Nosocomial bacterial infections and their antimicrobial resistance patterns in university hospitals of hamedan, iran.
BACKGROUND
Nosocomial infections constitute a global health problem, leading to a high rate of morbidity and mortality. The aim of this study was to determine the frequency and antimicrobial resistance patterns of nosocomial infections in edu-cational hospitals of Hamadan, western Iran.


METHODS
During a 1-year period from April 2006 to March 2007, all patients with cul-ture-proven nosocomial infections from educational hospitals in Hamedan, west-ern Iran were included. Nosocomial infections were defined as a culture-proven infection, which occurred more than 48h after admission in the hospital. An-timicrobial susceptibility testing of isolated bacteria was performed by disc dif-fusion method.


RESULTS
A total of 170 cases of culture-proven nosocomial infections were diag-nosed. Most cases were in intensive care units (ICUs) (57.4%). The common sites of infection were lower respiratory tract (51.8%) and urinary tract (31.9%). Kleb-siella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli, were the most prevalent pathogens (32.7%, 22.9%, and 14.8% respectively). Most en-terobacteriacea isolates were resistant to third generation cephalosporins. The resis-tant rates to ceftriaxone were 75.5% for K. pneumoniae, and 76% for E. coli. Among P. aeruginosa isolates, 26.5% were resistant to ceftazidim, and 36% to cipro-floxacin. Among S. aureus isolates, 80% were methicillin-resistant.


CONCLUSIONS
The patients in the ICUs are at a higher risk of nosocomial infec-tions. The high prevalence of antimicrobial resistance in the hospitals highlights the need of further infection control activities and surveillance programs.
Department of Infectious Diseases, Hamedan University of Medical Sciences, Hamedan, Iran.
Seyyed Hamid
SH
Hashemi
Mojgan
M
Mamani
Shirin
S
Jamal-Omidi
Amin
A
Niayesh