year 16, Issue 2 (March - April 2022)                   Iran J Med Microbiol 2022, 16(2): 134-140 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ghasemshahi S, Ahmadpor M, Booskabadi A, Rezaei H, Poopak B, Hakemi-Vala M. A Six-Month Survey of the Frequency of Extensively Drug-resistant Gram-Negative Bacteria by VITEK 2 System in 2020. Iran J Med Microbiol 2022; 16 (2) :134-140
1- Department of Microbiology, Payvand Clinical and Specialty Laboratory, Tehran, Iran
2- Head of Payvand Clinical and Specialty Laboratory, Tehran, Iran
3- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran ,
Abstract:   (1640 Views)

Background and Objective: Increasing of resistant bacteria is a major concern globally. The emergence of XDR gram-negative bacteria is a more serious problem due to treatment limitations. This study aimed to evaluate the frequency of extensively drug-resistant (XDR) gram-negative bacterial isolates in different clinical samples from Payvand Clinical and Specialty Laboratory, Tehran, Iran, for 6 months by VITEK 2 system.
Materials and Methods: During March 2020-September 2020, different clinical samples were collected from patients referred to Payvand Clinical and Specialty Laboratory. Bacterial identification and antimicrobial susceptibility test (AST) were performed applying an automated VITEK 2 system. The frequency of identified bacteria, their resistance to common antibiotics and also XDR bacteria were calculated and reported, respectively.
Results: Overall, 4125 urine specimens, 34 sputum samples, and 1 tracheal aspirate tube were submitted to Payvand Laboratory during 6 months. Of them, 486 urine, 32 sputum, and a tracheal aspirate tube samples were culture positive. Gram-negative isolated bacteria were included in this study. Based on AST, 63.3% of the isolated Klebsiella pneumoniae, 100% of Pseudomonas aeruginosa, and all Acinetobacter baumannii isolates were susceptible to amikacin and colistin. Totally, 31 XDR gram-negative bacteria, including: K. pneumonia (ssp. pneumonia (n=20), and ozaenae (n=2), Escherichia coli (n=3), P. aeruginosa (n=5), and A. baumannii (n=1) were identified from 18 urine samples, 12 sputum specimens, and a tracheal aspirate tube. 
Conclusion: The rate of XDR bacteria was high in the investigated laboratory in this study. Therefore, accurate screening and antimicrobial stewardship is recommended in different medical centers of Iran.

Full-Text [PDF 475 kb]   (651 Downloads) |   |   Full-Text (HTML)  (883 Views)  
Type of Study: Original Research Article | Subject: Antibiotic Resistance
Received: 2021/08/14 | Accepted: 2022/01/8 | ePublished: 2022/02/10

1. Basak S, Singh P, Rajurkar M. Multidrug Resistant and Extensively Drug Resistant Bacteria: A Study. J Pathog. 2016;2016:4065603. [DOI:10.1155/2016/4065603] [PMID] [PMCID]
2. Karaiskos I, Giamarellou H. Multidrug-resistant and extensively drug-resistant Gram-negative pathogens: current and emerging therapeutic approaches. Expert opinion on pharmacotherapy. 2014;15(10):1351-70. [DOI:10.1517/14656566.2014.914172] [PMID] [PMCID]
3. Cohen ML. Changing patterns of infectious disease. Nature. 2000 Aug 17; 406(6797):762-7. [DOI:10.1038/35021206] [PMID]
4. Ahmed Hasanin, Akram Eladawy, Hossam Mohamed , Yasmin Salah, Ahmed Lotfy. Prevalence of extensively drug-resistant gram negative bacilli in surgical intensive care in Egypt. Pan Afric Med J. 2014, 21; 19:177. [DOI:10.11604/pamj.2014.19.177.4307] [PMID] [PMCID]
5. Uc-Cachón AH, Gracida-Osorno C, Luna-Chi IG, Jiménez-Guillermo JG, Molina-Salinas GM. High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico. Medicina (Kaunas). 2019; 55(9):588. [DOI:10.3390/medicina55090588] [PMID] [PMCID]
6. Fitzroy A Orrett. Resistance patterns among selective Gram-negative bacilli from an intensive care unit in Trinidad, West Indies. 2004; 25(4):478-83.
