A national framework for an antimicrobial resistance surveillance system within Iranian healthcare facilities: Towards a global surveillance system

Safdari, Reza; Ghazisaeedi, Marjan; Masoumi-Asl, Hossein; Rezaei‐Hachesu, Peyman; Mirnia, Kayvan; Samad‐Soltani, Taha

doi:10.1016/j.jgar.2017.03.016

Cited by 12 publications

(11 citation statements)

References 13 publications

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Section: Discussionmentioning

confidence: 99%

“…The emergence of bacterial antibiotic resistance is a growing threat to public health all over the world, especially in developing countries (14). According to predictions, antibiotic-resistant infections may lead to 10 million deaths per year by 2050 (14). Antibiotic resistance in P. aeruginosa is an important issue, particularly in patients with cystic fibrosis as well as hospitalized and immunocompromised patients (5).…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Virulence Genes and Drug Resistance Profiles of Pseudomonas aeruginosa Isolated From Clinical Specimens

Bazghandi

Arzanlou

Peeridogaheh

et al. 2021

Jundishapur J Microbiol

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Background: Drug resistance and virulence genes are two key factors for the colonization of Pseudomonas aeruginosa in settings with high antibiotic pressure, such as hospitals, and the development of hospital-acquired infections. Objectives: The objective of this study was to investigate the prevalence of drug resistance and virulence gene profiles in clinical isolates of P. aeruginosa in Ardabil, Iran. Methods: A total of 84 P. aeruginosa isolates were collected from clinical specimens of Ardabil hospitals and confirmed using laboratory standard tests. The disk diffusion method was used for antibiotic susceptibility testing and polymerase chain reaction (PCR) for the identification of P. aeruginosa virulence genes. Results: The highest and the lowest antibiotic resistance rates of P. aeruginosa strains were against ticarcillin-clavulanate (94%) and doripenem (33.3%), respectively. In addition, the frequency of multidrug-resistant (MDR) P. aeruginosa was 55.9%. The prevalence of virulence factor genes was as follows: algD 84.5%, lasB 86.9%, plcH 86.9%, plcN 86.9%, exoU 56%, exoS 51.2%, toxA 81%, nan1 13.1%, and pilB 33.3%. A significant association was observed between resistance to some antibiotics and the prevalence of virulence genes in P. aeruginosa. Conclusions: Our results revealed a high prevalence of antibiotic resistance, especially MDR, and virulence-associated genes in clinical isolates of P. aeruginosa in Ardabil hospitals. Owing to the low resistance rates against doripenem, gentamicin, and tobramycin, these antibiotics are recommended for the treatment of infections caused by highly resistant and virulent P. aeruginosa strains.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of Virulence Genes and Drug Resistance Profiles of Pseudomonas aeruginosa Isolated From Clinical Specimens

Bazghandi

Arzanlou

Peeridogaheh

et al. 2021

Jundishapur J Microbiol

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“…Antibiotic resistance is growing rapidly worldwide. Therefore, antimicrobial resistance surveillance programs are required, especially in developing countries such as Iran, to monitor and predict the trend of drug resistance and assess the overuse and misuse of antimicro- bial agents and associated consequences (18). The emergence of imipenem-resistant P. aeruginosa strains is a concerning issue because these strains show simultaneous resistance to multiple antibiotics (19).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Metallo-beta-Lactamase-positive and High-risk Clone ST235 Pseudomonas aeruginosa at Ardabil Hospitals

