Health care associated infections, antibiotic resistance and clinical outcome: A surveillance study from Sanandaj, Iran

Table 1 Distribution of bacteria isolated from various hospitals wards

Hospital wardsBacteria	Pediatric/neonatal	PICU	Tertiary internal medicine	Infectious diseases	Surgery	General internal medicine	ICU	Total isolates
Escherichia coli	4	0	6	2	2	0	1	15 (19%)
Klebsiella pneumoniae	9	0	2	0	1	2	1	15 (19%)
Acinetobacter baumannii	0	1	4	0	0	0	0	5 (6.3%)
Pseudomonas aeruginosa	1	0	1	0	0	0	0	2 (2.5%)
Pseudomonas oryzihabitans	1	0	0	0	0	0	0	1 (1.3%)
Serratia marcescens	20	0	6	2	0	2	0	30 (38%)
Enterobacter cloacae	3	0	0	0	0	1	1	5 (6.3%)
Stenotrophomonas maltophilia	0	0	0	0	0	0	1	1 (1.3%)
Klebsiella oxytoca	0	0	0	0	1	0	0	1 (1.3%)
Serratia odorifera	3	0	0	0	0	0	0	3 (3.8%)
Pseudomonas luteola	0	1	0	0	0	0	0	1 (1.3%)
Total isolates in the related wards	41 (52%)	2 (2.50%)	19 (24%)	4 (5%)	4 (5%)	5 (6.5%)	4 (5%)	79 (100%）

PICU: Pediatric intensive care unit; ICU: Intensive care unit.

Table 2 Prevalence of infections and crude mortality by age groups and isolated organisms n (%)

Age groups Bacteria	Neonatal (< 28 d)	Infantile (1-11 mo)	Childhood (1-17 yr)	Adults (18-59 yr)	Elderly (> 60 yr)	Total isolates	Crude mortality by bacteria
Escherichia coli	3 (20)1	0	5 (33.3)1	2 (13.3)1	5 (33.3)1	15 (19)2	3 (23.1)3
Klebsiella pneumoniae	10 (66.7)	0	1 (6.7)	4 (26.7)	0	15 (19)2	2 (15.4)
Acinetobacter baumannii	3 (60.0)	0	0	1 (20)	1 (20)	5 (5.6)2	1 (7.7)
Pseudomonas aeruginosa	0	1 (50)	1 (50)	0	0	2 (2.2)2	1 (7.7)
Pseudomonas oryzihabitans	0	0	0	1 (100)	0	1 (1.1)2	0
Serratia marcescens	2 (6.7)	6 (20)	11 (36.7)	7 (23.3)	4 (13.3)	30 (33.3)2	6 (46.1)
Enterobacter cloacae	0	0	2 (40)	1 (20)	2 (40)	5 (5.6)2	0
Stenotrophomonas maltophilia	0	0	0	1 (100)	0	1 (1.1)2	0
Klebsiella oxytoca	0	0	0	0	1 (100)	1 (1.1)2	0
Serratia odorifera	2 (66.7)	0	1 (33.3)	0	0	3 (3.3)2	0
Pseudomonas luteola	0	0	0	0	1 (100)	1 (1.1)2	0
Total Isolates in the age groups	20 (25)	7 (8.8)	21 (26.5)	17 (21.5)	14 (17.7)	79 (100)	-
Crude mortality by age	4 (30.8)3	0	2 (15.4)	4 (30.7)	3 (23.1)	-	13 (100)

¹Percent within each isolate;

²Percent within total isolates of a specific bacteria;

³Percent within total mortality.

Table 3 Antibiotic susceptibility patterns of gram-negative bacteria isolated from sanandaj hospitals, Iran, 2012 (% susceptible)

