Antimicrobial resistance patterns of Gram-negative bacteria isolated from bloodstream infections in an Iranian referral paediatric hospital: A 5.5-year study

Mahmoudi, Shima; Mahzari, Masoumeh; Banar, Maryam; Pourakbari, Babak; Ashtiani, Mohammad Taghi Haghi; Mohammadi, Mohsen; Valian, Sepideh Keshavarz; Mamishi, Setareh

doi:10.1016/j.jgar.2017.04.013

Cited by 37 publications

(29 citation statements)

References 26 publications

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“…Our study also revealed that colistin, in comparison with levofloxacin and ciprofloxacin, has the highest resistance rate. These finding were in contrast with the results of Mahmoudi et al from Iran 12 and Dharmapalan et al from India. 38 In the current study, among GNB, Proteus spp.…”

Section: Discussioncontrasting

confidence: 98%

“…In the present study, P. aeruginosa and CoNS were the most frequent pathogens among GNB and GPB, respectively, which is in agreement with a study conducted by Mahmoudi et al (2011Mahmoudi et al ( -2016 Tehran, Iran). 12 However, in the investigations carried out by Ebrahim-Saraie et al and Alam et al, Acinetobacter spp. was the most common GNB in positive culture specimens.…”

Section: Discussionmentioning

confidence: 95%

“…10,11 Thus, inappropriate prescription and misuse of antibiotics could contribute to the emergence of AMR pathogenic bacteria, restriction of therapeutic options, increase of hospitalization time and high treatment costs and finally a greater death rate. [12][13][14] Bacteria are one of the main causes of infections in humans. [15][16][17] Children are usually considered as the most vulnerable group to bacterial infections.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17] Children are usually considered as the most vulnerable group to bacterial infections. 12,18 According to the global action plan on AMR endorsed by WHO, it is important to raise awareness on AMR through monitoring and research programs in different parts of the world. [19][20][21] AMR monitoring is critical and has several benefits including: 1) providing data on bacterial resistance rate, 2) helping select appropriate antibiotics and subsequently reduce AMR rate, 22 3) reduction in hospitalization rate and treatment costs, and 4) decrease in death rate.…”

Section: Introductionmentioning

confidence: 99%

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<p>Evaluating the antimicrobial resistance patterns among major bacterial pathogens isolated from clinical specimens taken from patients in Mofid Children’s Hospital, Tehran, Iran: 2013–2018</p>

Azimi

Maham

Fallah

et al. 2019

IDR

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Background: This study evaluates the epidemiology and antimicrobial resistance profile of Gram-negative bacteria (GNB) and Gram-positive bacteria (GPB) isolated from clinical specimens in children admitted to Mofid Children's Hospital. Methods: This was a retrospective study of the patients' clinical specimens collected from January 2013 until the end of December 2018. All specimens were evaluated to determine the presence of infection-causing agents using a BACTEC 9120 blood culture. Isolation and identification of bacterial strains were performed using conventional biochemical tests. Antibiotic resistance was determined using Kirby-Bauer disk diffusion and broth microdilution methods. Results were interpreted according to CLSI and EUCAST. Results: A total of 1130 different pathogenic bacteria were detected from 14,690 different clinical specimens and the overall detection rate was 7.7% (1130/14,690). Among bacterial pathogen isolated from clinical specimens, 55% (n=622) were GNB and 45% (n=508) were GPB. The predominant GNB isolates were Pseudomonas aeruginosa, Klebsiella spp., Acinetobacter baumannii, Escherichia coli, Enterobacter spp., Citrobacter spp., respectively. Among GPB, CoNS was the most frequent and Enterococcus spp. was found to have low levels of resistance to linezolid. In GNB, most A. baumannii and P. aeruginosa were ceftriaxone resistant. P. aeruginosa was found to have low levels of resistance to levofloxacin and ciprofloxacin. Conclusions: Our findings revealed that the resistance rate among GNB and GPB associated with different infections in children is very high. These results suggest a constant screening and follow-up programs for the detection of antibiotic resistance, and it also suggests to develop antimicrobial stewardship programs in Tehran, Iran.