Safarirad

Arzanlou

Mohammadshahi

et al. 2021

Jundishapur J Microbiol

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Background: Carbapenems are the most commonly administered drugs for the treatment of multidrug-resistant Pseudomonas aeruginosa (MDR-P. aeruginosa) infections. However, carbapenem-resistant P. aeruginosa is spreading rapidly and has led to a new threat to human health worldwide. Objectives: The current study aimed to determine the prevalence of imipenem-resistant P. aeruginosa, detect metallo-β-lactamase (MBL)-producer isolates, and evaluate their clonal relationships in strains isolated from patients referring to the hospitals of Ardabil city, Iran. Methods: The resistance rate to imipenem was evaluated using the disk diffusion method. Double-disk synergy test and PCR technique were used for phenotypic and genotypic screening of MBL-positive P. aeruginosa, respectively. Ultimately, ERIC-PCR and MLST methods were used for assessing clonal relatedness among the isolates. Results: The prevalence of imipenem-resistant P. aeruginosa strains was estimated at 57.1% (48 out of 84 isolates). In addition, 45 (93.7%) out of 48 imipenem-resistant P. aeruginosa isolates were phenotypically screened as MBL-positive, among which 16 (35.5%) and three (6.6%) isolates harbored blaIMP and blaVIM-1 genes, respectively. However, blaNDM, blaSIM-2, blaSPM, and blaGIM-1 genes were not detected in this study. MBL-producing P. aeruginosa strains were divided into 42 ERIC-PCR types. Based on the results of MLST, P. aeruginosa ST235 was the only identified sequence type. Conclusions: Our results revealed a high and alarming prevalence of imipenem-resistant and blaIMP-positive P. aeruginosa ST235 at Ardabil hospitals. Continuous monitoring is essential to control the further spread of this highly virulent and drug-resistant clone.

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“…In Iran, the 4% of imported drugs represent 40% of the total value of the Iranian pharmaceutical market [16,27]. And also due to the sanctions and lack of medical products, diffusion disk is the widely-used test in Iran, and the MIC or E-test tests are performed only in few hospitals and research centers [28].…”

Section: Discussionmentioning

confidence: 99%

Control of antimicrobial resistance in Iran: the role of international factors

et al. 2020

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Background Antimicrobial resistance (AMR) is currently causing various challenges for all countries around the world. Accordingly, the WHO is placing a great emphasis on the global partnership and allinaces to drive countries towards developing policy guidances and a strategic framework for AMR contatiment. This study thus seeks to elaborate on the international factors underlying AMR management in Iran. Methods Semi-structured interviews were conducted with managers from the Ministry of health (n = 14), Iran veterinary organization (n = 4), the national professional associations (n = 3) and researchers (n = 3), between November 2018 and July 2019. Participants were selected using purposeful and snowball sampling. Interviews were recorded and transcribed verbatim and were subsequently coded and analyzed thematically using MAXQDA software (V.18) and reported. Results International enabling and predisposing factors were identified in relation to the AMR control in the country. Enabling factors included knowledge transfer, facilitation in policy agenda setting, formulation and implementaion process, and AMR monitoring. Predisposing factors, alternatively, encompassed the migration of infectious patients, trafficking of medicine and livestock from neighboring countries, and the imposed sanctions. Conclusion Nowadays, AMR is taken cognizance of as a global challenge, thus to be addressed effectively, needs an international consensus more than ever. This harmony would not certainly underrate national efforts, but instead, is needed to reinforce such efforts through e.g. technical and financial assistance. It is suggested for policymakers to use all available political and legal means such as health diplomacy to establish humanitarian channels in order to enhance global convention and remove possible barriers as the sanctions and reduce their adverse consequences for AMR control.

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A national framework for an antimicrobial resistance surveillance system within Iranian healthcare facilities: Towards a global surveillance system

Cited by 12 publications

References 13 publications

Prevalence of Virulence Genes and Drug Resistance Profiles of Pseudomonas aeruginosa Isolated From Clinical Specimens

Prevalence of Virulence Genes and Drug Resistance Profiles of Pseudomonas aeruginosa Isolated From Clinical Specimens

Prevalence and Characteristics of Metallo-beta-Lactamase-positive and High-risk Clone ST235 Pseudomonas aeruginosa at Ardabil Hospitals

Control of antimicrobial resistance in Iran: the role of international factors

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