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  ABSTRACT

 Background and Aim: Nosocomial Infections are nearly the most important health problem in the world. The high costs of treatment, the great number of patients with high mortality and morbidity rates and also increased incidence of these infections are suggestive of the importance of these infections. The aim of this study was to assess the epidemiologic status and the rate of acquired infections together with their related factors in ICU and post ICU patients at Tohid Hospital, in Sanandaj.

 Material and Methods: This is a cross sectional descriptive study. The sample size included 160 patients who had been admitted to ICU and post ICU during a period of 6 months. Demographic data and prevalence rate of nosocomial infections and results of clinical and para-clinical measures were recorded. The data were analyzed by means of SPSS-win software.

 Results: In our study the prevalence rate of nosocomial infections was 15.6%. The most frequent infections were pneumonia (68%), UTI (19.2%), bed sore (7.8%), sepsis (3.8%) and infections of unknown origin (3.8%). The most frequent isolated microorganisms were Klebsiella Pneumonia (47.05%), Ecoli (17.64%), and Entrobacter spp (17.64%). There was an important relationship between the duration of hospitalization and the prevalence rate of the infections (p=0.000). But there was no significant linkage between age, intubation or tracheostomy with the prevalence rate of the infections

 Conclusions: The results of our study supported previous data concerning nosocomial infections. In order to decrease the rate of nosocomial infections, assignment of one nurse for one patient and proper hand washing should be emphasized.

  Key words: Nosocomial infections, ICU, Post ICU

 

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Background and Aim: Identification of the source of Pseudomonas aeruginosa (P. aeruginosa) as cause of nosocomial infections is an important step towards infection control. The purpose of this study was to perform multiple-locus variable number tandem repeat survey and analysis for typing of P. aeruginosa as a cause of nosocomial infection.
Material and Methods: This descriptive-analytic study included 134 clinical samples of P. aeruginosa in Sanandaj from December 2015 to August 2017. Phenotypic tests and PCR were performed to confirm P. aeruginosa. Molecular typing was carried out by variable number of tandem repeats (VNTR), and analysis was performed using a zero-and-one matrix. Using Stata 12, data were analyzed by chi-square and Fisher's exact tests (p≤0.05).
Results: 41.79% of P. aeruginosa strains were associated with nosocomial infections. The highest number of clinical specimens were related to tracheal (51.78%) and the least number associated with sputum and abdominal fluid (each one1.78%). There was a significant relationship between nosocomial infections and intensive care unit (ICU) (p≤0.05). Also nosocomial infections showed a significant relationship with tracheal samples (p≤0.05). Analysis of 10 strains isolated from nosocomial infections showed 10 patterns with a similarity of 72%.
Conclusion: Nosocomial infections were related to P. aeruginosa and we showed epidemiological distributions of this bacterium in our study. Identification of the origin of the bacteria responsible for nosocomial infections is an important step in the prevention and control of these infections.

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Background and Aim: Wound infections, as a common nosocomial infection, are contributing factors to mortality. Determining the prevalence of common pathogens causing wound infections and their antibiotic susceptibility patterns plays a key role in the rapid treatment and prevention of such infections. This study aimed to analyze wound infections in hospitalized patients in a university hospital in Tehran and determine the antimicrobial susceptibility patterns of the isolated bacteria.
Materials and Methods: Data about 563 hospitalized patients from different wards of a university hospital, who had participated in the study from March 2017 to June 2019, were collected, and sample collection from the wounds was carried out. For the identification of pathogens, we used standard bacteriological techniques. The disk diffusion method was used to determine the antimicrobial susceptibility patterns of the isolates. Data were analyzed using SPSS 18.
Results: Among five hundred and sixty-three samples, 382 (67.7%) had positive cultures. The most common isolated pathogens were Staphylococcus aureus (19.2%), Escherichia coli (17.7%), Acinetobacter spp. (14%), Pseudomonas aeruginosa (13.6%) and Klebsiella spp. (12.9%). Fifty percent of the Staphylococcus aureus isolates were resistant to cefoxitin. Escherichia coli and Acinetobacter spp. were resistant to most of the antibiotics.
Conclusion: Our study found that pathogens causing wound infections were highly resistant to commonly prescribed antibiotics. Identifying the etiological agents of wound infection and their antibiotic susceptibility patterns is essential, especially for the treatment of elderly patients and those hospitalized in intensive care. This can assist in designing a therapeutic strategy for these types of infections.

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Background and Aim: Nosocomial infection is an infection that a patient develops 48 hours after hospitalization or up to 72 hours after discharge. The infection should not exist at the time of admission, and should not be in the latent stage. Nosocomial infections can lead to economic, social, and physiological problems for the patients and hospital staff. Since nurse aids and service staff have important roles in controlling nosocomial infections, this study aimed to develop and validate a questionnaire to assess their knowledge, attitude, and performance in regard to nosocomial infections.
Materials and Methods: This descriptive-analytical study was performed in 2019. Questionnaire items were extracted by searching SID, Magiran, PubMed, Scopus, and Science Direct databases using Google Scholar search engine. The questionnaire validity was assessed using the opinion of 10 nosocomial infection control specialists. In order to assess the reliability and face validity, the questionnaire was given to 135 nurse aids and service staff working in Tehran hospitals. Data were analyzed using SPSS18 software and LISREL8.8.
Results: The content validity index and content validity ratio for knowledge, attitude, and performance sections of the questionnaire were between 0.8 and 1. The face validity of the questionnaire items ranged from 1.6 to 5. In the knowledge section of the questionnaire, Kuder- Richardson reliability coefficient was 0.7 and Cronbach's alpha for attitude and performance sections were 0.76 and 0.71, respectively. The Pearson correlation coefficient for knowledge, attitude, and performance were 0.86, 0.89, and 0.93, respectively. Three-factor confirmatory analysis showed the questionnaire had a good fit The mean scores of employees’ knowledge, attitude, and performance in regard to nosocomial infections were 0.44±0.19 (intermediate), 0.71±0.18 (positive) and 0.63±0.16 (intermediate), respectively
Conclusion: The questionnaire had good validity and reliability for assessment of nurse aids’ and service staffs’ knowledge, attitude and performance in relation to nosocomial infections. The levels of performance and knowledge of the nurse aids and service staff working at Tehran hospitals about nosocomial infections control were moderate and their attitude was neutral.
 

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Background and Aim: Antibiotic resistance of pathogens responsible for nosocomial infections, has been a growing concern for healthcare system in recent decades. The aim of the current study was to identify the strains responsible for nosocomial infections and determine their frequency rates and antimicrobial resistance profiles in the patients admitted to intensive care units of Hazrat-e Rasool General Hospital in Tehran.
Materials and Methods: In this cross-sectional study we collected 936 blood, urine and sputum samples from the patients who had been admitted to the intensive care units of Hazrat-e Rasool General Hospital in Tehran between March 2020 and March 2021. Determination of strains and frequency rates of pathogens were carried out using multiple specific differential cultures. Then, we detected antibiotic resistance profile of each pathogen by using disc diffusion method.
Results: Acinetobacter (22.5%), Klebsiella pneumoniae (18.7%), Pseudomonas aeruginosa (13.6%), Candida albicans (11.2%) and Escherichia coli (7.2%) were the most common pathogens involved in nosocomial infections in this study. Acinetobacter isolates showed the highest sensitivity to clostin (100%) and cefotaxime (97.2%), respectively, and the highest resistant rate to ampicillin sulbactam (38.9%).
Conclusion: The results of the present study showed that in addition to the diversity of different pathogens in causing nosocomial infections in intensive care units, antibiotic resistance of these pathogens which is on the rise should be regarded important. Results of the current study and other similar periodic studies can provide valuable information for monitoring and management of emerging drug resistant infections.