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Section: Discussioncontrasting

confidence: 98%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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<p>Evaluating the antimicrobial resistance patterns among major bacterial pathogens isolated from clinical specimens taken from patients in Mofid Children’s Hospital, Tehran, Iran: 2013–2018</p>

Azimi

Maham

Fallah

et al. 2019

IDR

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“…In addition to previously mentioned studies (1, 2), some research in Iran and China showed that the prevalence of Acinetobacter, as a nosocomial bloodstream infection, was about 1% -3% (5,14,15), that is almost similar to the results of our study which estimated a prevalence of about 1%.…”

Section: Discussionsupporting

confidence: 92%

Risk Factors for Resistance and Mortality in Patients with Extensively Resistant Acinetobacter Bacteremia in Taleghani Hospital in Tehran, Iran

Abolghasemi

Madadi

Mardani

2018

Arch Pediatr Infect Dis

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Objectives: This study describes the antibiotic resistance pattern in patients with Acinetobacter bacteremia and investigates the factors leading to extensively drug resistance (XDR) and mortality. Methods: This descriptive analytical study was conducted in patients with Acinetobacter bacteremia between February 2014 and February 2015. The microorganisms were identified with conventional bacteriological methods and then, following the clinical and laboratory standards institute (CLSI) recommendations, susceptibility testing was performed on all isolates. Moreover, we used electronic records to extract the patients' data and analyzed them using Chi-square test or Fisher's exact test and T-Test. Results: Among the influencing factors, the severity of clinical symptoms at the time of admission, longer duration of hospitalization especially in the ICU, and use of invasive devices such as ventilator had a significant relationship with the occurrence of resistance and mortality in the patients. In addition, the central venous catheterization and history of drug resistance such as XDR were associated with mortality. Conclusions: Given the increasing prevalence of XDR Acinetobacter strains causing resistant nosocomial infection, especially in immunocompromised patients, it is necessary to reduce the risk factors leading to drug resistance and mortality. Furthermore, early administration of empiric antibiotic therapy can have a good effect on the outcomes.

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Phenotypic Identification and Genotypic Characterization of Plasmid-Mediated AmpC β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates in Iran

et al. 2021

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One of the mechanisms of Klebsiella pneumoniae and Escherichia coli resistance to β-lactam antibiotics is the production of β-lactamase enzymes. Among these are the AmpC β-lactamases, which confer resistance to a class of antibiotics. However, little is known about the AmpC βlactamases of K. pneumoniae and E. coli clinical isolates in Qazvin, Iran. This study was designed to assess the AmpC β-lactamases-producing strains and also identify the prevalence of AmpC β-lactamases genes. Antimicrobial susceptibility tests were performed on 435 K. pneumoniae and E. coli isolates using disk diffusion technique. Plasmid-mediated AmpC genes were studied using a multiplex PCR assay. The AmpC β-lactamase-producer isolates were studied by employing cefoxitin disk diffusion test, AmpC induction test, AmpC cefoxitin-EDTA test, and boronic acid disk test. Our results showed that of 46 (18.4%) cefoxitin-insensitive E. coli isolates, 10 (21.7%) were positive for AmpC β-lactamase genes, among them 4 (8.69%) isolates were positive for blaDHA genes and 6 (13%) for blaCIT genes. Of 57 (30.4%) cefoxitin-insensitive K. pneumoniae isolates, 10 (17.5%) were positive for AmpC gene with 4 (6.34%) and 6 (9.5%) isolates positive for blaDHA and blaCIT genes, respectively. However, no MOX, ACC, FOX, or EBC genes were detected in the isolates. Considering the results of different confirmatory phenotypic tests, the AmpC cefoxitin-EDTA test showed a higher discriminatory power for detecting AmpC β-lactamase-producing strains. The specificity and sensitivity of AmpC cefoxitin-EDTA were 77%, 100% for K. pneumonia and 70%, 90% for E. coli higher than the other two tests, respectively. Also, the authors demonstrated high prevalence rate for resistance to certain antibiotics, such as cefuroxime, trimethoprim-sulfamethoxazole, ampicillin, and cefotaxime. In conclusion, our study provided valuable information regarding the plasmid-mediated AmpC βlactamase gene content, antibiotic resistance, and confirmatory phenotypic tests for AmpC βlactamases in E. coli and K. pneumoniae isolates from clinical sources.

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Antimicrobial resistance patterns of Gram-negative bacteria isolated from bloodstream infections in an Iranian referral paediatric hospital: A 5.5-year study

Cited by 37 publications

References 26 publications

<p>Evaluating the antimicrobial resistance patterns among major bacterial pathogens isolated from clinical specimens taken from patients in Mofid Children’s Hospital, Tehran, Iran: 2013–2018</p>

<p>Evaluating the antimicrobial resistance patterns among major bacterial pathogens isolated from clinical specimens taken from patients in Mofid Children’s Hospital, Tehran, Iran: 2013–2018</p>

Risk Factors for Resistance and Mortality in Patients with Extensively Resistant Acinetobacter Bacteremia in Taleghani Hospital in Tehran, Iran

Phenotypic Identification and Genotypic Characterization of Plasmid-Mediated AmpC β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates in Iran

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