Incidence of Rod Shaped Gramnegative Hospital Acquired Bacterial Infection and Antibiotic Resistance: A Retrospective Based Population Study
https://doi.org/10.24017/science.2020.ICHMS2020.9
Abstract views: 1280 / PDF downloads: 655Abstract
The gram-negative, especially rod shapes vary in the frequencies that they cause the most frequent types of hospital-acquired infection: pneumonia, surgical site infection, urinary tract infection, diabetic infection, burn and bloodstream infection. The presented study determined the microbial spectrum and antimicrobial susceptibility of gram-negative bacteria isolated from various infection sites in hospitalized patients in Sulaimani city. This study included 735 patients who underwent surgical and wound treatment admitted to the hospital. A microbiological standard technique was used for Identification, isolation and antimicrobial susceptibility. The data in this job were scaled into excel sheets and transferred to SPSS (Statistical Package for Social Sciences) version 24.0 software. The significance of associations between variables and predictor done by Chi-square (?2). P-value of <0.05 was regarded significant. Male was the most common cases 52.5%. Patients less than 18 years-old were the most frequently affected 54.3%. Gram negative infection is the most common and most serious complication of burn injuries and it is the majority suspected clinical finding nearly to 60%. The most common bacteria separatedd from wound and sepsis were Pseudomonas aeruginosa 91.91%. Individual pathogens’ incidence differ significantly between location of infection p<0.001. Pseudomonas aeruginosa, only resistant stabled at the lowest rates for Colistine and Imepenim (0.1% and 7.8%) and significant finding was confirmed p<0.001. But highly resistance to Ticarcillin/Clavulanic Acid, Cefepime, Tobramycin, and Gentamicin (85.6%, 80.8%, 79.3%, 79.2%) .In conclusion, these population-based study gram-negative infections predominate in burn wounds. Microbial resistance to the confirmed drugs leads to repeated antimicrobial treatment modifications and long-time of treatments.
Keywords:
Hospital acquired infection, Gram-negative, Pseudomonas aeruginosa, antimicrobial susceptibility
References
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https://doi.org/10.1097/01.BCR.0000095507.45481.76
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https://doi.org/10.1097/00004630-199011000-00018
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https://doi.org/10.1016/S0002-9343(98)00150-8
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https://doi.org/10.3109/17453679708996264
[14] SL. Gorbach, JW. Mayhew, JG. Bartlett, H Thadepalli, AB. Onderdonk, "Rapid diagnosis of anaerobic infections by direct gasliquid chromatography of clinical specimens," J. Clin. Investig, 57(2), pp. 478-484, 1976.
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https://doi.org/10.1016/0195-6701(92)90151-B
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https://doi.org/10.1542/peds.67.6.891
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https://doi.org/10.1136/jcp.34.7.701
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https://doi.org/10.1001/archsurg.1990.01410230039007
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https://doi.org/10.1093/clinids/20.Supplement_2.S279
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https://doi.org/10.1016/B978-0-12-256745-2.50024-6
[21] RD Griego, T. Rosen, I. Orengo, J. Wolf, "Dog, cat and human bites: a review," J. Am. Acad. Dermatol, 33(2), pp. 1019-1029, 1995.
https://doi.org/10.1016/0190-9622(95)90296-1
[22] DL. Brown, DJ. Smith, "Bacterial colonisation/infection and the surgical management of pressure ulcers," Ostomy Wound Manage, 45(3), pp. 119S-120S, 1999.
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https://doi.org/10.1016/B978-0-12-256745-2.50026-X
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https://doi.org/10.1046/j.1365-4362.1999.00738.x
[25] PW. Stone, E. Larson, LN. Kawar, "A systematic audit of economic evidence linking nosocomial infections and infection control interventions: 1990-2000," American journal of infection control, 30(3), pp. 145-52, 2002.
https://doi.org/10.1067/mic.2002.121099
[26] CDC. Healthcare- associated infections. Available from: http://wwwcdcgog/ncidod/ dhqp/healthdishtml. [Accessed: Sept. 9, 2014].
[27] AR. Rastegar, R. Alaghehbandan, L. Akhlaghi, "Burn wound infections and antimicrobial resistance in tehran, iran: an increasing problem," Annals of burns and fire disasters, 18(2), pp. 68-73, 2005.
