Prevalence of Nosocomial Infections and the Pattern of Microbial Resistance in a Tertiary Care Referral Hospital (Alzahra), Isfahan, Iran

Abstract

Nowadays, the resistance to available antibiotics could be mentioned as a global threat to public health. The aim of this preliminary study was to conduct a retrospective survey associated with the prevalence of Nosocomial Infections (NIs) and the pattern of microbial resistance in a tertiary care referral hospital (Alzahra), Isfahan, Iran. The data between the years 2016 to 2022 were extracted from the official database of hospital NI records. The microbiological culture results, represented by non-repetitive specimens, were further analyzed for pathogens and the pattern of antibiotic resistance. Then antibiotic susceptibility testing was done using standard methods of disk diffusion or Phoenix M50. The recorded variables have been presented as mean ± standard deviation, prevalence, and percentage. Data were analyzed using SPSS version 20. For a duration of 5.5 years, the period prevalence of NIs was recorded as 2%, with more than 50% associated with ventilator-associated events and urinary tract infections. Klebsiella pneumonia, Acinetobacter baumannii, and Staphylococcus were the main pathogens. Further study of specimens from the year 2022 (n= 898) confirmed the most isolated bacteria as Klebsiella pneumonia (n = 290, 32%), Acinetobacter baumannii (n= 206, 23%), Enterococcus (faecium-fecalis n=125, 14%), Escherichia coli (n = 116, 13%), Staphylococcus aureus (n = 95, 11%), and Pseudomonas aeruginosa (n = 66, 7%). Resistance (R%) in Isfahan versus the whole country was confirmed for Klebsiella pneumonia (third or fourth generation of cephalosporins: R = 80.9 vs. 82%), fluoroquinolones (R = 76.6 vs. 73%), beta-lactamase inhibitors (R = 75 vs. 79%), carbapenems (R = 65.7 vs. 66%), and so on, respectively. There has been reported an increase in the proportion of isolates resistant to cephalosporins, fluoroquinolones, and others. The variety of latent pathogens resistant to frequently administered antibiotics highlights the significance of continued and homogenous antimicrobial evidence-based pharmacotherapy investigations in Isfahan, Iran. Further studies in this direction are recommended.