Multidrug-resistant bacteria isolated from intensive-care-unit patient samples

Abstract

We examined epidemiological aspects and bacterial resistance patterns of bacteria isolated from intensive care unit (ICU) patient samples. During a 10 month period (from June 2006 to March 2007), 812 samples of blood, urine and cerebral spinal fluid (CSF) from 553 hospitalized patients, in ICU wards, including pediatric surgical, neonatal, adult surgical I, adult surgical II, general pediatrics, neurosurgical I, neurosurgical II, and internal medical, were collected. Minimum inhibitory concentration (MIC) of antibiotics for bacteria isolates was determined by the E-test method. The internal medicine ICU with 28.7% admissions gave the largest contribution. Coagulase negative staphylococci at frequencies of 66.7 % and 36.5 % and E. coli at 20.9% were the bacteria most frequently isolated from the blood, CSF and urine samples, respectively. Samples taken from patients 20-40 years old were the most frequent (32.2%), while the group of patients over sixty years contributed least (18.5%). Both Gram-positive and - negative isolates expressed resistance to most of the penicillins and cephalosporins tested. Combined therapy with vancomycin and meropenem or imipenem gave the most effective treatment against Gram-positive and Gram-negative isolates based on empirical therapy. High frequencies of multiresistant bacteria in ICUs warn us to administer a few effective antibiotics in our hospitals more wisely in order to reduce selective pressure on sensitive strains. This could help save the life of ICU patients and prevent of spread of resistant isolates in these critical wards. Due to continuous changes in antibacterial susceptibility patterns, periodical antibacterial sensitivity assessment in ICUs should be mandatory.

Prevalence of Etiological Agents and Antimicrobial Resistance Patterns of Bacterial Meningitis in Nemazee Hospital, Shiraz, Iran

“…Although the results of the study by Japoni et al (7) were not specific for CSF samples, a previous study in Shiraz provided good information on the susceptibility patterns of species isolated from CSF cultures. Overall, it seems that the Gram-positive isolates of the current study were more sensitive to co-trimoxazole and ciprofloxacin than the isolates in that of the Japoni et al (7). Vancomycin resistance in Gram-positive cocci of the current study was more than that of Japoni et al's with less than 10%.…”

“…New information of antimicrobial susceptibility testing for routinely used antibiotics could guide clinicians to better choices of antibiotics for prophylaxis purposes (2,8). Antibiotic susceptibility patterns may also vary among hospitals; therefore, this information is particularly vital for the effectiveness of empirical therapy in acute cases (7,9). Neisseria meningitides, Streptococcus pneumonia, and Haemophilus influenzae type b are most commonly associated with bacterial meningitis (5).…”

Ventilator-associated pneumonia in Iranian intensive care units

“…High rates of neurological disorders were also previously reported in the region [17,18]. Most of them were purportedly referred to ICUs as a result of car or motorbike accidents A significant correlation between normalization of the PaO2/FiO2 ratio and body temperature (fever) 72 Table 6.…”

“…When patients have previously received courses of antibiotics, resistant bacteria can survive and multiplication of antibiotic resistant bacteria continues despite empiric antibiotic therapy [22][23][24]. Therefore, determination of antibiotic sensitivity patterns alongside the administration of appropriate empiric antibiotic therapy could be mandatory in such cases [17,22]. Additionally, administration of corticosteroids could down-regulate specific and nonspecific immune system responses.…”

Antimicrobial Susceptibility Pattern and Age Dependent Etiology of Urinary Tract Infections in Nemazee Hospital, Shiraz, South-West of Iran

“…Antibiotic resistance is a growing concern in developing countries especially Iran; as has been noted in previous reports (8)(9)(10). Extensive empirical uses of broad-spectrum antibiotics often lead to the outbreaks of resistant isolates to many antimicrobials agents (11). The life-threatening risk of antibiotics resistance among bacteria responsible for UTIs is much critical for specific life time periods or conditions such as elderly age or pregnancy and necessitates an urgent attention (4)(5)(6).…”