[28] JJ. Lee, JA. Marvin, DM. Heimbach, BJ. Grube, LH. Engrav, "Infection control in a burn center," The Journal of burn care & rehabilitation, 11(6), pp. 575-80, 1990.
https://doi.org/10.1097/00004630-199011000-00018
[29] Raymond J, Aujard Y. Nosocomial infections in pediatric patients: a European, multicenter prospective study. European Study Group. Infection control and hospital epidemiology. 2000;21(4):260-3.
https://doi.org/10.1086/501755
[30] MR. Becerra, JA. Tantalean, VJ. Suarez, MC. Alvarado, JL. Candela, FC. Urcia, "Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country," BMC pediatrics, 10, pp.66, 2010.
https://doi.org/10.1186/1471-2431-10-66
[31] JA. Roberts, P. Kruger, DL. Paterson, J. Lipman, "Antibiotic resistance--what's dosing got to do with it?," Critical care medicine, 36(8), pp. 2433-40, 2008.
https://doi.org/10.1097/CCM.0b013e318180fe62
[32] T. Sjoberg, S. Mzezewa, K. Jonsson, V. Robertson, L. Salemark, "Comparison of surface swab cultures and quantitative tissue biopsy cultures to predict sepsis in burn patients: a prospective study," The Journal of burn care & rehabilitation, 24(6), pp. 365-70, 2003.
https://doi.org/10.1097/01.BCR.0000095507.45481.76
[33] W. Song, KM. Lee, HJ. Kang, DH. Shin, DK. Kim, "Microbiologic aspects of predominant bacteria isolated from the burn patients in Korea," Burns : journal of the International Society for Burn Injuries, 27(2), pp. 136-9, 2001.
https://doi.org/10.1016/S0305-4179(00)00086-3
[34] S. Behzadnia, A. Davoudi, MS. Rezai, F. Ahangarkani, "Nosocomial infections in pediatric population and antibiotic resistance of the causative organisms in north of iran," Iranian Red Crescent medical journal, 16(2), pp. e14562, 2014.
https://doi.org/10.5812/ircmj.14562
[35] Yavuz, A. Ayse, Y. Abdullah, A. Belkiz, "Clinical and demographic features of pediatric burns in the eastern provinces of Turkey," Scandinavian journal of trauma, resuscitation and emergency medicine, 19(1), pp. 6, 2011.
https://doi.org/10.1186/1757-7241-19-6
[36] LA. Barajas-Nava, J. Lopez-Alcalde, M. Roque i Figuls, I. Sola, X. Bonfill, "Antibiotic prophylaxis for preventing burn wound infection," The Cochrane database of systematic reviews, (6), pp. CD008738, 2013.
https://doi.org/10.1002/14651858.CD008738.pub2
[37] GM. AbdulRazzaq, "Pattern of antibiotic sensitivity and resistance pf uropathogenes among pediatric patients with urinary tract infection," Iraq J Pharm, 1, pp. 13, 2012.
https://doi.org/10.33899/iphr.2013.66906
[38] L. Ngai, HF. Wertheim, V. Phu, K. Dung, L. Hai, T. Bich, "High prevalence of hospital-acquired infections caused by gram-negative carbapenem resistant strains in Vietnamese pediatric ICUs," Medicine 95 (2), pp. 27(e4099), 2016.
https://doi.org/10.1097/MD.0000000000004099
[39] Undabeitia, B. Liu, G. Catalán, G. Bilbao, I. Pomposo, JM. Garibi, "Clinical and economic analysis of hospital acquired infections in patients diagnosed with brain tumor in a tertiary hospital," Neurocirugía; 22, pp. 535-541, 2011.
https://doi.org/10.1016/S1130-1473(11)70108-7
[40] R. Krumkamp, K. Oppong, B. Hogan, R. Strauss, H. Frickmann, C. Wiafe-Akenten, et al., "Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana," PLoS ONE, 15(8), pp. e0237263, 2020.
https://doi.org/10.1371/journal.pone.0237263
[41] WR. Jarvis, B. Robles, "Nosocomial infections in pediatric patients," Adv Pediatr Infect Dis, 12, pp. 243-95, 1997.
[42] WC. Huskins, DA. Goldmann, "Nosocomial infections. Textbook of Pediatric Infectious Diseases, 4th edn," Philadelphia: Saunders, 1998.
