Research code: 22687
Ethics code: IR.IUMS.FMD.REC.1402.325
Abolfazl Jafari1 
, Ramin Zare Mahmoudabadi2 , Fatemeh Montazer3 , Maryam Vafapour4 , Sedigheh Yousefzadegan *5
, Ramin Zare Mahmoudabadi2 , Fatemeh Montazer3 , Maryam Vafapour4 , Sedigheh Yousefzadegan *5
1- Medical Student, School of Medicine, Iran University of Medical Sciences(IUMS), Tehran, Iran, abolfazlz76z@gmail.com
2- Pediatric Intensivist, Assistant Professor, Department of Pediatrics, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran, 0000-0002-4738-9266, raminzarerzm@gmail.com
3- Dermatopathologist, Associate Professor of Pathology, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences(IUMS), Tehran, Iran, 0000-0002-4487-1399, saa_montazer@yahoo.com
4- Pediatrician, Assistant Professor, Department of Pediatrics, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences(IUMS), Tehran, Iran, vafapourm@gmail.com
5- Department of Pediatrics, Assistant Professor of Pediatric Pulmonology, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran, 0000-0003-2222-1472, dr.yousefzadegan@gmail.como ,dr.yousefzadegan@gmail.com
2- Pediatric Intensivist, Assistant Professor, Department of Pediatrics, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran, 0000-0002-4738-9266, raminzarerzm@gmail.com
3- Dermatopathologist, Associate Professor of Pathology, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences(IUMS), Tehran, Iran, 0000-0002-4487-1399, saa_montazer@yahoo.com
4- Pediatrician, Assistant Professor, Department of Pediatrics, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences(IUMS), Tehran, Iran, vafapourm@gmail.com
5- Department of Pediatrics, Assistant Professor of Pediatric Pulmonology, Firoozabadi Clinical Research Development Unit(FACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran, 0000-0003-2222-1472, dr.yousefzadegan@gmail.como ,
Abstract: (119 Views)
Introduction: This study was conducted with the aim of determining the distribution of pathogenic microorganisms isolated from tracheal aspirate samples and their antibiotic resistance characteristics in the intensive care unit. Considering that such a statistical analysis is performed for the first time in Firozabadi Hospital and there is no information about the microbial profile of intubated ICU patients, it can be determined by determining the prevalence of infectious organisms in patients and their early antibiotic treatment before the culture results are ready. The chip helped a lot in controlling the infection and treating these patients. Finally, by using the results of this study, it is possible to better understand the factors of hospital infections and make future decisions regarding the use of antibiotics in the cases of hospitalized patients who have acquired infections transmitted from the hospital. The reduction in mortality and morbidity resulting from it reduces the costs of the health system and the burden of these diseases.
Material and method: This retrospective and cross-sectional study was started after obtaining the necessary permits from the Ethics Committee of Iran University of Medical Sciences. The statistical population included all intubated children admitted to the PICU of Firozabadi Hospital from 2019 to 2021. The method of data collection was using a checklist including demographic information such as age and gender of patients and information available in the Hospital Information System (HIS) and patient files. The independent variables included age, gender, and the reason for hospitalization, and the dependent variables included the duration of hospitalization, the type of organism found, and the antibiogram. After data collection, all patient information was analyzed using SPSS version 26 statistical software.
