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J Nephropathol. 2017;6(3): 210-219.
doi: 10.15171/jnp.2017.35
PMID: 28975103
PMCID: PMC5607985
Scopus ID: 85019880940
  Abstract View: 4038
  PDF Download: 2230

Original Article

Evaluating the resistance pattern of gram-negative bacteria during three years at the nephrology ward of a referral hospital in southwest of Iran

Iman Karimzadeh 1*, Niloofar Sadeghimanesh 1, Mona Mirzaee 1, Mohammad Mahdi Sagheb 2

1 Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
2 Nephrology-Urology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
*Corresponding Author: *Corresponding author: Iman Karimzadeh, , Email: karimzadehiman@yahoo.com

Abstract

Background: Gram-negative bacteria are associated with an increase in rates of antibacterial
resistance. In most low- and middle-income countries such as Iran, there is no continuous
surveillance system for antibiotic resistance.

Objective: The purpose of this survey was to determine the pattern of antimicrobial
sensitivity of gram-negative bacteria within 3 consecutive years at a nephrology ward of
Nemazee hospital in Shiraz.

Materials and Methods: During a 3-year period from 2013 to 2015 at the adult nephrology
ward, bacteriological data of all biological samples of hospitalized patients in favor of
gram-negative microorganisms were analyzed retrospectively. Antimicrobial susceptibility
was performed by the Kirby-Bauer disc diffusion method.

Results: The most common gram negative bacterium isolated from biological samples was
Escherichia coli (43.9%). The highest (86.3%-94.1%) antibacterial resistance rate was associated
with Acinetobacter spp. The most frequent resistance was seen with cephalosporins. In
contrast to ceftriaxone, ciprofloxacin, and trimethoprim/sulfamethoxazole, nitrofurantoin
and aminoglycosides remained their acceptable activity against E. coli. At least three-fourths
(75%) of Acinetobacter spp. isolates was resistant to either aminoglycosides or imipenem.
All (100%) isolated Acinetobacter spp. and Pseudomonas aeruginosa species were susceptible to
colistin. The rate of Acinetobacter spp. and P. aeruginosa resistant to three or more drugs was
81.7% and 74.6%, respectively.

Conclusions: The resistant rate of gram negative pathogens to different tested antibacterial
agents was considerably high and has increased during the recent three years in our center.


Implication for health policy/practice/research/medical education:

 
Antibiotic resistance is responsible for considerable morbidity and mortality worldwide. Most low- and middle-income countries
such as Iran lack national continuous surveillance systems for antibiotic resistance. Resistant rate of gram-negative pathogens
to different antibacterial agents especially cephalosporins are considerably high in the nephrology ward. Nitrofurantoin and
aminoglycosides remained their acceptable activity against Escherichia coli during the recent 3 years in the nephrology ward.
Resistant rate of gram-negative pathogens especially Acinetobacter spp. have increased for most tested antibacterial agents during
the recent 3 years in the nephrology ward.

Please cite this paper as: Karimzadeh I, Sadeghimanesh N, Mirzaee M, Sagheb MM. Evaluating the resistance pattern of gramnegative
bacteria during three years at the nephrology ward of a referral hospital in southwest of Iran. J Nephropathol.
2017;6(3):210-219. DOI: 10.15171/jnp.2017.35.

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Submitted: 09 Jan 2016
Accepted: 22 Mar 2017
ePublished: 02 Apr 2017
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