Evaluating managers’ leadership style, career self-efficacy and burnout among nurses.

Introduction: The present study examined the relation between managers’ leadership style and burnout through career self-efficacy in the framework of a scientific model. Methodology: The study participants included 240 nurses (205 women, 35 men) from Shiraz city hospitals who were selected based on random multistage cluster sampling method. The participants completed three questionnaires of leadership style inventory, career self-efficacy and burnout. The model was analyzed using multiple regression method in simultaneous style based on Baron & Kenni stages. Results & Conclusion: The results showed that: a) managers leadership style is predictive of burnout dimensions, b) managers leadership style is predictive of career self -efficacy dimensions. Totally, the present study findings and Sobel test results showed that career self-efficacy has a moderate role between managers’ leadership style and burnout.

Determination of Vancomycin and Methicillin Resistance in Clinical Isolates of Staphylococcus aureus in Iranian Hospitals.

Aims: The aim of this study was to determine the prevalence of methicillin resistant S. aureus (MRSA), vancomycin resistant or vancomycin intermediate resistant S. aurues (aureus) (VRSA/VISA) among clinical isolates. Study Design: S.aureus isolates used in this study were randomly collected from in-patient and outpatient of several hospitals of 7 cities in Iran (Tehran, Shiraz, Zahedan, Tabriz, Sannandaj, Sari, and Ahvaz) during 2006-2008. Methodology: Antibiotic susceptibility of 250 strains of Staphylococcus aureus isolated from Iranian hospitals were determined by disk diffusion method. Minimum inhibitory concentration (MICs) were determined for oxacillin and vancomycin by E-test. PCRs were used by specific primers (PCR used specific primers) for detection of mecA, vanA, vanB genes. Results: The percentage of resistance by disk diffusion method was as below: methicillin 46%, vancomycin 0%, penicillin 86%, erythromycin 42%, ciprofloxacin 29%, gentamicin 39% and clindamycin 33%. E-test MIC method showed that 43% isolates were resistant to methicillin and 4% isolates were VISA (≤ 8μg/ml). The prevalence of resistance genes in the clinical isolates were: mecA 44%, vanA 0%, vanB 0%. Conclusion: This study revealed that clinical isolates have rather high resistance to methicillin, erythromycin, gentamicin, penicillin and clindamycin We did not observe resistance to vancomycin. In order to avoid a possible outbreak involving VISA), vancomycin should be used carefully as a drug for treatment of S. aureus infections.

Incidence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in patients with urinary tract infection / Incidência de Klebsiella pneumoniae produtoras de beta-lactamases de espectro estendido em pacientes com infecção do trato urinário

CONTEXT AND OBJECTIVES: Resistant bacteria are emerging worldwide as a threat to favorable outcomes from treating common infections in community and hospital settings. The present investigation was carried out to study the incidence of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae in patients with urinary tract infection in different seasons of the year, in order to determine the prevalence of the genes blaTEM, blaSHV and blaCTX-M, which are responsible for ESBL production among ESBL-producing K. pneumoniae, in three cities in Iran, and to investigate the antimicrobial susceptibility pattern of K. pneumoniae in different seasons. DESIGN AND SETTING: Retrospective study carried out among patients with urinary tract infections in five hospitals in Iran. METHOD: Two hundred and eighty-eight clinical isolates of K. pneumoniae were collected between March 2007 and April 2008 from five hospitals in three cities in Iran. ESBLs were identified by phenotypic and genotypic methods. ESBL-producing Klebsiella pneumoniae were evaluated against non-beta-lactam antibiotics. Genes coding for ESBLs (blaSHV, TEM and CTX-M) were screened. RESULTS: Among the 288 clinical isolates of K. pneumoniae, 37.7 percent, 46.7 percent and 15.6 percent were obtained from hospitals in Ilam, Tehran and Tabriz, respectively, of which 39.4 percent, 50.7 percent and 45.8 percent were ESBL-producing K. pneumoniae in Ilam, Milad and Emam Reza hospitals, respectively. CONCLUSION: According to the results from this study, resistance to third-generation cephalosporins is higher during the cold months than during the warm months.

CONTEXTO E OBJETIVOS: As bactérias resistentes estão surgindo em todo o mundo como uma ameaça ao resultado favorável no tratamento de infecções comuns em ambientes comunitários e hospitalares. O presente estudo foi realizado com o objetivo de avaliar a incidência de Klebsiella pneumoniae produtoras de beta-lactamases de espectro estendido (BLEEs) em pacientes com infecção do trato urinário em diferentes estações do ano, para verificar a prevalência dos genes blaTEM, blaSHV e blaCTX-M responsáveis para a produção de BLEEs em K. pneumoniae productoras de BLEEs, em três cidades do Irã, e investigar o perfil de sensibilidade antimicrobiana de K. pneumoniae em diferentes estações. DESENHO E LOCAL: Estudo retrospectivo realizado em pacientes com infecções do trato urinário em cinco hospitais no Irã. MÉTODO: Duzentos e oitenta e oito isolados clínicos de K. penumoniae foram coletados entre março de 2007 e abril de 2008 em cinco hospitais de três cidades no Irã. BLEEs foram identificados por métodos fenotípicos e genotípicos. K. pneumoniae produtoras de BLEEs foram avaliadas contra antibióticos não beta-lactâmicos. Os genes codificadores de BLEEs (blaSHV, TEM e CTX-M) foram investigados. RESULTADOS: Entre os 288 isolados clínicos de K. pneumoniae, 37,7 por cento, 46,7 por cento e 15,6 por cento eram provenientes dos hospitais em Ilam, Tehran e Tabriz, respectivamente, dos quais 39,4 por cento, 50,7 por cento e 45,8 por cento eram K. pneumoniae produtoras de BLEEs nos hospitais em Ilam, Milad e Eman Reza, respectivamente. CONCLUSÃO: De acordo com os resultados deste estudo, a resistência às cefalosporinas de terceira geração é maior nos meses frios do que nos meses quentes.

Prevalence of antibiotic-resistant Acinetobacter baumannii in a 1000-bed tertiary care hospital in Tehran, Iran.

Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections. Acinetobacter baumannii usually causes respiratory tract, urinary tract, blood stream and surgical site infections. They are of increasing importance because of its ability to rapidly develop resistance to the major groups of antibiotics. There are few data available on the antimicrobial susceptibility of A. baumannii in Iran. During the period of study from July 2005 to November 2006, a total of 88 strains of A. baumannii were isolated from clinical specimens obtained from patients hospitalized in an Iranian 1000-bed tertiary care hospital. Conventional bacteriological methods were used for identification of A. baumannii. Susceptibility testing was performed by the method recommended by Clinical Laboratory and Standards Institute (CLSI). The majority of isolates were from respiratory tract specimens. The organism showed high rate of resistance to ceftriaxone (90.9%), piperacillin (90.9%), ceftazidime (84.1%), amikacin (85.2%) and ciprofloxacin (90.9%). Imipenem was the most effective antibiotic against A. baumannii and the rate of resistance for imipenem was 4.5%. The second most effective antibiotic was tobramycin, and 44.3% of A. baumannii isolates were resistant to this antibiotic. In conclusion, our study showed that the rate of resistance in A. baumannii to imipenem was low. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay and drug resistance.