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 percent admissions gave the largest contribution. Coagulase negative staphylococci at frequencies of 66.7 percent and 36.5 percent and E. coli at 20.9 percent 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 percent), while the group of patients over sixty years contributed least (18.5 percent). 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.
Subject(s)
Adult , Child, Preschool , Humans , Infant , Infant, Newborn , Middle Aged , Young Adult , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial/drug effects , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Intensive Care Units , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Microbial Sensitivity Tests , Young AdultABSTRACT
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.
Subject(s)
Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial/drug effects , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Intensive Care Units , Adult , Child, Preschool , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Humans , Infant , Infant, Newborn , Microbial Sensitivity Tests , Middle Aged , Young AdultABSTRACT
The purpose of this study was to determine the prevalence of multidrug-resistant Escherichia coli in clinical specimens. In addition, the existence of integrons in resistant isolates was assessed by amplification of intergase genes. Susceptibility of 200 isolates from five Shiraz hospitals and health centers to 13 antibiotics was determined by the Kirby-Bauer disk diffusion method. The majority of the bacteria were isolated from urine (70.5%) and stool (25.5%) specimens. Antibiotic resistance patterns were observed as follows: amoxicillin 63%, tetracycline 57.5%, co-trimoxazole 48%, cephalotin 40%, nalidixic acid 36%, ciprofloxacin 21%, nitrofurantoin 25%, norfloxacin 20.5%, gentamicin 18%, chloramphenicol 18%, ceftazidime 14%, amikacin 8.5% and imipenem 2%. Of 200 isolates tested, 165 (82.5%) were multidrug resistant. The frequency of multidrug resistance to more than 5 antibiotics was 24.2%. The existence of integrons was confirmed in 44.8% of isolates. Significant association between resistance to gentamicin, amikacin, cephalotin, nalidixic acid, ciprofloxacin, norfloxacin and co-trimoxazole with the existence of integrons was obtained by the PCR-RFLP method. These results showed that integrons may be partly responsible for multidrug resistance. Imipenem, amikacin and ceftazidime were the most effective antibiotics in vitro; however, the clinical efficacy of these antibiotics remains to be assessed.