	Escherichia coli	Klebsiella pneumoniae	Klebsiella oxytoca	Serratia marcescens	Serratia ordorifera	Acinetobacter	Species enterobacter	Pseudomonas aeruginosa	Pseudomonas orizihibitans	Pseudomonas luteola	Stenotropho-monas	Suscepti bility of all Isolates	No. ofisolates tested
Ampicillin	1 (6.7)	3 (20)	0 (0)	1 (3.3)	0 (0)	0 (0)	0 (0)	-	-	-	-	5 (6.7)	74
Amoxicillin	2 (13.3)	1 (6.7)	0 (0)	1 (3.3)	0 (0)	0 (0)	1 (20)	-	-	-	-	5 (6.7)	74
Amikacin	14 (93.3)	8 (53.3)	1 (100)	23 (76.7)	2 (66.7)	2 (40)	4 (80)	2 (100)	1 (100)	1 (100)	1 (100)	58 (73.4)	79
Gentamicin	11 (73.3)	7 (46.7)	0 (0)	22 (73.3)	1 (33.3)	0 (0)	4 (80)	2 (100)	1 (100)	1 (100)	0 (0)	48 (60.7)	79
Tobramycin	-	-	-	-	-	-	-	2 (100)	1 (100)	1 (100)	0 (0)	4 (80)	5
Cotrimoxazole	2 (13.3)	6 (40)	0 (0)	21 (70)	2 (66.7)	1 (20)	4 (80)	0 (0)	0 (0)	0 (0)	0 (0)	36 (45.5)	79
Nitrofurantoin	15 (100)	10 (66.7)	0 (0)	6 (20)	2 (66.7)	0 (0)	3 (60)	-	-	-	-	35 (47.2)	74
Cephalothin	6 (40)	5 (33.3)	0 (0)	1 (3.3)	1 (33.3)	0 (0)	1 (20)	-	-	-	-	13 (17.6)	74
Cefixime	10 (66.7)	5 (33.3)	0 (0)	22 (73.3)	1 (33.3)	0 (0)	2 (40)	-	-	-	-	39 (52.7)	74
Cefotaxime	9 (60)	5 (33.3)	0 (0)	22 (73.3)	1 (33.3)	0 (0)	4 (80)	-	-	-	-	40 (54)	74
Ceftazidim	11 (73.3)	5 (33.3)	0 (0)	24 (80)	2 (66.7)	0 (0)	4 (80)	2 (100)	1 (100)	1 (100)	0 (0)	49 (62)	79
Ceftriaxone	8 (53.3)	6 (40)	0 (0)	22 (73.3)	1 (33.3)	0 (0)	3 (60)	-	-	-	-	39 (52.7)	74
Cefepim	13 (86.7)	7 (46.7)	0 (0)	24 (80)	3 (100)	0 (0)	4 (80)	1 (50)	1 (100)	1 (100)	0 (0)	52 (65.8)	79
Ciprofloxacin	11 (73.3)	13 (86.7)	0 (0)	30 (100)	3 (100)	1 (20)	4 (80)	2 (100)	1 (100)	1 (100)	0 (0)	65 (82.3)	79
Levofloxacin	11 (73.3)	13 (86.7)	0 (0)	30 (100)	3 (100)	1 (20)	5 (100)	2 (100)	1 (100)	1 (100)	1 (100)	67 (84.8)	79
Imipenem	15 (100)	15 (100)	1 (100)	30 (100)	3 (100)	5 (100)	5 (100)	2 (100)	1 (100)	1 (100)	1 (100)	79 (100)	79
Meropenem	-	-	-	-	-	-	-	2 (100)	1 (100)	1 (100)	1 (100)	5 (100)	5
Carbenicillin	-	-	-	-	-	-	-	2 (100)	1 (100)	1 (100)	0 (0)	4 (80)	5
Ticarcillin	-	-	-	-	-	-	-	2 (100)	1 (100)	1 (100)	0 (0)	4 (80)	5
Piperacillin	-	-	-	-	-	-	-	2 (100)	1 (100)	1 (100)	0 (0)	4 (80)	5
Piperacillin/ Tazobactam	10 (66.7)	13 (86.7)	1 (100)	27 (90)	3 (100)	0 (0)	4 (80)	2 (100)	1 (100)	1 (100)	-	57 (73)	78
Aztreonam	-	-	-	-	-	-	-	2 (100)	1 (100)	1 (100)	-	3 (75)	4
ESBL(positive)	5 (33.3)1	10 (66.7)1	-	-	-	-	-	-	-	-	-	16 (51.6)1	311
Total susceptible isolates (%)	149 (62.1)	122 (50.8)	3 (18.7)	306 (63.7)	28 (58.3)	10 (12.5)	52 (65)	27 (90)	14 (93.3)	14 (93.3)	4 (30.7)	711 (56.6)2	--
Total isolates tested (sum)	240	240	16	480	48	80	80	30	15	15	13	--	1257

¹Not counted in the sum and susceptibility percents;

²Total sensitive Isolates (% susceptibility of total tested isolates).