fa ‫ﻣﻘﺎوﻣﺖ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ در ﻋﻮاﻣﻞ ﺷﺎﯾﻊ ﻋﻔﻮﻧﺖ ﻫﺎی ﺧﻮﻧﯽ‬ جدا شده از بیماران مقاومت پادزیستی (آنتی بیوتیکی) Antibiotic Resistance مقاله پژوهشی Original Research Article <div align="justify" style="direction: rtl"> ‫<b>زﻣﯿﻨﻪ و اﻫﺪاف:</b> ﻋﻔﻮﻧﺖ ﻫﺎی ﺧﻮﻧﯽ (‪ (Bloodstream Infections=BSI‬از ﺟﻤﻠﻪ ﻋﻔﻮﻧﺖ ﻫﺎی ﺧﻄﺮﻧﺎﮐﯽ اﺳﺖ ﮐﻪ در‬ ‫ﺻﻮرت ﻋﺪم درﻣﺎن ﻣﻨﺎﺳﺐ ﺑﺎ ﻣﺮگ و ﻣﯿﺮ ﺑﺎﻻﯾﯽ ﻫﻤﺮاه ﺧﻮاﻫﺪ ﺑﻮد. ﻫﺪف از اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ ﺷﯿﻮع ﻋﻮاﻣﻞ‬ ‫ﺑﺎﮐﺘﺮﯾﺎﯾﯽ ﻣﺨﺘﻠﻒ در ﻋﻔﻮﻧﺖ ﻫﺎی ﺧﻮﻧﯽ و اﻟﮕﻮی ﻣﻘﺎوﻣﺖ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ آﻧﻬﺎ ﻣﯽ ﺑﺎﺷﺪ.‬ <br><b>مواد و روش ها:</b> اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮروی 129 ﻧﻤﻮﻧﻪ ﮐﺸﺖ ﻣﺜﺒﺖ ﺧﻮن ﺟﻤﻊ آوری ﺷﺪه از ﺑﯿﻤﺎران ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ‬ ‫ﺑﯿﻤﺎرﺳﺘﺎن ﺑﻌﺜﺖ ﺗﻬﺮان در ﻃﯽ ﺳﺎل ﻫﺎی 1388 -1389 اﻧﺠﺎم ﺷﺪه اﺳﺖ. ﻣﻘﺎوﻣﺖ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ ﺑﺎ روش دﯾﺴﮏ‬ ‫دﯾﻔﯿﻮژن وﻣﻄﺎﺑﻖ ﺑﺎ ﭘﺮوﺗﻮﮐﻞ (‪ CLSI (clinical laboratory standard institute‬اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ ﺑﺎ اﺳﺘﻔﺎده‬ ‫ازﻧﺮم اﻓﺰار ‪ SPSS‬ اﻧﺎﻟﯿﺰ و ‪ P value‬ﮐﻤﺘﺮ از 0.05 ﻣﻌﻨﯽ دار در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ.‬ <br>‫<b>ﯾﺎﻓﺘﻪ ﻫﺎ:</b> ﺑﯿﺸﺘﺮﯾﻦ ﭘﺎﺗﻮژن ﺟﺪا ﺷﺪه از ﮐﺸﺖ ﺧﻮن اﺳﺘﺎﻓﯿﻠﻮﮐﻮک ﻫﺎی ﮐﻮ اﮔﻮﻻز ﻣﻨﻔﯽ 45(34.9%) و <i>E.coli</i>‬‬ ‫38(29.5%) و ﮐﻤﺘﺮﯾﻦ آن <i>ﭘﺮوﺗﺌﻮس وﻟﮕﺎرﯾﺲ</i> 2 (1.6%) ﺑﻮد. ﻧﺴﺒﺖ ﺑﺎﮐﺘﺮی ﮔﺮم ﻣﻨﻔﯽ ﺟﺪا ﺷﺪه ﺑﻪ ﮔﺮم ﻣﺜﺒﺖ (1.58‬) ﺑﻮد. ﺑﯿﺸﺘﺮﯾﻦ ﻣﻘﺎوﻣﺖ ﻧﺴﺒﺖ ﺑﻪ ﭘﻨﯽ ﺳﯿﻠﯿﻦ 95 (73.6%)، آﻣﭙﯽ ﺳﯿﻠﻦ 86 (66.6%) ﺗﺘﺮاﺳﺎﯾﮑﻠﯿﻦ 76 (58.9%) و ﺑﯿﺸﺘﺮﯾﻦ‬ ‫ﺣﺴﺎﺳﯿﺖ ﻧﺴﺒﺖ ﺑﻪ ﺟﻨﺘﺎﻣﺎﯾﺴﯿﻦ 68.3% و اﯾﻤﯽ ﭘﻨﻢ 65.9%دﯾﺪه ﺷﺪ.‬ ‫<br><b>ﻧﺘﯿﺠﻪ ﮔﯿﺮی:</b> ﻋﻔﻮﻧﺘﻬﺎی ‪ BSI‬ ﻧﺎﺷﯽ از ﮔﺮم ﻣﻨﻔﯽ ﻫﺎ در ﺑﯿﻤﺎرﺳﺘﺎن ﻣﺎ 1.5 ﺑﺮاﺑﺮ ﮔﺮم ﻣﺜﺒﺖ ﻫﺎ اﺳﺖ. اﺳﺘﺎﻓﯿﻠﻮﮐﻮک‬ ‫ﻫﺎی ﮐﻮاﮔﻮﻻز ﻣﻨﻔﯽ و ‪ <i>E.coli‬ </i>ﺷﺎﯾﻊ ﺗﺮﯾﻦ ﻋﻮاﻣﻞ ﻋﻔﻮﻧﺖ ﺧﻮﻧﯽ در ﺑﯿﻤﺎرﺳﺘﺎن ﻣﺎ ﻫﺴﺘﻨﺪ ، ﺑﻪ ﻃﻮری ﮐﻪ 64% از ﮐﻞ‬ ‫ﻋﻔﻮﻧﺖ را ﺷﺎﻣﻞ ﻣﯽ ﺷﺪﻧﺪ. وﻧﮑﻮﻣﺎﯾﺴﯿﻦ داروی ﻣﻨﺎﺳﺒﯽ ﺑﺮای درﻣﺎن اﺳﺘﺎﻓﯿﻠﻮﮐﻮک ﻫﺎی ﮐﻮاﮔﻮﻻز ﻣﻨﻔﯽ‬ ‫و <i>اﺳﺘﺎﻓﯿﻠﻮﮐﻮﮐﻮس اورﺋﻮس </i>اﺳﺖ.