7. Souli M, Galani I, Giamarellou H. Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe. Euro Surveill. 2008, 20; 13(47):19045. [DOI:10.2807/ese.13.47.19045-en] [PMID]
8. Oliva A, Giacobbe DR, Di Luca M, Miller NS. New insights into infections due to multidrug resistant Gram negative bacteria: The interplay between lab and clinic. BioMed Res Int. 2018 Dec 25;2018. [DOI:10.1155/2018/8905874] [PMID] [PMCID]
9. Teerawattanapong N, Kengkla K, Dilokthornsakul P, Saokaew S, Apisarnthanarak A, Chaiyakunapruk N. Prevention and control of multidrug-resistant gram-negative bacteria in adult intensive care units: a systematic review and network meta-analysis. Clin Infect Dis. 2017 May 15;64(suppl_2):S51-60. [DOI:10.1093/cid/cix112] [PMID]
11. Patricia M. Tille. Baily and Scott's Diagnostic microbiology. Elsevier publisher, 14th edition. 2017.
12. Performance Standards for Antimicrobial Susceptibility Testing.30th ed. CLSI supplement M100. Wayne, PA: Clinical and laboratory standards institute: 2020.
13. Alebel M, Mekonnen F, Mulu W. Extended-Spectrum β-Lactamase and Carbapenemase Producing Gram-Negative Bacilli Infections Among Patients in Intensive Care Units of Felegehiwot Referral Hospital: A Prospective Cross-Sectional Study. Infect Drug Resist. 2021;14:391. [DOI:10.2147/IDR.S292246] [PMID] [PMCID]
14. Beyene D, Bitew A, Fantew S, Mihret A, Evans M. Multidrug-resistant profile and prevalence of extended spectrum β-lactamase and carbapenemase production in fermentative Gram-negative bacilli recovered from patients and specimens referred to National Reference Laboratory, Addis Ababa, Ethiopia. PloS one. 2019 Sep 25;14(9):e0222911. [DOI:10.1371/journal.pone.0222911] [PMID] [PMCID]
15. Giuffrè M, Geraci DM, Bonura C, Saporito L, Graziano G, Insinga V, Aleo A, Vecchio D, Mammina C. The increasing challenge of multidrug-resistant gram-negative bacilli: results of a 5-year active surveillance program in a neonatal intensive care unit. Medicine. 2016 Mar;95(10). [DOI:10.1097/MD.0000000000003016] [PMID] [PMCID]
16. Alexandraki I, Palacio C. Gram-negative versus Gram-positive bacteremia: what is more alarmin (g)?. Crit Care. 2010 Jun;14(3):1-2. [DOI:10.1186/cc9013] [PMID] [PMCID]
17. Pop-Vicas AE, D'Agata EM. The rising influx of multidrug-resistant gram-negative bacilli into a tertiary care hospital. Clinical infectious diseases. 2005 Jun 15;40(12):1792-8. [DOI:10.1086/430314] [PMID]
18. Gashaw M, Berhane M, Bekele S, Kibru G, Teshager L, Yilma Y, Ahmed Y, Fentahun N, Assefa H, Wieser A, Gudina EK. Emergence of high drug resistant bacterial isolates from patients with health care associated infections at Jimma University medical center: a cross sectional study. Antimicrob Resist Infect Control. 2018 Dec;7(1):1-8. [DOI:10.1186/s13756-018-0431-0] [PMID] [PMCID]
19. Bassetti M, Peghin M, Vena A, Giacobbe DR. Treatment of infections due to MDR Gram-negative bacteria. Front Med. 2019 Apr 16;6:74. [DOI:10.3389/fmed.2019.00074] [PMID] [PMCID]
20. Zhou L, Feng S, Sun G, Tang B, Zhu X, Song K, Zhang X, Lu H, Liu H, Sun Z, Zheng C. Extensively drug-resistant Gram-negative bacterial bloodstream infection in hematological disease. Infecti Drug Resist. 2019;12:481. [DOI:10.2147/IDR.S191462] [PMID] [PMCID]