[43] JS. Harris, "Pediatric nosocomial infections: Children are not little adults," Infect Control Hosp Epidemiol, 18, pp. 739-42, 1997.
https://doi.org/10.1086/647526
[44] CG. Mayhall, "The epidemiology of burn wound infections: then and now. Clinical infectious diseases," An official publication of the Infectious Diseases Society of America., 37(4), pp. 543-50, 2003.
https://doi.org/10.1086/376993
[45] Balaban, G. Tanir, O. Metin Timur, FN. Oz, T. Aydin Teke, GI. Bayhan, et al., "Nosocomial infections in the general pediatric wards of a hospital in Turkey," Japanese journal of infectious diseases, 65(4),pp. 318-21, 2012.
https://doi.org/10.7883/yoken.65.318
[46] M. Souli, I. Galani, H. Giamarellou, "Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe. Euro surveillance: bulletin Europeen sur les maladies transmissibles," European communicable disease bulletin, 13(47), pp. 157-162, 2008.
https://doi.org/10.2807/ese.13.47.19045-en
[47] E. Jafar, MR. Shakibaie, L. Poormasoomi, "Isolation of a novel antibiotic resistance plasmid DNA from hospital isolates of Pseudomonas aeruginosa," Journal of Clinical & Experimental Pathology, 3(2), pp. 1-5, 2013.
https://doi.org/10.4172/2161-0681.1000140
https://doi.org/10.1086/432803
[2] J. Raymond, Y. Aujard, "Nosocomial infections in pediatric patients: a European, multicenter prospective study," European Study Group. Infection control and hospital epidemiology, 21 (4), pp. 260-3, 2000.
https://doi.org/10.1086/501755
[3] MR. Becerra, JA. Tantalean, VJ. Suarez, MC. Alvarado, JL. Candela, FC. Urcia, "Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country," BMC pediatrics, 10, pp. 66, 2010.
https://doi.org/10.1186/1471-2431-10-66
[4] T. Sjoberg, S. Mzezewa, K. Jonsson, V. Robertson, L. Salemark, "Comparison of surface swab cultures and quantitative tissue biopsy cultures to predict sepsis in burn patients: a prospective study," The Journal of burn care & rehabilitation, 24 (6), pp. 365-70, 2003.
https://doi.org/10.1097/01.BCR.0000095507.45481.76
[5] AR. Rastegar, R. Alaghehbandan, L. Akhlaghi, "Burn wound infections and antimicrobial resistance in tehran, iran: an increasing problem," Annals of burns and fire disasters, 18(2), pp. 68-73, 2005.
[6] JJ. Lee, JA. Marvin, DM. Heimbach, BJ. Grube, LH. Engrav, "Infection control in a burn center," The Journal of burn care & rehabilitation, 11(6), pp. 575-80, 1990.
https://doi.org/10.1097/00004630-199011000-00018
[7] MM. Olson, JT. Lee, "Continuous, 10-year wound infection surveillance. Results, advantages, and unanswered questions," Archives of surgery, 125(6), pp. 794-803,1990.
https://doi.org/10.1001/archsurg.1990.01410180120020
[8] WHO. ANTIMICROBIAL RESISTANCE Global Report on Surveillance. Available: wwwwhoint/about/licensing/copyright_form/en/indexhtml. [Accessed: Sept. 11, 2014].
[9] Peel, "Definition of infection In E. W. Taylor (ed.), Infection in surgical practice," Oxford University Press, Oxford, United Kingdom, 1992.
[10] RL. Nichols, "Postoperative infections in the age of drug-resistant Gram-positive bacteria," Am. J. Med, 104(5S), pp. 11S-16S, 1998.
https://doi.org/10.1016/S0002-9343(98)00150-8
[11] JR. Benger, AJ. Kelly, IG. Winson, "Does early wound infection after elective orthopaedic surgery lead on to chronic sepsis?," J. R. Coll. Surg. Edinb, 43(1), pp. 43-44, 1998.
[12] KS. Dhillon, CS. Kok, "The incidence of post-operative wound infection in orthopaedic surgery," Med. J. Malays, 50(3), pp. 237-240, 1995.
[13] TS, Sorensen, AI. Sorensen, A. Bremmelgaard, "Orthopedic wound infections. 182 cases after 8913 operations during an 8-year survey," Acta Orthop. Scand, 68(5), pp.466-469, 1997.
https://doi.org/10.3109/17453679708996264
[14] SL. Gorbach, JW. Mayhew, JG. Bartlett, H Thadepalli, AB. Onderdonk, "Rapid diagnosis of anaerobic infections by direct gasliquid chromatography of clinical specimens," J. Clin. Investig, 57(2), pp. 478-484, 1976.
https://doi.org/10.1172/JCI108300
[15] K. Twum-Danso, C. Grant, SA. Al-Suleiman, S. Abdel-Khaders, MS. Al-Awami, H. Al-Breiki, et al., "Microbiology of postoperative wound infection: a prospective study of 1770 wounds," J. Hosp. Infect, 21(3):29-37, 1992.