‬ </div> <div align="justify" style="direction: ltr"><b>Background and objective:</b> Bloodstream infections (BSI) are dangerous and if not treated appropriately will be accompanied by high mortality. the aim of this study was to determine the frequency of different etiological agents of BSI and their resistance to commonly used antibiotics. <br><b>Material and Method:</b> This study performed by 129 positive blood culture samples collected during 2009 to 2010 from patients of tehran besat hospital. Antibiotic susceptibility testing was performed by using disk diffusion method as per clinical and laboratory standards institu (CLSI) guideline. Data analysed by Chi-square test and SPSS soft ware. P value of <0.05 was determined as significant. <br><b>Results:</b> The most common causes of BSI were coagulase-negative staphylococcus (CONS) and <i>E.coli</i> 45(34.9%), 38(29.5%) respectively. Infections with proteus vulgaris was rare 2 (1.6%). Prevalence of gram negative infections in comparison with gram positive infections was (1.58:1). The highest resistance was demonstrated as: Penicillin 73.6% - Ampicillin 66.6% -Tetracyclin 58.9%. The highest susceptibility was demonstrated as Gentamicin and Imipenem 68.3%,65.9% respectively. <br><b>Conclusion:</b> BSI caused by gram negative bacteria is 1.5 fold more than gram positive bacteria. In our hospital CONS and <i>E.coli</i> are more common etiological agents of BSI (64% of all infections). Vancomycin are suitable antibiotic for treatment of CONA and <i>S.aureus</i> infections. </div> ﻋﻔﻮﻧﺖ ﻫﺎی ﺧﻮﻧﯽ، ﺳﭙﺘﯽ ﺳﻤﯽ، ﻣﻘﺎوﻣﺖ اﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ، ﺑﺎﮐﺘﺮﯾﻤﯽ‬ Bloodstream infections,Antibiotic resistance,Bacterimi,Septicemia 52 58 http://ijmm.ir/browse.php?a_code=A-10-1-169&slc_lang=fa&sid=1 Hamid vaez ‫ﺣﻤﯿﺪ واﻋﻆ vaezhamid84@gmail.com 10031947532846001035 10031947532846001035 Yes Department of microbiology ,Golestan university of medical science ﮔﺮوه ﻣﯿﮑﺮوب ﺷﻨﺎﺳﯽ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﮔﻠﺴﺘﺎن Samira khosravi ﺳﻤﯿﺮا ﺧﺴﺮوی 10031947532846001036 10031947532846001036 No Besat hospital, Microbiology laboratory آزﻣﺎﯾﺸﮕﺎه ﻣﯿﮑﺮوب ﺷﻨﺎﺳﯽ ﺑﯿﻤﺎرﺳﺘﺎن ﺑﻌﺜﺖ Ebrahim soleymani اﺑﺮاﻫﯿﻢ ﺳﻠﯿﻤﺎﻧﯽ‬ 10031947532846001037 10031947532846001037 No Besat hospital,Pathobiology laboratory آزﻣﺎﯾﺸﮕﺎه ﭘﺎﺗﻮﺑﯿﻮﻟﻮژی ﺑﯿﻤﺎرﺳﺘﺎن ﺑﻌﺜﺖ