title: Five-year evaluation of the antimicrobial susceptibility patterns of bacteria causing bloodstream infections in Iran.
abstract: BACKGROUND
  Bloodstream infections (BSI) are a serious cause of morbidity and mortality worldwide. Emerging antimicrobial drug resistance among bacterial pathogens causing BSI can limit therapeutic options and complicate patient management.
  
  
  METHODS
  To encourage the prudent use of appropriate antibiotics in our pediatric population at Children's Medical Center Hospital, Tehran, Iran, we studied the frequency and antibiogram patterns of blood culture isolates from January 2001 to December 2005.
  
  
  RESULTS
  Of 25,223 blood cultures examined, 2,581 (10.23 %) were positive for bacterial growth. The frequency of Gram-positive bacteria isolated was 47.6% (1228 of 2581) and that for Gram-negatives was 52.4% (1353 of 2581). The rates of methicillin (oxacillin) resistance in Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were 79% and 89%, respectively. About 45% of Streptococcus pneumoniae were resistant to trimethoprim-sulfamethoxazole and approximately 66% to penicillin. Among the Gram-negative isolates, Pseudomonas aeruginosa was most frequently isolated, representing 943 (36.7%) over five years. This possibly represents an unrecognized hospital outbreak or contamination of blood culture bottles or other products such as skin disinfectants. Additionally, this pathogen showed extremely high rates of antimicrobial resistance. There were notable differences in frequency of the five most common microorganisms isolated from blood cultures, which can help set priorities for focused infection control efforts.
  
  
  CONCLUSIONS
  Our findings underscore the need to monitor blood culture isolates and their antimicrobial resistance patterns to observe resistance trends that would influence appropriate empiric treatment and infection control strategies for bacteremic children.
authors.affiliation: Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Pourakbari
authors.forename: Alireza
authors.initials: A
authors.lastname: Sadr
authors.forename: Mohammad Taghi Haghi
authors.initials: MT
authors.lastname: Ashtiani
authors.forename: Setareh
authors.initials: S
authors.lastname: Mamishi
authors.forename: Mahdi
authors.initials: M
authors.lastname: Dehghani
authors.forename: Shima
authors.initials: S
authors.lastname: Mahmoudi
authors.forename: Ali
authors.initials: A
authors.lastname: Salavati
authors.forename: Farhad
authors.initials: F
authors.lastname: Asgari
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000382:microbiology*; D001419:Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D024881:Drug Resistance, Bacterial; D006801:Humans; D007492:Iran; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents