Brief Report

The Prevalence of Gram-Negative Microorganisms Isolated from VentilatorAssociated Pneumonia Patients in the Intensive Care Units of Southwest of Iran

Abstract

Background: Increasing microbial resistance is a severe threat to global public health. One of the most common diseases in the intensive care unit is ventilator-associated pneumonia.
Methods: The method of this research was non-interactive and descriptive. This study was carried out from January to March 2018, at the Golestan Hospital of Ahvaz. Patients with ventilator-associated pneumonia (VAP) were included in the study. The prevalence of resistant gram-negative microorganisms was studied through reported laboratory antibiogram results of cultures.
Results: From 373 hospitalized patients, 38 (10.2%) were diagnosed with VAP. From the 57 respiratory cultures performed, overall 90 microorganisms were isolated, from which Enterobacter with 36 cases (39.5%) and E.Coli with 28 cases (30.7%) were most frequently compared to other organisms. From the 90 organisms responsible for the infection, 43 cases (47.2%) were Multiple drug-resistant (MDR)  microorganisms and 47 (51.6%) were Extensively drug-resistant (XDR) microorganisms. Enterobacter and E.Coli were the most prevalent MDR microorganisms with 17 cases (39.5%) and 13 (30.2%), respectively. Also, these two microorganisms were the most abundant XDR microorganisms with 19 cases (40.4%) and 15 (31.9%), respectively.
Conclusion:The results show the requirement of robust antibiotic monitoring and the optimization of antibiotic use in order to prevent the progression of antibiotic resistance in these units.

1. Cook DJ, Walter SD, Cook RJ, et al. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med 1998;129(6):433-40.
2. Heyland DK, Cook DJ, Griffith L, Keenan SP, Brun-Buisson C. The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. Am J Respir Crit Care Med 1999;159(4 Pt 1):1249‐56.
3. Apostolopoulou E, Bakakos P, Katostaras T, Gregorakos L. Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens, Greece. Respir Care 2003;48(7):681‐8.
4. Kollef MH. Prevention of ventilator-associated pneumonia. In: Rello J, Valles J, Marin H. Kollef MH, editors. Critical Care Infectious Diseases Textbook. Boston: Springer; 2001. p. 707-17.
5. Corley DE, Kirtland SH, Winterbauer RH, et al. Reproducibility of the histologic diagnosis of pneumonia among a panel of four pathologists: analysis of a gold standard. Chest 1997;112(2):458‐65.
6. raven DE, Steger KA. Nosocomial pneumonia in mechanically ventilated adult patients: epidemiology and prevention in 1996. Semin Respir Infect 1996;11(1):32‐53.
7. Izadpanah M, Khalili H. Antibiotic regimens for treatment of infections due to multidrug-resistant Gram-negative pathogens: An evidence-based literature review. J Res Pharm Pract 2015;4(3):105‐14.
8. Rello J, Ollendorf DA, Oster G, et al. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 2002;122(6):2115‐21.
9. Restrepo MI, Peterson J, Fernandez JF, Qin Z, Fisher AC, Nicholson SC. Comparison of the bacterial etiology of early-onset and late-onset ventilator-associated pneumonia in subjects enrolled in 2 large clinical studies. Respir Care 2013;58(7):1220‐5.
10. Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett's Principles and practice of infectious diseases. 8th ed. Philadelphia: Elsevier Health Sciences; 2014.
11. Salehifar E, Abedi S, Mirzaei E, Kalhor S, Eslami G, Ala S, Alyali M, Sharifpour A. Profile of Microorganisms Involved in Nosocomial Pneumonia and Their Antimicrobial Resistance Pattern in Intensive Care Units of Imam Khomeini Hospital, Sari, 2011-2012. Journal of Mazandaran University of Medical Sciences 2013;23(1):151-62.
12. Chawla R. Epidemiology, etiology, and diagnosis of hospital-acquired pneumonia and ventilator-associated pneumonia in Asian countries. Am J Infect Control 2008;36(4 Suppl):S93‐S100.
13. Afkhamzadeh AR, Lahoorpour F, Delpisheh A, Janmardi R. Incidence of ventilator-associated pneumonia (VAP) and bacterial resistance pattern in adult patients hospitalised at the intensive care unit of Besat Hospital in Sanandaj. Scientific Journal of Kurdistan University of Medical Sciences 2011; 16(1):20-26
14. Sabery M, Shiri H, Moradiance V, Taghadosi M, Gilasi HR, Khamechian M. The frequency and risk factors for early-onset ventilator-associated pneumonia in intensive care units of Kashan Shahid-Beheshti hospital during 2009-2010. Feyz, Journal of Kashan University of Medical Sciences 2013;16(6):560-9.
15. Blot S, Koulenti D, Dimopoulos G, et al. Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients. Crit Care Med 2014;42(3):601‐9.
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IssueVol 8, No 2 (Spring 2020) QRcode
SectionBrief Report
DOI https://doi.org/10.18502/jpc.v8i2.3833
Keywords
Pneumonia Ventilator-Associated Gram-Negative Bacteria Intensive care Units Drug Resistance
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How to Cite
1.
Mehralinejadian S, Izadpanah M, Soltani F, Sayadi S, Aghakouchakzadeh M. The Prevalence of Gram-Negative Microorganisms Isolated from VentilatorAssociated Pneumonia Patients in the Intensive Care Units of Southwest of Iran. J Pharm Care. 2020;8(2):83-87.