Tahmasebi Zahra, Asadollahi Parisa, Sadeghifard Nourkhoda, Ghafourian Sobhan, Kalani Behrooz Sadeghi, Kalaei Esmail Ghasemi Pasha, Pakzad Iraj
MSc, Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Pajuhesh Boulevard, Banganjab Avenue, postal code: 6939177143, Ilam, Iran.
PhD, Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Pajuhesh Boulevard, Banganjab Avenue, postal code: 6939177143, Ilam, Iran.
Germs. 2022 Sep 30;12(3):333-343. doi: 10.18683/germs.2022.1337. eCollection 2022 Sep.
Pulmonary diseases are amongst the most common causes of premature death and distressing disorders worldwide. This study aimed to detect the fastidious and routine infectious agents, and their drug resistance patterns in bronchoalveolar lavage (BAL) samples.
A total of 44 BAL samples were collected by bronchoscopy from patients with respiratory disorders hospitalized at 2 teaching hospitals in Ilam, Iran. The samples were cultured on routine bacterial culture media to identify the bacterial agents and calculate the colony count. Antibiotic susceptibility was determined by disk diffusion method according to the CLSI protocol. PCR was used to detect the fastidious bacteria and using the specific primers and Legionella pneumophila using the mip specific primers.
Overall, 100 bacterial isolates were isolated by culture from the 44 BAL samples including: (24, 31.2%), (18, 23.4%), (11, 14.3%), (11, 14.3%), (11, 14.3%), (10, 13%), (5, 6.5%), (5, 6.5%) and (5, 6.5%). PCR detected 4 positive samples (9.1%) for but no positive cases for and . showed the highest resistance rate (81.8%) to aztreonam and ceftazidime. Seventy-five percent of the isolates were resistant to cefoxitin (MRSA) and 83.3% had the gene. Vancomycin resistance was observed in 27.3% of the species (VRE). Resistance to piperacillin, cefotaxime, ciprofloxacin and imipenem was observed in 54.5%, 45.5%, and 36.4% of the isolates, respectively. The frequency of organisms isolated from the ICU was higher (46%) than from other wards.
The presence of MRSA, cephalosporins-resistant Enterobacteriaceae as well as and resistant against piperacillin, imipenem, cefotaxime, aztreonam and ciprofloxacin amongst different wards, especially the ICU ward of the surveyed hospitals, is a major healthcare concern and it is necessary to wisely scrutinize the preventive strategies for antibiotic resistant infections.
肺部疾病是全球过早死亡和令人痛苦的疾病的最常见原因之一。本研究旨在检测支气管肺泡灌洗（BAL）样本中的苛养菌和常规感染病原体及其耐药模式。
通过支气管镜检查从伊朗伊拉姆的2家教学医院住院的呼吸系统疾病患者中收集了44份BAL样本。将样本接种于常规细菌培养基上以鉴定细菌病原体并计算菌落数。根据CLSI协议通过纸片扩散法测定抗生素敏感性。使用特异性引物通过PCR检测苛养菌，使用mip特异性引物检测嗜肺军团菌。
总体而言，通过培养从44份BAL样本中分离出100株细菌分离株，包括：（24株，31.2%），（18株，23.4%），（11株，14.3%），（11株，14.3%），（11株。14.3%），（10株，13%），（5株，6.5%），（5株，6.5%）和（5株，6.5%）。PCR检测到4份（9.1%）样本呈阳性，但未检测到和呈阳性的病例。对氨曲南和头孢他啶的耐药率最高（81.8%）。75%的分离株对头孢西丁耐药（耐甲氧西林金黄色葡萄球菌），83.3%携带基因。在27.3%的该菌种中观察到万古霉素耐药（耐万古霉素肠球菌）。分别在54.5%、45.5%和36.4%的分离株中观察到对哌拉西林、头孢噻肟和环丙沙星耐药。从重症监护病房分离出的病原体频率（46%）高于其他病房。
在所调查医院的不同病房，尤其是重症监护病房中，存在耐甲氧西林金黄色葡萄球菌、耐头孢菌素的肠杆菌科细菌以及对哌拉西林、亚胺培南、头孢噻肟、氨曲南和环丙沙星耐药的和，这是一个主要的医疗问题，有必要明智地审视抗生素耐药感染的预防策略。