https://doi.org/10.1016/0195-6701(92)90151-B
[16] S. Brook, "Aerobic and anaerobic bacteriology of cutaneous abscesses in children," Pediatrics, 67(4), pp. 891-895, 1981.
https://doi.org/10.1542/peds.67.6.891
[17] DC. Daltrey, B. Rhodes, JG. Chattwood, "Investigation into the microbial flora of healing and non-healing decubitus ulcers," J. Clin. Pathol, 34(2), pp. 701-705, 1981.
https://doi.org/10.1136/jcp.34.7.701
[18] Brook, EH. Frazier, "Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses," Arch. Surg, 125(4), pp. 1445-1451, 1990.
https://doi.org/10.1001/archsurg.1990.01410230039007
[19] PH. Summanen, DA. Talan, C. Strong, M. McTeague, R. Bennion, JE. Thompson, et al., "Bacteriology of skin and soft-tissue infections: comparison of infections in intravenous drug users and individuals with no history of intravenous drug use," Clin. Infect. Dis, 20(5), pp. S279-S282, 1995.
https://doi.org/10.1093/clinids/20.Supplement_2.S279
[20] EJ. Goldstein, "Bite infections: Anaerobic infections in humans," Academic Press, Inc., San Diego, Calif, p. 455-465, 1989.
https://doi.org/10.1016/B978-0-12-256745-2.50024-6
[21] RD Griego, T. Rosen, I. Orengo, J. Wolf, "Dog, cat and human bites: a review," J. Am. Acad. Dermatol, 33(2), pp. 1019-1029, 1995.
https://doi.org/10.1016/0190-9622(95)90296-1
[22] DL. Brown, DJ. Smith, "Bacterial colonisation/infection and the surgical management of pressure ulcers," Ostomy Wound Manage, 45(3), pp. 119S-120S, 1999.
[23] W. Lance George, "Other infections of skin, soft tissue, and muscle, In Anaerobic infections in humans," Academic Press, Inc., San Diego, Calif, p. 1491-1492, 1989.
https://doi.org/10.1016/B978-0-12-256745-2.50026-X
[24] PG. Bowler, BJ. Davies, "The microbiology of infected and noninfected leg ulcers," Int. J. Dermatol, 38(3), pp. 101-106, 1999..
https://doi.org/10.1046/j.1365-4362.1999.00738.x
[25] PW. Stone, E. Larson, LN. Kawar, "A systematic audit of economic evidence linking nosocomial infections and infection control interventions: 1990-2000," American journal of infection control, 30(3), pp. 145-52, 2002.
https://doi.org/10.1067/mic.2002.121099
[26] CDC. Healthcare- associated infections. Available from: http://wwwcdcgog/ncidod/ dhqp/healthdishtml. [Accessed: Sept. 9, 2014].
[27] AR. Rastegar, R. Alaghehbandan, L. Akhlaghi, "Burn wound infections and antimicrobial resistance in tehran, iran: an increasing problem," Annals of burns and fire disasters, 18(2), pp. 68-73, 2005.
[28] JJ. Lee, JA. Marvin, DM. Heimbach, BJ. Grube, LH. Engrav, "Infection control in a burn center," The Journal of burn care & rehabilitation, 11(6), pp. 575-80, 1990.
https://doi.org/10.1097/00004630-199011000-00018
[29] Raymond J, Aujard Y. Nosocomial infections in pediatric patients: a European, multicenter prospective study. European Study Group. Infection control and hospital epidemiology. 2000;21(4):260-3.
https://doi.org/10.1086/501755
[30] MR. Becerra, JA. Tantalean, VJ. Suarez, MC. Alvarado, JL. Candela, FC. Urcia, "Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country," BMC pediatrics, 10, pp.66, 2010.
https://doi.org/10.1186/1471-2431-10-66
[31] JA. Roberts, P. Kruger, DL. Paterson, J. Lipman, "Antibiotic resistance--what's dosing got to do with it?," Critical care medicine, 36(8), pp. 2433-40, 2008.
https://doi.org/10.1097/CCM.0b013e318180fe62
[32] T. Sjoberg, S. Mzezewa, K. Jonsson, V. Robertson, L. Salemark, "Comparison of surface swab cultures and quantitative tissue biopsy cultures to predict sepsis in burn patients: a prospective study," The Journal of burn care & rehabilitation, 24(6), pp. 365-70, 2003.
