Volume 25, Issue 1 (Avicenna Journal of Clinical Medicine - Spring 2018)                   Avicenna J Clin Med 2018, 25(1): 41-48 | Back to browse issues page

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Majzoobi M M, Pirdehghan A, Rashidian Z, Saadatmand A. Etiologic Agents and Antibiotic Resistance Pattern of Community- and Hospital-Acquired Infections. Avicenna J Clin Med. 2018; 25 (1) :41-48
URL: http://sjh.umsha.ac.ir/article-1-1697-en.html
MSc in Microbiology, Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran , Ali.s_umsha@yahoo.com
Abstract:   (1026 Views)
Background and Objective: Empirical antibiotic therapy of community- and hospital-acquired infections without the knowledge of the common causes and resistance patterns of the infections can lead to the enhancement of antibiotic resistance. Regarding this, the aim of this study was to determine the etiologic agents and antibiotic resistance pattern of community- and hospital-acquired infections.
Materials and Methods: This descriptive-analytical study was conducted on hospitalized patients with positive microbial cultures in two hospitals of Hamadan city, Iran, during 2012-2015. The participants were assigned into two groups of community- and hospital-acquired infections after their examination in terms of clinical manifestations. In addition to the common pathogens and their resistance patterns, the patients were examined for the type of interventions and underlying diseases. The data were analyzed in SPSS software (version 20) using the statistical tests.
Results: Out of the 818 documented infections, 108 (13.2%) and 710 (86.8%) cases were community- and hospital-acquired infections, respectively. The majority of the positive cultures were respectively observed in the tracheal (62.7%), urinary (23.7%), and blood (9%) samples. Furthermore, the most frequent medical interventions included peripheral venous catheter (71.9%), suction (64.3%), ventilator (59.6%), and urinary catheter (16.5%). The most common etiologic agents of nosocomial infections were Escherichia coli (19.3%), Pseudomonas aeruginosa  (18.9%), and Acinetobacter baumannii (16.6%). Regarding the community-acquired infections, the most common etiologic agents included E. coli (19.4%), coagulase-negative staphylococci (18.5%), and Pseudomonas aeruginosa (14.8%). The highest reported resistance among nosocomial infections was related to oxacillin and ciprofloxacin. On the other hand, community-acquired infection showed the highest resistance to vancomycin and ciprofloxacin.   
Conclusion: As the findings indicated, Gram-negative bacteria are more common in both community- and hospital-acquired infections. In addition, the results were indicative of the enhancement of antibiotic resistance over time.
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1. Cardoso T, Ribeiro O, Aragao I, Costa PA, Sarmento A. Differences in microbiological profile between community-acquired, healthcare-associated and hospital-acquired infections. Acta Med Port. 2013;26(4):377-84. [PubMed]
2. Rodriguez-Bano J, Angeles Dominguez M, Blas Millan A, Borraz C, Pau González M, Almirante B, et al. Clinical and molecular epidemiology of community-acquired, healthcare-associated and nosocomial methicillin-resistant Staphylococcus aureus in Spain. Clin Microbiol Infect. 2009;15(12):1111-8. [DOI] [PubMed]
3. Weinstein RA. Infections acquired in health care facilities. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Principles of Internal medicine. New York: McGraw-Hill; 2015. P. 911-8.
4. Khosravi B, Razavi A. Nosocomial infection. Ebnesina J Med. 2010;13(1 and 2):43-51.
5. McBryde ES, Bradley LC, Whit by M, McElwain DL. An investigation of contact transmission of methicillin-resistant Staphylococcus aureus. J Hosp Infect. 2004;58(2):104-8. [DOI] [PubMed]
6. Rodriguez-Bano J, Lopez-Prieto M, Portillo M, Retamar P, Natera C, Nuño E, et al. Epidemiology and clinical features of community-acquired, healthcare-associated and nosocomial bloodstream infections in tertiary-care and community hospitals. Clin Microbiol Infect. 2010;16(9):1408-13. [DOI] [PubMed]
7. Lenz R, Leal JR, Church DL, Gregson DB, Ross T, Laupland KB. The distinct category of healthcare associated blood stream infections. BMC Infect Dis. 2012;12:85. [DOI] [PubMed]
8. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39(3):309-17. [DOI] [PubMed]
9. Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP, Pollock DA, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep. 2007;122(2):160-6. [DOI] [PubMed]
10. Sadeghzade V, Hasani N. The frequency rate of nosocomial urinary tract infection in Intensive care unit patients in Shafieh Hospital in Zanjan 2004. J Zanjan Univ Med Sci Health Serv. 2005;13(50):28-35. [Persian]
11. Zamanzad B, Shirzad H, Naseri F. Comparison of the causative bacteria and antibacterial susceptibility pattern of nosocomial and community- acquired urinary tract pathogens in 13-35 years old women, Shahrekord. Arak Med Univ J. 2004;8(4):23-30. [Persian]
12. Hashemi SH, Esna-Ashari F, Tavakoli S, Mamani M. The prevalence of Antibiotic Resistance of Enterobacteriaceae strains isolated in community- and hospital-acquired infections in teaching hospitals Hamadan. West of Iran. J Res Health Sci. 2013;13(1):75-80. [PubMed]
13. Sohrabi M, Khosravi A, Zolfaghari P, Sarrafha J. Evaluation of nosocomial infections in Imam Hossein (as) hospital of Shahrood, 2005. J Birjand Univ Med Sci. 2009;16(3):33-9. [Persian]
14. Lipsky BA, Weigelt JA, Gupta V, Killian A, Peng MM. Skin, soft tissue, bone, and joint infections in hospitalized patients: epidemiology and microbiological, clinical, and economic outcomes. Infect Control Hosp Epidemiol. 2007; 28(11):1290-8. [DOI] [PubMed]
15. Barak M, Mamishi S, Siadati S A, Salamati P, Khotaii G, Mirzarahimi M. Risk factors and bacterial etiologies of nosocomial infections in NICU and PICU wards of children’s medical center and Bahrami hospitals during 2008-2009. J Ardabil Univ Med Sci. 2011;11(2):113-20. [Persian]
16. Shojaei S, Rahimi T, Amini M, Shams S. Survey of nosocomial infections in patients admitted to Nekoei hospital of Qom city in 2012, Iran. Qom Univ Med Sci J. 2015;9(4):64-73. [Persian]
17. Mobaien A, Amirhasani S, Nekoei A, Nekoei B. Study of nosocomial urinary tract infections in the ICUs of Hamadan Besat and Ekbatan hospitals during the 2008-2009 Period. J Zanjan Univ Med Sci. 2012;20(79):94-102. [Persian]
18. Esmaeili R, Hashemi H, Moghadam shakib M, Alikhani M, Sohrabi Z. Bacterial etiology of urinary tract infections and determining their antibiotic resistance in adults hospitalized in or referred to the Farshchian Hospital in Hamadan. Sci J Ilam Univ Med Sci. 2014;21(7):281-7. [Persian]
19. Mahmoudi H, Ghasemi Bassir HR, Hosseini SM, Arabestani MR, Alikhani MY. The frequency of bacteria isolated from blood cultures and antibiotic susceptibility patterns among admitted patients in Hospital of Hamedan University of Medical Sciences. Iran J Med Microbiol. 2016;10(4):69-74. [Persian]
20. Barak M, Pourfarzi F, Jirodi S, Rahimi G, Pahlavan Y. Etiology and clinical investigation of nosocomial infections at Ardabil Bou-Ali hospital during 2010. J Ardabil Univ Med Sci. 2012;12(5):33-9. [Persian]
21. Quartin AA, Scerpella EG, Puttagunta S, Kett DH. Comparison of microbiology and demographics among patients with healthcare-associated, hospital-acquired, and ventilator-associated pneumonia: a retrospective analysis of 1184 patients from a large, international study. BMC Infect Dis. 2013;13:561. [DOI] [PubMed]
22. Al Sweih N, Jamal W, Rotimi VO. Spectrum and antibiotic resistance of uropathogens isolated from hospital and community patients with urinary tract infections in two large hospitals in Kuwait. Med Princ Pract. 2005;14(6):401-7. [DOI] [PubMed]
23. Asencio Egea MÁ, Huertas Vaquero M, Carranza González R, Herráez Carrera Ó, Redondo González O, Arias Arias Á. Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models. Enferm Infecc Microbiol Clin. 2017;4:S0213. [DOI] [PubMed]
24. Agostino JW, Ferguson JK, Eastwood K, Kirk MD. The increasing importance of community-acquired methicillin-resistant Staphylococcus aureus infections. Med J Aust. 2017;207(9):388-93. [PubMed]
25. Amini M, Sanjari L, Vasei M, Alavi S. Prevalence of nosocomial infections and related factors in the intensive care unit of Shahid Mostafa Khomeini Hospital, Tehran based on NNIS system. J Army Univ Med Sci. 2009;7(1):9-14. [Persian]
26. Askarian M, Gooran NR. National nosocomial infection surveillance system-based study in Iran; additional hospital stay attributable to nosocomial infections. Am J Infect Control. 2003;31(8):465-8. [PubMed]
27. Hadadi A, Rasoulinejad M, Maleki Z, Yonesian M, Shirani A, Kourorian Z. Antimicrobial resistance pattern of Gram-negative bacilli of nosocomial origin at 2 university hospitals in Iran. Diagn Microbiol Infect Dis. 2008;60(3):301-5. [DOI]

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