21. Nagvekar V, Sawant S, Amey S. Prevalence of multidrug-resistant Gram-negative bacteria cases at admission in a multispeciality hospital. J Glob Antimicrob Resist. 2020 Sep 1;22:457-61. [DOI:10.1016/j.jgar.2020.02.030] [PMID]
22. Papadopoulos A, Ribera A, Mavrogenis AF, Rodriguez-Pardo D, Bonnet E, Salles MJ, Del Toro MD, Nguyen S, Blanco-García A, Skaliczki G, Soriano A. Multidrug-resistant and extensively drug-resistant Gram-negative prosthetic joint infections: Role of surgery and impact of colistin administration. Int J Antimicrob Agents. 2019;53(3):294-301. [DOI:10.1016/j.ijantimicag.2018.10.018] [PMID]
23. Mirzaei B, Bazgir ZN, Goli HR, Iranpour F, Mohammadi F, Babaei R. Prevalence of multi-drug resistant (MDR) and extensively drug-resistant (XDR) phenotypes of Pseudomonas aeruginosa and Acinetobacter baumannii isolated in clinical samples from Northeast of Iran. BMC Res Notes. 2020 Dec;13(1):1-6. [DOI:10.1186/s13104-020-05224-w] [PMID] [PMCID]
24. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson-Liljequist B, Paterson DL. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268-81. [DOI:10.1111/j.1469-0691.2011.03570.x] [PMID]
25. Guan X, He L, Hu B, Hu J, Huang X, Lai G, Li Y, Liu Y, Ni Y, Qiu H, Shao Z. Laboratory diagnosis, clinical management and infection control of the infections caused by extensively drug-resistant Gram-negative bacilli: a Chinese consensus statement. Clin Microbiol Infect. 2016 Mar 1;22:S15-25. [DOI:10.1016/j.cmi.2015.11.004] [PMID]
26. Ibrahim ME. High antimicrobial resistant rates among gram-negative pathogens in intensive care units: a retrospective study at a tertiary care hospital in Southwest Saudi Arabia. Saudi Med J. 2018;39(10):1035. [DOI:10.15537/smj.2018.10.22944] [PMID] [PMCID]
27. Alawadhi SA, Ohaeri JU. Validity and reliability of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTC QLQ): experience from Kuwait using a sample of women with breast cancer. Ann Saudi Med. 2010 Sep;30(5):390-6. [DOI:10.4103/0256-4947.67083] [PMID] [PMCID]
28. Alhumaid S, Al Mutair A, Al Alawi Z, Alzahrani AJ, Tobaiqy M, Alresasi AM, Bu-Shehab I, Al-Hadary I, Alhmeed N, Alismail M, Aldera AH. Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia. Ann Clin Microbiol Antimicrob. 2021 Dec;20(1):1-8. [DOI:10.1186/s12941-021-00450-x] [PMID] [PMCID]
29. Manandhar S, Zellweger RM, Maharjan N, Dongol S, Prajapati KG, Thwaites G, Basnyat B, Dixit SM, Baker S, Karkey A. A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes. Ann Clin Microbiol Antimicrob. 2020;19(1):1-3. [DOI:10.1186/s12941-020-00390-y] [PMID] [PMCID]
30. Oliveira J, Reygaert WC. Gram Negative Bacteria. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2021. PMID: 30855801.
31. Kosikowska U, Rybojad P, Stępień-Pyśniak D, Żbikowska A, Malm A. Changes in the prevalence and biofilm formation of Haemophilus influenzae and Haemophilus parainfluenzae from the respiratory microbiota of patients with sarcoidosis. BMC Infect Dis. 2016;16(1):1-3. [DOI:10.1186/s12879-016-1793-7] [PMID] [PMCID]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian Journal of Medical Microbiology

Designed & Developed by : Yektaweb | Publisher: Farname Inc