Results: Out of 78 examined patients, 44 patients (56.4%) were boys and 34 patients (43.6%) were girls, and the average age of the examined patients was 4.8 ± 0.5 years. In the examination of the cause of hospitalization of the patients, the most common causes were respectively pneumonia with 26 patients (33.3%), covid with 19 patients (24.4%) and seizures with 10 patients (12.8%) and the average The length of stay of the patients in the hospital was 25.0 ± 31.8 days. Out of the 78 investigated patients, 135 positive trachea cultures were obtained, and in the examination of the abundance of organisms in positive trachea cultures, the most abundant organisms include Acinetobacter baumannii in 26 cases (19.3%), Klebsiella pneumoniae in 26 cases (19.3%) 24 cases (17.8%) and Pseudomonas aeruginosa in 20 cases (14.8%). In antibiogram analysis, the highest sensitivity to antibiotics was amikacin in 27 cases (20.0%), ciprofloxacin in 26 cases (19.3%), and meropenem in 19 cases (14.1%), respectively. The highest resistance to antibiotics was, respectively, to ceftriaxone in 98 cases (72.6%), cefixime in 93 cases (68.9%), and imipenem in 82 cases (60.7%). In examining the relationship between the length of hospitalization and the type of organism in trachea culture, there was a statistically significant relationship (correlation coefficient = -0.230, P < 0.001); So that the longest period of hospitalization was respectively in positive cultures with Enterobacter aerogenes (119.0 ± 5.3 days), Escherichia coli (97.2 ± 3.7 days) and Enterobacter agglomerans (75.1 ± 6.6 days).
Conclusion: Considering the identification of the most common pathogens in the trachea culture of patients hospitalized in PICU, it seems necessary to take measures to prevent hospital transmission of these infections and their timely and correct management. Also, not using antibiotics that have the most resistance among the positive trachea culture pathogens, will help in more optimal experimental management of these infections.
Material and method: This retrospective and cross-sectional study was started after obtaining the necessary permits from the Ethics Committee of Iran University of Medical Sciences. The statistical population included all intubated children admitted to the PICU of Firozabadi Hospital from 2019 to 2021. The method of data collection was using a checklist including demographic information such as age and gender of patients and information available in the Hospital Information System (HIS) and patient files. The independent variables included age, gender, and the reason for hospitalization, and the dependent variables included the duration of hospitalization, the type of organism found, and the antibiogram. After data collection, all patient information was analyzed using SPSS version 26 statistical software.
Results: Out of 78 examined patients, 44 patients (56.4%) were boys and 34 patients (43.6%) were girls, and the average age of the examined patients was 4.8 ± 0.5 years. In the examination of the cause of hospitalization of the patients, the most common causes were respectively pneumonia with 26 patients (33.3%), covid with 19 patients (24.4%) and seizures with 10 patients (12.8%) and the average The length of stay of the patients in the hospital was 25.0 ± 31.8 days. Out of the 78 investigated patients, 135 positive trachea cultures were obtained, and in the examination of the abundance of organisms in positive trachea cultures, the most abundant organisms include Acinetobacter baumannii in 26 cases (19.3%), Klebsiella pneumoniae in 26 cases (19.3%) 24 cases (17.8%) and Pseudomonas aeruginosa in 20 cases (14.8%). In antibiogram analysis, the highest sensitivity to antibiotics was amikacin in 27 cases (20.0%), ciprofloxacin in 26 cases (19.3%), and meropenem in 19 cases (14.1%), respectively. The highest resistance to antibiotics was, respectively, to ceftriaxone in 98 cases (72.6%), cefixime in 93 cases (68.9%), and imipenem in 82 cases (60.7%). In examining the relationship between the length of hospitalization and the type of organism in trachea culture, there was a statistically significant relationship (correlation coefficient = -0.230, P < 0.001); So that the longest period of hospitalization was respectively in positive cultures with Enterobacter aerogenes (119.0 ± 5.3 days), Escherichia coli (97.2 ± 3.7 days) and Enterobacter agglomerans (75.1 ± 6.6 days).
Conclusion: Considering the identification of the most common pathogens in the trachea culture of patients hospitalized in PICU, it seems necessary to take measures to prevent hospital transmission of these infections and their timely and correct management. Also, not using antibiotics that have the most resistance among the positive trachea culture pathogens, will help in more optimal experimental management of these infections.
Type of Study: Letter to the editor |
Subject:
Children's lungs
Send email to the article author