https://doi.org/10.1097/01.BCR.0000095507.45481.76
[33] W. Song, KM. Lee, HJ. Kang, DH. Shin, DK. Kim, "Microbiologic aspects of predominant bacteria isolated from the burn patients in Korea," Burns : journal of the International Society for Burn Injuries, 27(2), pp. 136-9, 2001.
https://doi.org/10.1016/S0305-4179(00)00086-3
[34] S. Behzadnia, A. Davoudi, MS. Rezai, F. Ahangarkani, "Nosocomial infections in pediatric population and antibiotic resistance of the causative organisms in north of iran," Iranian Red Crescent medical journal, 16(2), pp. e14562, 2014.
https://doi.org/10.5812/ircmj.14562
[35] Yavuz, A. Ayse, Y. Abdullah, A. Belkiz, "Clinical and demographic features of pediatric burns in the eastern provinces of Turkey," Scandinavian journal of trauma, resuscitation and emergency medicine, 19(1), pp. 6, 2011.
https://doi.org/10.1186/1757-7241-19-6
[36] LA. Barajas-Nava, J. Lopez-Alcalde, M. Roque i Figuls, I. Sola, X. Bonfill, "Antibiotic prophylaxis for preventing burn wound infection," The Cochrane database of systematic reviews, (6), pp. CD008738, 2013.
https://doi.org/10.1002/14651858.CD008738.pub2
[37] GM. AbdulRazzaq, "Pattern of antibiotic sensitivity and resistance pf uropathogenes among pediatric patients with urinary tract infection," Iraq J Pharm, 1, pp. 13, 2012.
https://doi.org/10.33899/iphr.2013.66906
[38] L. Ngai, HF. Wertheim, V. Phu, K. Dung, L. Hai, T. Bich, "High prevalence of hospital-acquired infections caused by gram-negative carbapenem resistant strains in Vietnamese pediatric ICUs," Medicine 95 (2), pp. 27(e4099), 2016.
https://doi.org/10.1097/MD.0000000000004099
[39] Undabeitia, B. Liu, G. Catalán, G. Bilbao, I. Pomposo, JM. Garibi, "Clinical and economic analysis of hospital acquired infections in patients diagnosed with brain tumor in a tertiary hospital," Neurocirugía; 22, pp. 535-541, 2011.
https://doi.org/10.1016/S1130-1473(11)70108-7
[40] R. Krumkamp, K. Oppong, B. Hogan, R. Strauss, H. Frickmann, C. Wiafe-Akenten, et al., "Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana," PLoS ONE, 15(8), pp. e0237263, 2020.
https://doi.org/10.1371/journal.pone.0237263
[41] WR. Jarvis, B. Robles, "Nosocomial infections in pediatric patients," Adv Pediatr Infect Dis, 12, pp. 243-95, 1997.
[42] WC. Huskins, DA. Goldmann, "Nosocomial infections. Textbook of Pediatric Infectious Diseases, 4th edn," Philadelphia: Saunders, 1998.
[43] JS. Harris, "Pediatric nosocomial infections: Children are not little adults," Infect Control Hosp Epidemiol, 18, pp. 739-42, 1997.
https://doi.org/10.1086/647526
[44] CG. Mayhall, "The epidemiology of burn wound infections: then and now. Clinical infectious diseases," An official publication of the Infectious Diseases Society of America., 37(4), pp. 543-50, 2003.
https://doi.org/10.1086/376993
[45] Balaban, G. Tanir, O. Metin Timur, FN. Oz, T. Aydin Teke, GI. Bayhan, et al., "Nosocomial infections in the general pediatric wards of a hospital in Turkey," Japanese journal of infectious diseases, 65(4),pp. 318-21, 2012.
https://doi.org/10.7883/yoken.65.318
[46] M. Souli, I. Galani, H. Giamarellou, "Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe. Euro surveillance: bulletin Europeen sur les maladies transmissibles," European communicable disease bulletin, 13(47), pp. 157-162, 2008.
https://doi.org/10.2807/ese.13.47.19045-en
[47] E. Jafar, MR. Shakibaie, L. Poormasoomi, "Isolation of a novel antibiotic resistance plasmid DNA from hospital isolates of Pseudomonas aeruginosa," Journal of Clinical & Experimental Pathology, 3(2), pp. 1-5, 2013.
https://doi.org/10.4172/2161-0681.1000140
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K. Jalal Rashid, “Incidence of Rod Shaped Gramnegative Hospital Acquired Bacterial Infection and Antibiotic Resistance: A Retrospective Based Population Study”, KJAR, vol. 6, no. 3, pp. 81–90, Dec. 2020, doi: 10.24017/science.2020.ICHMS2020.9.
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