Antimicrobial resistance pattern of Gram-negative bacilli isolated from patients at ICUs of Army hospitals in Iran

Abstract

Background and Objectives: Patients at intensive-care-unit (ICU) are at risk of acquiring nosocomial infections which contributes to higher rates. Approximately 25% of all hospital infections and 90% of outbreaks occur in ICUs. Multi-resistant gram-negative rods are important pathogens in ICUs, causing high rate of mortality. The purpose of this study was to investigate the antimicrobial resistance patterns among common Gram-negative bacilli isolated from patients with nosocomial infection at Army Hospitals. Materials and Methods: A total of 187 isolates of Gram-negative bacilli were isolated from 904 patients at ICUs of three Army hospitals in Iran during May 2007 to May 2008. All isolates were examined for antimicrobial resistance using disc diffusion method. Results: The most frequent pathogens were E. coli (32.08%) followed by K. pneumoniae (31%), P. aeruginosa (12.8%) and Acinetobacter spp. (9.1%). High rate of resistance to third generation cephalosporines was observed among isolates of E. coli and K. pneumoniae. Production of extended spectrum beta lactamases (ESBLs) was found in 46.6% of isolates of both organisms, but in 38% of all Gram negative bacteria. Conclusion: The prevalence of ESBL producing strains at three Army Hospitals is considerable (38%). However, resistance to imipenem has emerged in these hospitals. Furthermore, studies are required to clarify the situation with multi-drug resistant organisms including the Gram positive bacteria at Army hospitals.

Keywords

• Gram negative
• ICU
• Antimicrobial resistance
• Antibiotic