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Nosocomial infections and antimicrobial susceptibility patterns among patients admitted to intensive care unit of Imam Khomeini hospital in Ilam, Iran

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Abstract

Introduction

Nosocomial infections (NIs) are a major challenge worldwide. Identification of antibiotic resistance pattern extended spectrum beta-lactamases (ESBLs) and carbapenem-resistant Enterobacteriaceae (CRE) were the objectives of this study.

Methods

In this cross-sectional study, the antimicrobial susceptibility pattern of bacterial isolates collected from patients with NIs in ICU was determined. Overall, 42 Escherichia coli and Klebsiella pneumoniae isolates from different infection sites were used to determine phenotypic tests of ESBLs, Metallo-β-lactamases (MBLs) and CRE. Detection of ESBLs, MBLs and CRE genes were performed by the polymerase chain reaction (PCR) method.

Results

From 71 patients with NIs, 103 different bacterial strains were isolated. The most frequently isolated bacteria were E. coli (n = 29; 28.16%), Acinetobacter baumannii (n = 15; 14.56%), and K. pneumoniae (n = 13; 12.26%). Also, the rate of multidrug-resistant (MDR) isolates was 58.25% (60/103). Based on phenotypic confirmation tests, 32 (76.19%) isolates of E. coli and K. pneumoniae produced ESBLs, and 6 (14.28%) isolates were identified as CRE producers. PCR showed the high prevalence of the blaCTX-M (n = 29; 90.62%) in ESBL genes. In addition, blaNDM was detected in 4 (66.66%), blaOXA-23 in 3 (50%), and blaOXA-48 gene in 1 (16.66%) isolates. The blaVIM, blaKPC, and blaIMP genes were not detected in any of the isolates.

Conclusion

The Gram-negative bacteria E. coli, A. baumannii, and K. pneumoniae with high resistance levels were the most common bacteria causing NIs in the ICU. This study for the first time identified blaOXA-11, blaOXA-23, and blaNDM-1 genes in E. coli and K. pneumoniae in Ilam city of Iran.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article.

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Acknowledgements

We would like to thank the Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran, for their cooperation. The authors also acknowledge the Vice Chancellor for Research Affairs, Ilam University of Medical Sciences, for their executive and financial support.

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Authors and Affiliations

  1. Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran

    Marzieh Hashemian, Vahab Hassan Kaviar, Somayeh Karamolahi & Nourkhoda Sadeghifard

  2. Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran

    Hossein Kazemian & Saeed Khoshnood

  3. Department of Infectious Diseases, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran

    Ali Nazari

  4. Department of Nursing, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran

    Mohammad Reza Bagheri

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  1. Marzieh Hashemian
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  2. Hossein Kazemian
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Contributions

NS and HK contributed to the study conception and design. Data collection and analysis were performed by MH and SK. The first draft of the manuscript was written by MH and SK, and all the authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Nourkhoda Sadeghifard or Saeed Khoshnood.

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Conflict of interest

The authors report no conflict of interest in this study.

Ethical approval

The study protocol was approved by the local ethics committee of Ilam University of Medical Sciences Iran (ethical code: IR.MADILAM.REC.1400.003). Written informed consent was received from each patient.

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Hashemian, M., Kazemian, H., Kaviar, V.H. et al. Nosocomial infections and antimicrobial susceptibility patterns among patients admitted to intensive care unit of Imam Khomeini hospital in Ilam, Iran. Mol Biol Rep 50, 5565–5574 (2023). https://doi.org/10.1007/s11033-023-08476-4

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