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Volume 7
Issue 3
10.18683/germs.2017.1117
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Article

Multidrug and Co-Resistance Patterns of Non-Fermenting Gram-Negative Bacilli Involved in Ventilator-Associated Pneumonia Carrying Class 1 Integron in the North of Iran

by
Masoumeh Bagheri-Nesami
1,
Mohammad Sadegh Rezai
2,*,
Fatemeh Ahangarkani
3,
Alireza Rafiei
4,
Attieh Nikkhah
5,
Gohar Eslami
6,
Kheironesa Shafahi
7,
Azin Hajalibeig
2 and
Rezvan Khajavi
4
1
Department of Medical-Surgical Nursing, Nasibeh Faculty of Nursing and Midwifery, Infectious Diseases Research Center with Focus on Nosocomial Infection, Mazandaran University of Medical Sciences, Bou Ali Sina Hospital, Pasdaran Boulevard, Sari, Iran
2
Department of Pediatrics, Infectious Diseases Research Center with Focus on Nosocomial Infection, Mazandaran University of Medical Sciences, Bou Ali Sina Hospital, Pasdaran Boulevard, Sari, Iran
3
Department of Infectious Diseases, Antimicrobial Resistant Research Center, Student Research Committee, Mazandaran University of Medical Sciences, Razi Teaching Hospital, Yosuf Reza Street, Sari, Iran
4
Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran, University of Medical Sciences, Km 18 Khazarabad Road, Sari, Iran
5
Infectious Diseases Research Center with Focus on Nosocomial Infection, Mazandaran University of Medical Sciences, Km 18 Khazarabad Road, Sari, Iran
6
Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran, University of Medical Sciences, Km 18 Khazarabad Road, Sari, Iran
7
Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Shahrdari Square, Artesh Street, Sari, Iran
*
Author to whom correspondence should be addressed.
GERMS 2017, 7(3), 123-131; https://doi.org/10.18683/germs.2017.1117
Submission received: 10 January 2017 / Revised: 1 May 2017 / Accepted: 4 May 2017 / Published: 1 September 2017
Versions Notes

Abstract

Introduction: Ventilator-associated pneumonia (VAP) due to non-fermenting Gram-negative bacilli (NFGNB), especially Pseudomonas aeruginosa and Acinetobacter spp., is one of the main hospital-acquired infections leading to mortality and morbidity, especially in intensive care units (ICUs). This study seeks to determine the multidrug and co-resistance (MDR) patterns of NFGNB that are agents of VAP, and assess the presence of class 1 integron in these bacteria. Methods: This cross-sectional study involved VAP patients admitted in the ICUs of 18 hospitals in the Mazandaran province, located in the North of Iran. The antibiotic susceptibility pattern was determined by the minimum inhibitory concentration (MIC) test by using broth microdilution method. Presence of class 1 integron was evaluated by the polymerase chain reaction (PCR) assay. Results: Out of a total of 83 patients who were microbiologically diagnosed as VAP, 52 non-duplicated NFGNBs (24 P. aeruginosa and 28 A. baumannii) were causative of VAP, out of which MDR NFGNBs were responsible for 48 (57.83%) cases. The frequencies of MDR NFGNBs were as follows: 27 (56.25%) A. baumannii and 21 (43.75%) P. aeruginosa. P. aeruginosa isolates were resistant to all aminoglycoside antibiotics (50%), ciprofloxacin (45.8%), ceftazidime (70.8%), cefepime (87.5%), colistin (62.5%), and imipenem (29.2%). A. baumannii isolates were resistant to aminoglycosides (53.6%), ciprofloxacin (85.7%), ceftazidime (92. 9%), cefepime (92.9%), colistin (35.7%), and imipenem (57.1%). Twelve isolates were resistant to all 10 tested antibiotics. The number of rates of class 1 integron, positive for MDR P. aeruginosa and MDR A. baumannii, were 20 (95.23%) and 21 (77.78%), respectively. Conclusion: The high prevalence of multidrug resistance and incidence of class 1 integron is a therapeutic concern. Employing antibiotic stewardship in hospitals could prevent the dissemination of MDR bacteria.
Keywords: VAP; A. baumannii; P. aeruginosa; MDR; class 1 integron; co-resistance VAP; A. baumannii; P. aeruginosa; MDR; class 1 integron; co-resistance

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MDPI and ACS Style

Bagheri-Nesami, M.; Rezai, M.S.; Ahangarkani, F.; Rafiei, A.; Nikkhah, A.; Eslami, G.; Shafahi, K.; Hajalibeig, A.; Khajavi, R. Multidrug and Co-Resistance Patterns of Non-Fermenting Gram-Negative Bacilli Involved in Ventilator-Associated Pneumonia Carrying Class 1 Integron in the North of Iran. GERMS 2017, 7, 123-131. https://doi.org/10.18683/germs.2017.1117

AMA Style

Bagheri-Nesami M, Rezai MS, Ahangarkani F, Rafiei A, Nikkhah A, Eslami G, Shafahi K, Hajalibeig A, Khajavi R. Multidrug and Co-Resistance Patterns of Non-Fermenting Gram-Negative Bacilli Involved in Ventilator-Associated Pneumonia Carrying Class 1 Integron in the North of Iran. GERMS. 2017; 7(3):123-131. https://doi.org/10.18683/germs.2017.1117

Chicago/Turabian Style

Bagheri-Nesami, Masoumeh, Mohammad Sadegh Rezai, Fatemeh Ahangarkani, Alireza Rafiei, Attieh Nikkhah, Gohar Eslami, Kheironesa Shafahi, Azin Hajalibeig, and Rezvan Khajavi. 2017. "Multidrug and Co-Resistance Patterns of Non-Fermenting Gram-Negative Bacilli Involved in Ventilator-Associated Pneumonia Carrying Class 1 Integron in the North of Iran" GERMS 7, no. 3: 123-131. https://doi.org/10.18683/germs.2017.1117

APA Style

Bagheri-Nesami, M., Rezai, M. S., Ahangarkani, F., Rafiei, A., Nikkhah, A., Eslami, G., Shafahi, K., Hajalibeig, A., & Khajavi, R. (2017). Multidrug and Co-Resistance Patterns of Non-Fermenting Gram-Negative Bacilli Involved in Ventilator-Associated Pneumonia Carrying Class 1 Integron in the North of Iran. GERMS, 7(3), 123-131. https://doi.org/10.18683/germs.2017.1117

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