Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
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2023
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بررسی شیوع و الگوی مقاومت میکروبی در بیماران مبتلا به عفونتهای بیمارستانی در بیمارستان رازی قائمشهر، مازندران
Evaluation of Prevalence and Microbial Resistance Pattern in Patients with Nosocomial Infections in Razi Ghaemshahr Hospital, Mazandaran
عفوني
infection
گزارش کوتاه
Brief Report
<div><span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><span lang="FA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="FA" style="font-family:"B Zar""><span style="color:black">با </span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">وجود پیشرفت در روش</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">های جدید درمانی، عفونت</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">های بیمارستانی هم</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">چنان یکی از معضلات عمده بهداشتی و درمانی است. عفونت</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">های بیمارستانی همراه با ظهور و گسترش پاتوژن</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">های با مقاومت چندگانه یکی از مهم</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">ترین مشکلات بهداشتی در سراسر جهان است. این مطالعه با هدف بررسی میزان شیوع عفونت</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">های بیمارستانی و تعیین الگوی مقاومت آنتی</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">بیوتیکی در بیمارستان رازی قائم</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">شهر، استان مازندران انجام پذیرفت.</span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:#0e101a"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">این مطالعه توصیفی- مقطعی، در بیمارستان رازی قائم</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">شهر، استان مازندران در سال 1397-1396 انجام شد. نمونه</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">های جدا شده</span></span></span> <span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">از بیماران بستری با کشت مثبت انتخاب شدند. </span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">الگوی مقاومت آنتی</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">بیوتیکی با استفاده از روش دیسک دیفیوژن (</span></span><span dir="LTR" style="font-size:10.0pt"><span style="background:white"><span style="line-height:90%">Disk diffusion</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">) انجام شد.</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">از میان 672 بیمار بستری در بخش های مختلف، بیش</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">ترین توزیع فراوانی بیماران در بخش عفونی (40 درصد) بود.</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""> شایع ترین پاتوژن جدا شده <i>اشریشیاکلی</i> (26/2</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">درصد)، <i>آسینتوباکتر بائومانی</i> (14/7</span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">درصد)، <i>انتروباکتر</i> (14/1 درصد)، <i>پسودوموناس آئروژنوزا</i> (13/5</span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">درصد) و <i>سیترو باکتر </i>(12/8</span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">درصد) بود</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">ند</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">. </span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">پاتوژنها در برابر سفالوسپورین</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">ها، فلوروکینولونها و مهارکننده</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">های بتا لاکتاماز و کارباپنم ها مقاومت بالایی نشان دادند.</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span class="Heading1Char" style="font-family:KOODAK"><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">در مطالعه حاضر </span></span></span><span lang="AR-SA" style="font-family:"B Zar"">شایع</span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="font-family:"B Zar"">ترین پاتوژن جدا شده<i> اشریشیاکلی</i> بود. ظهور<i> سیترو </i>باکتر با مقاومت آنتی</span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="font-family:"B Zar"">بیوتیکی بالا<i> </i>می</span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="font-family:"B Zar"">تواند ناشی از تغییر الگوی شیوع میکروارگانیسم</span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="font-family:"B Zar"">ها در این بیمارستان باشد<i>.</i></span></span></span></span></span></span></div>
<span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial",sans-serif"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%">Hospital infections remain a significant health concern despite advancements in treatment methods. The emergence and spread of pathogens with multiple resistance remain a global health issue. The purpose of this study was to investigate the prevalence of nosocomial infections and determine the antibiotic resistance pattern in Razi Ghaemshahr Hospital, Mazandaran.</span></span><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:150%"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial",sans-serif"><span style="letter-spacing:-.1pt">Materials and methods:</span></span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:150%"><span style="color:#161719"><span style="letter-spacing:-.1pt">This descriptive cross-sectional study was carried out at Razi Ghaemshahr</span></span></span></span></span><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:150%"><span style="color:#161719"> Hospital in Mazandaran province during 2016-2017. Positive cultures from hospitalized patients were used as samples and subjected to antibiotic resistance pattern analysis using the disk diffusion method.</span></span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial",sans-serif">Results:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="background:white"><span style="line-height:150%"><span style="color:#161719">Out of the 672 hospitalized patients in different wards, the infectious ward had the <span style="letter-spacing:-.1pt">highest frequency distribution of patients (40%). The most commonly isolated pathogens were <i>Escherichia</i></span><i> <span style="letter-spacing:-.1pt">coli</span></i><span style="letter-spacing:-.1pt"> (26.2%), <i>Acinetobacter baumannii</i> (14.7%), <i>Enterobacter</i> (14.1%), <i>Pseudomonas aeroginosa</i> (13.5%),</span> and <i>Citrobacter</i> (12.8%). The pathogens were highly resistant to cephalosporins, fluoroquinolones, beta-lactamase inhibitors, and carbapenems.</span></span></span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:150%"></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="vertical-align:top"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="font-family:"Arial",sans-serif">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"> <span style="background:white"><span style="color:#161719">It was found that the most frequently isolated pathogen was <i>Escherichia coli.</i> The emergence of <i>Citrobacter</i> with high antibiotic resistance can possibly be attributed to a shift in the prevalence pattern of microorganisms within this hospital</span></span><i><span style="color:black"></span></i></span></span></span></span></span></span><br>
مقاومت میکروبی, عفونتهای بیمارستانی, باکتریهای گرم منفی
microbial resistance, nosocomial infections, gram-negative bacteria
192
196
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-9918-2&slc_lang=fa&sid=1
Lotfollah
Davoodi
لطف اله
داودی
lotfdavoodi@yahoo.com
1003194753284600160502
1003194753284600160502
No
Associate Professor, Department of Infectious Diseases, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
دانشیار، گروه عفونی، مرکز تحقیقات مقاومتهای میکروبی، پژوهشکده بیماریهای واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Mohammad
Abedi Samakoosh
محمد
عابدی سماکوش
Masnirasb@gmail.com
1003194753284600160503
1003194753284600160503
No
Associate Professor, Department of Internal Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
دانشیار، گروه داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Qazal
Mirani
غزل
میرانی
grahimzadeh@mazums.ac.ir
1003194753284600160504
1003194753284600160504
No
Medical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Golnar
Rahimzadeh
گلنار
رحیم زاده
rahimzadehgolnar@yahoo.com
1003194753284600160505
1003194753284600160505
Yes
Assistant Professor, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، مرکز تحقیقات عفونی اطفال، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران