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  ABSTRACT

  Background and Aim: The aim of this cross sectional study was to determine the prevalence of intestinal colonization by vancomaycin-resistant enterococci (VRE) in Namazi Hospital in Shiraz.

  Materials and Methods: Serial rectal swabs were obtained every 5 days from all the 700 hospitalized patients, ( from December 2003 through July 2004 ), and VRE (Vancomycin-resistant Enterococci) were detected by disk diffusion method and then confirmed with Minimum Inhibitory Concentration dilution Method. The data collected out of interviews and patients` records, were analyzed by means of chi-square test.

  Results: 99 (%14) out of 700 patients were colonized by VRE. 3% of 23 patients who had negative tests for VRE, at the time of hospitalization, were colonized by resistant enterococci. In this study the prevalence of VRE showed a significant relationship with variables of age, ward, history of previous admissions, history of previous antibiotic use, duration of hospitalization, underlying disease, neutropenia, renal failure, dialysis and major surgery (p<0/05). But association between prevalence of VRE and sex, clinical outcome or conditions such as immunosuppression, cancer and diabetes were not statistically significant (p>0.05).�

  Conclusion: This study that was the first on VRE in Iran and revealed that colonizeation with VRE has a high prevalence in Namazi Hospital and this organism might be endemic in large hospitals. Interventional strategies are required to control this emerging nosocomial infection.

  Key words: Colonization, Vancomycin-resistant, Prevalence, Enterococci,

 

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Background and Aim: Enterococci were the first organisms which developed resistance to vancomycin. In the recent years, they have shown resistance to many antibiotics and vancomycin is one of such antibiotics. Risk factors for rectal colonization with vancomycin-resistant enterococci include patient related factors such as underlying diseases and hospital related factors such as duration of hospitalization, treatment procedures and antibiotic use. In this study the prevalence and risk factors for rectal colonization with vancomycin-resistant enterococci (VRE) in the medical and surgical wards were assessed and the results of the study in the 2 above mentioned wards were compared with each other. Material and Methods: Serial rectal swabs were obtained from 370 hospitalized patients in seven medical wards and 143 patients in five surgical wards every five days. Sampling method was stratified random sampling. During the study 750 samples of rectal swab were taken under sterile conditions. Enterococci were detected by disk diffusion method and their resistance to vancomycin was verified by minimum inhibitory concentration dilution method. Chi square and T tests were used for data analysis. Results: Among 513 patients, 76 (15%) were colonized with VRE (cases) and 40 patients with vancomycin-sensitive strains (VSE). Medical wards showed a higher rate of colonization (18.1%) in comparison to surgical wards (6.3%). In surgical wards, prevalence of VRE was related to clinical outcome (p=0.04) and major surgery (p=0.000), but in medical wards, VRE colonization showed a significant relationship with duration of hospitalization (p=0.03), underlying disease (p=0.04), the number of antibiotics (p=0.02), renal failure, history of dialysis (p=0.01) and duration of antibiotic use. Conclusion: Our study demonstrates that VRE prevalence in medical wards is three times as those of surgical wards. Considering longer period of hospitalization, use of more drugs for longer periods and also presence of underlying diseases in medical ward patients, performance of infection control strategy in regard to VRE seems necessary. Key words: Enterococci, Entric colonization, Vancomycin-resistant, Medical wards, Surgical wards. Conflict of Interest: Nill Received: June 9, 2008 Accepted: August 4, 2008

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Background and Aim: Staphylococcus aureus can cause a range of diseases including skin disorders, food poisoning and nosocomial infections. Resistance to antibiotics is a major problem and widespread use of antibiotics plays a major role in the emergence of resistant bacteria. The aim of this study was to evaluate the antibiotic resistance and isolation of vancomycin resistance genes in S. aureus strains isolated from clinical samples by multiplex PCR.

Material and methods: 150 clinical samples were collected randomly from ulcers and nasal swabs from medical centers in Tehran from April to July 2015. Biochemical and microbiological tests were performed to identify strains of S. aureus. Antibiotic susceptibility test was conducted by disc diffusion (Kirby-Bauer) method.

Results: The highest resistance rate belonged to clindamycin (83.3 %). Vancomycin and linezolid had the highest sensitivity rate (96.6%). Using  multiplex PCR, from 60 human samples only one (1.6%) had VanA and VanB genes, but we did not detect VanC gene in the samples.

Conclusion: The results showed a high prevalence rate of S. aureus with low resistance to vancomycin in the clinical samples.

Key words: Staphylococcus aureus, vancomycin resistance genes, Multiplex PCR.

Received: Jan 3, 2016      Accepted: Jul 13, 2016

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Background and Aim: Considering widespread use of vancomycin in childeren and the occurrence of phlebitis related peripheral intravenous catheters (PIVC); we decided to determine Predisposing factorsof phlebitis in the childeren receiving vancomycin.
Methods and Materials: This cross-sectional descriptive-analytic study included 145 children older than 1 month who had been admitted to a medical education center in Isfahan and were under treatment with vancomycin. The sampling method was convenience and phlebitis measuring instruments were used 24, 48 and 72 hours, after the peripheral intravenous catheter insertion for every child. Chi-square test and multinomial logistic regression tests were used to analyze the data.
Results: Chi-Square test showed a significant relationship between phlebitis and catheter place, catheter size and washing catheter with 0.09%NaCl (p<0.05). Multinomial logistic regression indicated that age (p=0.009), male gender (p=0.009), catheter placement in upper extremity (p=0.005), catheter No.24 (p=0.04), washing catheter with 0.09%NaCl (p<0.001), vancomycin concentration of <5mg/ml (p=0.004) and infusion of total peripheral nutrition (p=0.017) and cephalosporins (p=0.025) significantly influenced incidence of phlebitis.
Conclusion: nurses can prevent phlebitis by selecting appropriate catheter considering the ratio of catheter to vein size, washing catheter with 0.09%NaCl and use of the upper extremities for catheter insertion. The concentration of vancomycin should also be <5 mg/ml and the infusion rate should not exceed 5-10 mg/min. These factors have considerable importance when childeren receive total peripheral nutrition and cephalosporins along with vancomycin