title: Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae Isolated From Patients in Kashan, Iran.
abstract: BACKGROUND
  Escherichia coli and Klebsiella pneumoniae are common human pathogens that cause a wide spectrum of infections. Antimicrobial resistance is a basic obstacle in the management of these infections which has different patterns in various regions.
  
  
  OBJECTIVE
  In this study, the antibiotic resistance patterns and risk factors for multidrug-resistant (MDR) E. coli and K. pneumoniae were determined.
  
  
  METHODS
  In this cross-sectional study, a total of 250 isolates (134 E. coli and 116 K. pneumoniae) were collected and antimicrobial resistances to ampicillin, amoxicillin-clavulanic acid, amikacin, gentamycin, ceftriaxone, ceftazidime, ciprofloxacin and imipenem were evaluated by disc diffusion method and confirmed by E-test. Moreover, risk factors for MDR E. coli and K. pneumoniae were also detected.
  
  
  RESULTS
  The mean ages of the culture-positive cases of E. coli and K. pneumoniae were 33.39 ± 24.42 and 36.54 ± 24.66 years, respectively (P = 0.31); 137 (54.8%) cases were male and 113 (45.2%) were female (P = 0.53). Nineteen (14.2%) isolates of E. coli and 12 (10.3%) isolates of K. pneumoniae were sensitive to all the evaluated antibiotics. The prevalence of MDR E. coli and MDR K. pneumoniae was 50% and 46.6%, respectively (P = 0.59). The highest resistance for both strains was to ampicillin and no imipenem resistance was seen. The risk factors for MDR E. coli were admission history during the recent three months (P = 0.043) and antibiotic use in the previous month (P = 0.03); for MDR K. pneumoniae, they were admission in the pediatric ward (P = 0.016), surgical ward (P = 0.019), or gynecology ward (P = 0.12), admission duration of > seven days, and antibiotic use during the past month (P = 0.04).
  
  
  CONCLUSIONS
  The prevalence of multidrug resistance was high compared with developed countries, and history of admission, antibiotic use, admission duration and admission wards were the risk factors for multidrug resistance.
authors.affiliation: Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Atieh Sadat
authors.initials: AS
authors.lastname: Moini
authors.affiliation: Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Soltani
authors.affiliation: Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Taghavi Ardakani
authors.affiliation: Department of Community Medicine, Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Moravveji
authors.affiliation: Department of Microbiology, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mahzad
authors.initials: M
authors.lastname: Erami
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Haji Rezaei
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mansoor
authors.initials: M
authors.lastname: Namazi
keywords: Escherichia coli; Klebsiella pneumoniae; Multidrug Resistance; Risk Factors