediatrics hospital during 3 years.
During the 3-year period, all electronic medical records of nosocomial infection episodes in hospitalized patients were retrospectively reviewed. The bacterial and fungal profile and antimicrobial susceptibility profiles of isolates recovered from different samples of patients with NIs were determined.
In this study, a total of 718 patients with NIs was found, among which 61.3% were male (N = 440). The median age of the patients was 2.5 years (IQR: 1 month to 3 years). Klebsiella pneumonia and Candida spp. isolates were the most prevalent microorganisms (N = 125, 17.4%, N = 121, 16.9%, respectively), followed by Pseudomonas aeruginosa (N = 72, 10%) and Coagulase-negative Staphylococci (CoNS) (N = 69, 9.6%). Pseudomonas aeroginusa strains showed high sensitivity to the studied antibiotics. Acinetobacter baumannii strains displayed more than 90% resistance to the almost all antibiotics. All of the tested isolates of S. maltophilia were susceptible to Trimethoprim-sulfamethoxazole (100%) and showed high susceptibility rate to ciprofloxacin (96.4%). Vancomycin resistance was not reported in S. aureus isolates, while 64% of Enterococcus spp. was resistant to vancomycin. The rates of methicillin resistance for S. aureus and CoNS isolates were 45.5% and 85.7%, respectively.
High frequency of antimicrobial resistance to the commonly tested antibiotics is a concerning alarm. Therefore, effective infection control programs and rational antibiotic use policies should be established promptly.
医院获得性感染（NIs）可导致死亡率、住院时间和费用显著增加，是全球范围内严重的公共卫生问题。此外，抗生素的不合理使用可导致对不同抗生素的耐药性，并导致治疗选择有限、治疗失败风险增加和患者管理不善。本研究旨在评估伊朗一家儿科转诊医院 3 年内 NIs 的患病率和抗菌药物敏感性。
在 3 年期间，回顾性分析了住院患者医院感染病例的电子病历。从不同 NIs 患者样本中分离出的细菌和真菌以及抗菌药物敏感性。
本研究共发现 718 例 NIs 患者，其中 61.3%为男性（N=440）。患者的中位年龄为 2.5 岁（IQR：1 个月至 3 岁）。肺炎克雷伯菌和念珠菌属是最常见的微生物（N=125，17.4%，N=121，16.9%），其次是铜绿假单胞菌（N=72，10%）和凝固酶阴性葡萄球菌（CoNS）（N=69，9.6%）。铜绿假单胞菌菌株对所研究的抗生素表现出高度敏感性。鲍曼不动杆菌菌株对几乎所有抗生素的耐药率均超过 90%。所有测试的嗜麦芽窄食单胞菌菌株均对甲氧苄啶-磺胺甲恶唑（100%）敏感，对环丙沙星（96.4%）显示出高敏感性。未报告金黄色葡萄球菌分离株对万古霉素的耐药性，而 64%的肠球菌属对万古霉素耐药。金黄色葡萄球菌和凝固酶阴性葡萄球菌分离株的耐甲氧西林率分别为 45.5%和 85.7%。
对常用抗生素的耐药率较高令人担忧。因此，应迅速制定有效的感染控制计划和合理的抗生素使用政策。
