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Antibiotic Susceptibility of Staphylococcus aureus and Enterococcus Spp. Isolated from some Hospitals in Tehran
Razaz Rahmati, N, Mohabati Mobarez, A, Khoram Abadi, N, Sharifzade Peyvasti, V, Shokoohizade, L,
Volume 9, Issue 2 (7-2015)
Abstract

Abstract

Background and Objective: Vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) are the leading nosocomial pathogens in Iran. We aimed at evaluating the resistance patterns of Staphylococcus aureus and enterococci to the antibiotics recommended by Clinical and Laboratory Standards Institute (CLSI).

Material and Methods: Two-hundred forty Staphylococcus aureus and 203 Enterococcus isolated from urine, wound, blood, trachea, stool and other clinical specimens of inpatients and outpatients were obtain from some hospitals in Tehran. Sensitivity of S. aureus to oxacillin, vancomycin, chloramphenicol, nitrofurantoin, erythromycin, clindamycin and linezolid were determined by disk diffusion according to CLSI (M100-S22) guidelines. Likewise, sensitivity of enterococci to ampicillin, vancomycin, teicoplanin, tigecycline, linezolid, tetracycline, chloramphenicol and nitrofurantoin was invesditated by the same method.

Results: Of 240 S. aureus isolates, 56%, 46.6% and 40.4%were resistant to oxacillin, erythromycin and clindamycin, respectively. We found one S. aureus isolate with low   susceptibility to vancomycin (VISA; 0.5%). All S. aureus isolates were sensitive to chloramphenicol, nitrofurantoin and linezolid. Of 203 Enterococcus spp., 47.3%, 24.6%, 9.4%, 85.2%, 11.3% and 4.4% were resistant to ampicillin, vancomycin, teicoplanin, tetracycline, chloramphenicol and nitrofurantoin, respectively. All these isolates were sensitivity  to tigecycline and linezolid.

Conclusion: Resistance of S. aureus isolates to oxacillin, erythromycin and clindamycin was significant. Enterococci isolates were remarkably resistant to ampicillin, vancomycin, teicoplanin, tetracycline, chloramphenicol and nitrofurantoin. Given our results, we suggest vancomycin, chloramphenicol, linezolid and nitrofurantoin for S. aureus infections and tigecycline and linezolid as drugs of choice for enterocoocal infections treatment.

Keywords: Staphylococcus aureus, Enterococcus, Tehran, Hospitals


Investigation of Antibiotic Resistance Pattern in Isolated From Urine and Blood Samples of Patients Admitted To the Intensive Care Unit of Velayat Hospital in Qazvin, Iran
Fatemeh Bagherian, Alireza Nikoonejad, Abbas Allami, Samira Dodangeh, Layla Taha Yassen, Bahram Hosienbeigi,
Volume 15, Issue 6 (11-2021)
Abstract
Background and objectives: Antibiotic resistance is a global health challenge that affects both individuals and the health system in many ways. The aim of this study was to evaluate the antibiotic resistance pattern in isolates from patients admitted to the intensive care unit (ICU) of a hospital in Qazvin, Iran.
Methods: This descriptive and retrospective study was performed on urine and blood samples collected from 1318 ICU patients in the Velayat Hospital of Qazvin (Iran) during 2017-2019. Data were collected from patients’ medical records. All statistical analyses were performed using SPSS software (version 25).
Results: Based on the findings, 65.2% of the samples were related to urinary tract infections and 34.7% to bloodstream infections. Escherichia coli (68.6%) and Stenotrophomonas (41.0%) were the most common bacteria isolated from urinary tract infections and bloodstream infections, respectively. Moreover, the rate of antibiotic resistance was higher among Acinetobacter, Escherichia coli, Stenotrophomonas, Enterococcus and Pseudomonas isolates.
Conclusion: The rate of drug resistance in isolates from ICU patients is alarmingly high and requires immediate attention. It is recommended to modify antibiotic prescriptions in the hospital based on the results of antibiotic resistance pattern, particularly for treatment of infections caused by E. coli and Stenotrophomonas.
Quality Tools to Ensure Patient Safety and Reduce the Turnaround Time of Medical Laboratories in Tertiary Care Teaching Hospitals
Puja Kumari Jha, Rachna Agarwal, Rafat Sultana Ahmed,
Volume 15, Issue 6 (11-2021)
Abstract
Background and objectives: Turnaround time (TAT) is an important quality indicator for benchmarking laboratory performance. Delay in TAT may affect patient safety; thus, continuous monitoring and analysis of laboratory workflow is mandatory. This study was designed to improve the TAT of two biochemistry laboratories serving in tertiary care teaching hospitals (multispecialty and super-specialty) through the application of quality tools namely quality failure reporting, the Fishbone model, and process mapping.
Methods: First, TAT was defined for routine (four hours) and urgent samples (two hours). Then, TAT failureincidents in 2018-2019 were analyzed using the Fishbone model. The process map of TAT was studied and made more value streamed and lean after removal of waste steps.Corrective action plans were prioritized and implemented for potential causes with more adverse outcomes. Pilot solutions were implemented for six months and TAT failures incidents were reanalyzed.
Results: The quality failure in TAT reporting was reduced by 22% (from 34% to 12%) for urgent samples and by 19% (from 27% to 8%) for routine samples after the implementation of quality tools in multispecialty hospital laboratory. In the super-specialty hospital laboratory, the improvement was more profound and the TAT percentage achieved after the corrective actions was 96.57% and 98% for urgent and routine samples, respectively.
Conclusion: Implementation of quality failure reporting culture along with quality tools led to significant improvement in TAT and higher quality laboratory performance in terms of efficiency, reliability, and increased patient safety.
Histopathological spectrum of upper gastrointestinal endoscopic biopsies in a rural teaching hospital
Smita Bhide, Dr. Rupali Lahane,
Volume 18, Issue 1 (1-2024)
Abstract
Background: Gastrointestinal tract complaints are prevalent among individuals in rural settings, encompassing all age groups. This study aimed to examine histopathological lesions in the upper gastrointestinal tract through endoscopic biopsy and determine the frequency of various upper gastrointestinal lesions in relation to age, sex, and site.
Methods: The specimens included in our study comprise endoscopic biopsies of the upper gastrointestinal tract during October 2018 to October 2020. A total of 70 biopsies from the upper gastrointestinal tract were analyzed using endoscopy. All specimens were fixed in 10% formalin and processed following routine hematoxylin and eosin (HE) examination. Special stains were employed when necessary.
Results: Among the 70 upper gastrointestinal endoscopic biopsies studied during this period, 25 (35.71%) were from the esophagus, 35 (50.0%) were from the stomach, and 10 (14.29%) were from the duodenum. Of the 70 upper gastrointestinal endoscopic biopsies, 34 displayed inflammatory lesions, while 36 exhibited neoplastic lesions. There was a male predominance among the cases examined. Non-neoplastic lesions were observed in individuals aged from the second to the fifth decade, while neoplastic lesions were more prevalent in older age groups.
Conclusion: This research highlights the stomach as the predominant location for inflammatory and neoplastic lesions in the upper gastrointestinal tract. The study reveals a notable occurrence of gastric carcinoma among malignant upper gastrointestinal lesions. Thus, early detection and management of upper gastrointestinal lesions necessitate endoscopy and subsequent histopathological evaluation.

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