---

Background&Objective: Hospital infection is one of the important determinants on lengthening hospitalization and increasing the costs and mortality rates in hospitals. Intensive Care Unit (ICU) is one of the wards that are most afflicted with the incidence of this morbidity. This study involves investigating the incidence of infection in one of the Intensive Care Units. Materials&Methods: This study was designed in the form of a prospective cohort which was implemented on patients who were hospitalized in the ICU of Khatamol Anbia Hospital from September 21st 2002 for at least 72 hours and didn’t reveal signs of infection. The status and duration of using tracheal tube, ventilator, urinary catheter, and venous catheter, the duration of hospitalization in ICU and the time infection appeared were all recorded. Results: During the six months spent on this study, 234 patients were hospitalized in ICU, among which 50 patients were investigated. The group of these 50 patients cumulatively spent 528 days in ICU. During their hospitalization, 9 cases of infection occurred in these patients. The incidence of infection was 18% (with a 95% confidence interval of 7.35% to 28.65%). The incidence rate was 17 patients in 1000 person-year of hospitalization in ICU (with a 95% confidence interval of 8.8 to 106.3). Conclusion: Hospital infection is a relatively common complication among patients who have been hospitalized in ICU for at least 3 days. The frequency of infection reported in Iran is equal or more than the results of studies carried out in other parts of the world.

---

Background & Objective: in recent years antibiotic resistance of Pseudomonas aeruginosa is increased as a causetive factor in hospital contamination. This study was done to determine the prevalence and antibiotics susceptibility of Pseudomonas aeruginosa isolated from inanimate objects in Taleghani hospital.

 

Materials & Methods: This descriptive study was done on inanimate objects in different wards of Taleghani hospital during 2006. Sampling was performed by sterile gauze pad for dry surfaces and swab for wet surfaces. To differentiate and identify P.aeruginosa, various culture media such as Brain Heart Infusion Agar, Citrimide Agar and Triple Sugar Iron Agar were used. Antibiotic sensitivity of the isolated strains was determined by Kirby-Bauer Method using Muller-hinton Agar medium. Moreover, antiseptic sensitivity of the strains to Decosept and Povidone-Iodine as the main antiseptic agents was identified by determining Minimal Bactericidal Concentration and Minimal Inhibitory Concentration using Nutrient Agar and Nutrient Broth media.

 

Results: Fifty-five of the total 292 samples were positive for P.aeruginosa. Based on the ratio of the number of positive samples to the total samples, Thalassemia ward (38.5%) was the most infected ward and taps (61.1%) was the most infected sampling place. None of the samples from room atmosphere and intensive care equipments were positive for P.aeruginosa. 20% of the samples were resistant to ceftazidime and 32.7% were resistant to piperacillin, also 10.9% of samples were resistance to both ceftazidime and piperacillin.

 

Conclusion: This study showed that contamination with P.aeruginosa and antibiotic resistance of the isolated bacteria are the main problems in Taleghani hospital.

---

Background and Objective: Early antibiotic administration is a cornerstone of infection control and treatment. Empirical treatment based on clinical signs and available guidelines reduces mortality and accelerates recovery; however, a lack of information about bacterial species and antibiotic susceptibility may lead to unfavorable outcomes. This study aimed to assess the concordance of empirical antibiotic therapy with definitive prescriptions and antibiogram results.
Methods: This descriptive study included 152 hospitalized patients receiving antibiotics (80 men and 72 women; mean age, 54.41±20.91 years), enrolled by census sampling from the infectious diseases and surgical wards of Shahid Sayyad Shirazi Teaching Hospital in Gorgan, Iran during 2021. Demographic characteristics and data on the initial diagnosis, empirical antibiotic type, microbial culture and antibiogram results, definitive treatment, and treatment duration were extracted from patient records and evaluated.
Results: The most common clinical manifestations were fever (77%) and weakness and fatigue (39%), while the leading reasons for hospitalization were sepsis (31.58%) and urinary tract infection (25.66%). Blood (45.39%) and urine (32.24%) were the most frequently cultured clinical specimens. Escherichia coli (38.8%) and Staphylococcus epidermidis (23.7%) were the most commonly isolated bacteria. Empirical antibiotics were prescribed on 454 occasions, but antibiograms were performed in only one-quarter of cases. The commonly used antibiotics for which antibiograms were performed included ciprofloxacin (14.5%), clindamycin (42%), and ceftriaxone (66.2%). Amikacin (68.4%), ceftriaxone (64.5%), and gentamicin (56.6%) were the antibiotics most frequently included in antibiogram testing. Empirical and definitive therapy were concordant in 75% of cases. The most frequently prescribed antibiotics in definitive therapy were ciprofloxacin (14.04%), clindamycin (13.2%), and ceftriaxone (12.9%). The highest concordance rates in definitive therapy were observed for doxycycline (90%), Tavanex (89.4%), and ciprofloxacin (87.3%), whereas gentamicin (83.3%) and ceftriaxone (40.2%) showed the highest discordance rates.
Conclusion: Empirical antibiotic prescriptions were concordant with definitive prescriptions in most patients. Nevertheless, the antibiotics included in antibiogram testing were not fully aligned with those prescribed in clinical practice.