Background: Indiscriminate use of antibiotics in the treatment of Nosocomial Infections (NIs) has led to microbial mutation and drug resistance. Antibiotic resistance is a threat to public health, especially for children. The aim of this study was to investigate NIs and antibiotic resistance in children's hospitals.
Methods: This study was conducted retrospectively and descriptively using paper and electronic files of patients admitted to Dr. Sheikh Children's Hospital of Mashhad, Iran in 2023. The data were categorized in three seasons. Type and frequency of NIs, microbial mass, and antibiotic resistance were investigated based on seasons and hospital departments. Data were analyzed through descriptive statistics by Excel software.
Results: The most common type of NIs in all three seasons of the study was blood system infection (BSI) (64.98 %). Although in ICU, Ventilator-Associated Event Infection (VAEI) was more common. Klebsiella, with an average of 18.97%, was the most common cause of NIs. The most commonly used antibiotics were cephalosporin, and vancomycin. The highest rate of resistance was related to Acinetobacter. In the second and third seasons, this bacterium showed more than 80-100% resistance to cephalosporin, fluoroquinolone, aminoglycoside and carbapenem. The highest rate of Klebsiella antibiotic resistance was seen against carbapenem (83.33%) in the second season of the study. In the third season of the study, Escherichia coli showed more resistance to cephalosporin compared to other antibiotics (66%). In the second season, Pseudomonas showed 100% resistance to carbapenem.
Conclusion: The results showed high antibiotic resistance of common pathogens against commonly used antibiotics. And due to the vulnerability of children, necessary interventions should be made to reduce the rate of NIs and control the use of antibiotics. |
- Nouri F, Karami P, Zarei O, Kosari F, Alikhani MY, Zandkarimi E, Rezazadeh Zarandi E, Taheri M. Prevalence of common nosocomial infections and evaluation of antibiotic resistance patterns in patients with secondary infections in Hamadan, Iran. Infection and drug resistance. 2020:2365-74.
- Yaghubi T, Pourkazemi A, Farashbandi H, Balu H. Epidemiological study of nosocomial infections and antibiotic resistance patterns in Guilan. Yafteh. 2019; 21(1).
- Nimer NA. Nosocomial infection and antibiotic-resistant threat in the Middle East. Infection and drug resistance. 2022:631-9.
- Ghasemi S, Nosrati S, Fakhry M, Khadang M. Investigating the Rate of Nosocomial Infections and Providing Solutions to Prevent and Control it. Journal of Paramedical Sciences and Military Health. 2021; 15(4):64-71.
- Despotovic A, Milosevic B, Milosevic I, Mitrovic N, Cirkovic A, Jovanovic S, Stevanovic G. Hospital-acquired infections in the adult intensive care unit—Epidemiology, antimicrobial resistance patterns, and risk factors for acquisition and mortality. American journal of infection control. 2020; 48(10):1211-5.
- Mohammadimehr M, Feizabadi MM, Bahadori O, Khosravi M. Study of prevalence of gram-negative bacteria caused nosocomial infections in ICU in Besat hospital in Tehran and detection of their antibiotic resistance pattern-year 2007. Iranian Journal of Medical Microbiology. 2009; 3(2):47-54.
- Amraei S, Eslami G, Taherpour A, Hashemi A. Relationship between MOX genes and antibiotic resistance in Klebsiella pneumoniae strains in nosocomial infections. Micro Nano Bio Aspects. 2022; 1(2):12-7.
- Iseppi R, Mariani M, Condò C, Sabia C, Messi P. Essential oils: A natural weapon against antibiotic-resistant bacteria responsible for nosocomial infections. Antibiotics. 2021; 10(4):417.
- Medernach RL, Logan LK. The growing threat of antibiotic resistance in children. Infectious Disease Clinics. 2018; 32(1):1-7.
- Romandini A, Pani A, Schenardi PA, Pattarino GA, De Giacomo C, Scaglione F. Antibiotic resistance in pediatric infections: global emerging threats, predicting the near future. Antibiotics. 2021; 10(4):393.
- Nasiri MJ, Goudarzi AM, Aslani HR, Goudarzi M, Zamani S, Kharrat SA. Nosocomial Infections Caused by Drug-Resistant Bacteria in a Referral University Hospital, Tehran, Iran. Novelty in Biomedicine. 2019; 7(2).
- Iyer AP, Baghallab I, Albaik M, Kumosani T. Nosocomial infections in Saudi Arabia caused by methicillin resistance Staphylococcus aureus (MRSA). Clin Microbial. 2014; 3(3):146.
- Sohrabi MB, Khosravi AH, Zolfaghari P, Sarrafha J. Evaluation of nosocomial infections in Imam Hossein (as) Hospital of Shahrood, 2005. Journal of Birjand University of Medical Sciences. 2009; 16(3):33-9.
- Darvishpoor K, Rezaei Manesh MR. Prevalence of nosocomial infections and microbial causes in Torbat heydariyeh 9dey educational and clinical hospital in 2012 and 2013. Iranian Journal of Medical Microbiology. 2016; 10(1):93-6.
- Zhou X, García-Cobos S, Ruijs GJ, et al. Epidemiology of extended-spectrum β -lactamase-producing E. coli and vancomycin-resistant enterococci in the Northern Dutch–German cross-border region. Front Microbiol. 2017; 8:1914
- Kalanuria AA, Zai W, Mirski M. Ventilator-associated pneumonia in the ICU. Critical care. 2014; 18 (2):1-8.
- Tolera M, Abate D, Dheresa M, Marami D. Bacterial nosocomial infections and antimicrobial susceptibility pattern among patients admitted at Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Advances in medicine. 2018; 2018.
- Sikka R, Mann JK, Vashist MG, Chaudhary U, Deep A. Prevalence and Antibiotic Sensitivity Pattern of Bacteria Isolated from Nosocomial Infections in a Surgical Ward.2012.
- Agaba P, Tumukunde J, Tindimwebwa JV, Kwizera A. Nosocomial bacterial infections and their antimicrobial susceptibility patterns among patients in Ugandan intensive care units: a cross sectional study. BMC research notes. 2017; 10:1-2.
- Wang A, Daneman N, Tan C, Brownstein JS, MacFadden DR. Evaluating the relationship between hospital antibiotic use and antibiotic resistance in common nosocomial pathogens. Infection control & hospital epidemiology. 2017; 38(12):1457-63.
- Hormozi SF, Vasei N, Aminianfar M, Darvishi M, Saeedi AA. Antibiotic resistance in patients suffering from nosocomial infections in Besat Hospital. European journal of translational myology. 2018; 28(3).
- Behzadnia S, Davoudi A, Rezai MS, Ahangarkani F. Nosocomial infections in pediatric population and antibiotic resistance of the causative organisms in north of Iran. Iran Red Crescent Med J 2014; 16:e14562.
- Weinstein RA. Controlling antimicrobial resistance in hospitals: infection control and use of antibiotics. Emerg Infect Dis 2001; 7:188-92.
- World Health Organization (WHO). Healthcare-associated infections FACTSHEET. Available from: https://www.who.int/ gpsc country_work/gpsc_ccisc_fact_sheet_en. pdf. Accessed February 9, 2022.
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