Evaluating antibiotic resistance pattern of ventilator-associated pneumonia in intensive care units of Alzahra Hospital, Isfahan University of Medical Sciences, Iran

Abstract

Background: Ventilator-associated pneumonia (VAP) is the most common infection in intensive care units (ICUs) which in most of cases is resistant to regular antibiotics. This study aimed to identify the antibioticresistance pattern of common pathogens in ventilator-associated pneumonia and risk factors of multi-drug resistance (MDR) in ICUs of Alzahra Hospital, Isfahan University of Medical Sciences, Iran. Methods: In this cross-sectional study, files of 196 patients with ventilator-associated pneumonia, which were hospitalized in ICUs of Alzahra teaching hospital from March 2014 to March 2015, were reviewed. To identify the common pathogens and related antibiotic-resistance pattern, reports of bronchoalveolar fluid culture were used. Pathogens were divided to multi-drug and non-multi-drug resistance groups and the groups were compared for some demographic and resistance risk factors. Findings: From 196 cases, 63 were early pneumonia and 133 were delayed. Number of multi-drug resistance pathogens showed no significant differences between the early and delayed pneumonia. Multi-drug and nonmulti- drug resistance groups were compared for age, sex, immune deficiency, duration of hospitalization, and previous antibiotic therapy; and there were no significant differences. The most common pathogens for both early and delayed pneumonia were Acinetobacter baumannii (40.4) and Klebsiella pneumoniae (31.8) and minimum resistance among these bacteria was against colistin and amikacin. Conclusion: Resistance to antibiotics is most affected by situational conditions. Considering this point and increasing prevalence of antibiotic resistance, it is necessary to do some actions such as preparing culture sample before antibiotic therapy, empirical treatment based on common pathogens and their resistance rate, and avoiding antibiotic therapy without indication. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.