Emergence of Highly Multidrug-Resistant Bacteria Isolated from Patients with Infections Admitted to Public Hospitals in Southwest Iran

Abstract

Background. The emergence of multidrug-resistant (MDR) microorganisms causing infections is increasing worldwide and becoming more serious in developing countries. Among those, Acinetobacter species are becoming prominent. Objectives. The aim of this study was to determine the rate of antimicrobial resistance of the bacteria causing infections, Acinetobacter species in particular, in local public hospitals in Firuzabad, Fars province, Iran. Methods. This cross-sectional study was performed on different clinical specimens collected from patients who were suspected of infections hospitalized from March 2016 to March 2019 in local hospitals of Firuzabad, Fars province, Iran. The bacterial isolates were identified following standard microbiological methods. Clinical and Laboratory Standards Institute guidelines were used to identify the antibiotic susceptibility of these isolates. Results. Overall, 1778 bacterial etiologies were isolated from 1533 patients diagnosed with infection. Of these, 1401 (78.8%) were Gram-negative and the remaining were Gram-positive bacteria. Escherichia coli (37.1%), Klebsiella spp. (13.9%), and Acinetobacter species (10.4%) were the most common isolated bacteria. Antibiotic sensitivity testing in this study showed a high resistance rate of Acinetobacter species to all antibiotics tested except Colistin. During the study period, the rate of infection with highly multidrug-resistant Acinetobacter species increased from 7.2% to 13.3%. Conclusions. This study highlights the emergence of MDR bacterial agents such as Acinetobacter species as a new threat in our region. However, a decrease in the rate of infection with Pseudomonas aeruginosa was noticeable.

Community-Acquired Methicillin-Resistant Staphylococcus aureus in Hospitals: Age-Specificity and Potential Zoonotic–Zooanthroponotic Transmission Dynamics

“…This allows for zoonotic and anthroponoses transmission of animal lineages that are by nature methicillin-sensitive [ 4 , 8 , 9 ] and has led to the evolution of community-associated S. aureus (CA-MRSA) lineages with enhanced virulence in young and otherwise healthy individuals. As a result, waves of global pandemics with significant economic and public health losses have occurred [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Many of the reasons for the emergence of virulence were due to the low-level usage of antimicrobial substances [ 43 , 44 ].…”

“…For example, the emergence of colistin-resistant Enterobacteriaceae occurred after the introduction of selective digestive tract decontamination in an intensive care unit [ 31 ]. Similarly, an increasing trend in the outbreaks of resistant hypervirulent Acinetobacter strains in public hospitals in southwest Iran [ 32 ], and campylobacter in broiler chickens in north Lebanon [ 33 ], are a few examples of zoonotic transmission. Perhaps one of the most devastating transmissions was that of the zoonotic and reverse-zoonotic evolutions of community-associated S. aureus (CA-MRSA) lineages with enhanced virulence in young and otherwise healthy individuals.…”

Comparative Analysis of Microbial Species and Multidrug Resistance Patterns in Acute Cholangitis Patients with Cholecystectomy: A Single-Center Study

“…The prevalence of acute cholangitis has seen an upward trend, with studies indicating an increase in hospitalizations for cholangitis in the United States between 2005 and 2014, reflecting a growing burden of gallstone disease and associated complications [2][3][4]. This rise is paralleled by a growing concern over the emergence of MDR pathogens, which pose a significant threat to patient outcomes [5,6].…”