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 آنتی بیوتیکی عفونتهای باکتریال بیمارستانی در بیمارستان امام خمینی (ره)، ساری
Investigating the Prevalence and Antibiotic Resistance
Pattern of Nosocomial Bacterial Infections in
Imam Khomeini Hospital, Sari
عفوني
infection
گزارش کوتاه
Brief Report
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:95%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="line-height:95%"><span b="" koodak="" style="font-family:"><span style="color:black"> </span></span></span></span><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:95%"><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:95%"><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">عفونت</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">های بیمارستانی از معظلات مراکز درمانی که سبب مرگ و میر بیماران بستری در بیمارستان، افزایش طول مدت بستری و هزینه</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">های درمانی می شوند.</span></span><span lang="AR-SA" style="font-family:"B Zar""> اکثر </span><span lang="FA" style="font-family:"B Zar""><span style="color:black">عفونت</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">های بیمارستانی توسط باکتری</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">های گرم منفی ایجاد <span style="letter-spacing:-.1pt">می</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">شوند. این باکتری</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">ها با تغییرات ژنتیکی و ساختاری سبب ایجاد مقاومت در مقابل اکثر آنتی</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">بیوتیک</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">ها شده</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">اند.</span></span></span> <span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">این مطالعه</span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"> با هدف بررسی شیوع و الگوی مقاومت آنتی</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">بیوتیک عفونت</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">های باکتریال بیمارستانی در بیمارستان امام خمینی (ره)، ساری در سال 1398، انجام پذیرفت.</span></span><span lang="FA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#0e101a"></span></span></span></span></span></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:95%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:95%"><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:95%"><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:95%"><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:95%"><span style="font-family:"B Zar""><span style="color:black">این مطالعه توصیفی- مقطعی گذشتهنگر، در بیمارستان امام خمینی(ره)، ساری در سال 1398 انجام شد. همه نمونه</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:black">های جدا شده کشت مثبت از بیماران بستری انتخاب شدند. الگوی مقاومت آنتیبیوتیکی با استفاده از روش دیسک دیفیوژن (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:95%"><span style="color:black">Kirby-Bauer</span></span></span><span lang="FA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:black">) بررسی شد.</span></span></span></span></span></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:95%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:95%"><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:95%"><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:95%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA" style="font-family:"B Zar"">در این مطالعه <span style="color:black">فراوان</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">ترین عفونت بیمارستانی در بخش مراقبت</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">های ویژه با بیش</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">ترین عفونت تنفسی (42 درصد) توسط <i>اشریشیاکلی</i> (25 درصد) با بیش</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">ترین مقاومت به سیپروفلوکساسین (78/5 درصد) مشاهده شد.</span></span><span lang="FA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></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:95%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">در این مطالعه شیوع عفونت</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">های بیمارستانی توسط باکتری</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">های گرم منفی با حداکثر مقاومت به سفالوسپورین</span></span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">ها </span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">قابل توجه است. تجویز غیرمنطقی و تجربی سفالوسپورین</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">ها و کارباپنم</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">ها میتواند درمان عفونت</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:#202124"></span></span></span><span lang="FA" style="font-family:"B Zar""><span style="color:black">های بیمارستانی را دچار چالش نماید.</span></span><span lang="AR-SA" style="line-height:95%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></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 new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt"> </span></span></span></span></b></span></span></span></span><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%">Nosocomial infections are considered as a significant problem in medical centers, causing a high mortality rate among hospitalized patients, increasing the duration of hospitalization and treatment costs. Most nosocomial infections are caused by gram-negative bacteria.</span></span> <span style="font-size:10.0pt"><span style="line-height:150%">These bacteria are resistant to a wide range of antibiotics through changing their genetics and structure. The purpose of this study was to investigate the prevalence and pattern of antibiotic resistance of nosocomial bacterial infections at Imam Khomeini Hospital in Sari, during 2019. </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="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"">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">This retrospective descriptive cross-sectional study was performed at <span style="letter-spacing:-.1pt">Imam Khomeini Hospital in Sari during 2019. All isolated positive samples were selected from hospitalized</span> patients. Antibiotic resistance pattern was investigated using disk fusion method (Kirby-Bauer).</span></span><span style="font-size:10.0pt"><span style="line-height:150%"></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="line-height:150%">In this study, the most frequent nosocomial infection was observed in the intensive care unit (ICU), with respiratory infection (42%), as the most frequent one, caused by <i>Escherichia coli</i> (25%) with the highest resistance to ciprofloxacin.</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="letter-spacing:-.1pt">The findingins showed that gram-negative bacteria, more specifically those resistant</span> to cephalosporins, are the most common cause of nosocomial infections. </span></span><span style="font-size:10.0pt"><span style="line-height:150%">Irrational and imprudent prescription of cephalosporins and carbapenems may be a significant contributor to antibiotic resistance and the main challenge for treating.</span></span><i><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></i></span></span></span></span><br>
شیوع, مقاومت آنتیبیوتیکی, عفونت باکتریال بیمارستانی, مقاومت چندگانه دارویی
prevalence, antibiotic resistance, nosocomial bacterial infections, multiple drug resistance (MDR)
157
162
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-9918-3&slc_lang=fa&sid=1
Roya
Ghasemian
رویا
قاسمیان
roya31gh@yahoo.com
1003194753284600158063
1003194753284600158063
No
Professor, Antimicrobial Resistance Research Center, Razi Hospital, Mazandaran University of Medical Sciences, Sari, Iran
استاد، مرکز تحقیقات مقاومت های میکروبی، بیمارستان رازی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Elnaz
Nasiri Parman
الناز
نصیری پرمان
1003194753284600158064
1003194753284600158064
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
1003194753284600158065
1003194753284600158065
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 علو پزشکی مازندران، ساری، ایران