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Antibiotic Resistance Pattern in Intensive Care Units in a Large Referral Hospital in Iran Publisher



Salarvand S1 ; Abdollahi A1 ; Afarinesh Khaki P2 ; Norouzi Shadehi M2 ; Beigh Mohammadi MT3 ; Miratashi Yazdi SA4 ; Nazar E5
Authors
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Authors Affiliations
  1. 1. Department of Pathology, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Central Laboratory, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Intensive care medicine, Imam Khomeini complex hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Pathology Published:2023


Abstract

Background & Objective: Antibiotic resistance, especially in the form of multidrug-resistant (MDR), is a big problem, especially in intensive care units (ICUs). This study aimed to evaluate antibiotic resistance and MDR patterns among patients hospitalized in the ICUs in one of the large referral centers in Iran. Methods: The present study was conducted at Imam Khomeini Hospital in Tehran (a great referral hospital), which admits critically ill patients requiring ICU services. To determine the rate of positive cultures for resistant strains, the patient’s blood specimens were sent to the laboratory of the hospital for inoculation on proper culture media within 2 hours of extraction. Antimicrobial susceptibility tests were done using the Bauer– Kirby disk diffusion method. Results: A total of 1,755 samples were collected from the patients to assess microbial strains and antibiotic resistance. The most common microbial strains detected in the cultures extracted from peripheral blood samples were Klebsiella pneumonia (22.1%), Staphylococcus epidermidis (7.9%) and another coagulase-negative Staphylococcus (15.0%). The antibiogram test showed antibiotic resistance in 1,509 cases, leading to a resistance prevalence rate of 85.9%. The most common antimicrobial resistance observed was against cotrimoxazole (61.7%), ciprofloxacin (51.3%), imipenem (50.0%), and ampicillin (49.6%). The rate of MDR was found to be 96.3%. Conclusion: In Iran’s ICUs, a significantly high level of antibiotic resistance may be seen especially the MDR pattern, which indicates the need to change the pattern of prescribing and managing these drugs in ICU centers. © 2023, Iranian Society of Pathology. All rights reserved.