Comparison of antimicrobial resistance pattern in hospital versus community-acquired infections in pediatric patients

Abstract

Background & Objective: Nosocomial infection is one of the most daunting challenges to the global health care system. The current study aimed to compare the antimicrobial resistance pattern in hospital versus community-acquired infections in pediatric patients in Besat Hospital, Hamadan, Iran. Materials & Methods: The current study was carried out on all patients with a hospital-acquired infection (HAI) who were hospitalized in Besat Hospital, Hamadan, Iran, for 48 hours. Moreover, patients with community-acquired infections (who had an infection before hospitalization) were also included in the current study. E-test and Kirby-Bauer disk diffusion test were utilized to determine antimicrobial susceptibility patterns according to the report test/CLSI M100/S27 guidelines. Antibiotic resistance patterns in both patients with hospital and community-acquired infections were separately recorded. Subsequently, the obtained data were analyzed by SPSS software (version 16). Results: A number of 43 and 68 patients showed HAI and CAI, respectively. The most common HAI and CAI were blood-stream infection and urinary tract infection (UTI) with a prevalence of 69.8%, and 73.5%, respectively. The most frequent organisms isolated from CA and HA-infections were E. coli and Staphylococcus aureus with a prevalence of 67.9%, and 30.2%, respectively. The highest level of resistance in Gram-negative bacteria was observed against cotrimoxazole and ceftriaxone. Furthermore, the highest resistance in Gram-positive organisms was against clindamycin. The prevalence rates of MRSA isolates in HAI and CAI were reported as 46.2% and 36.9%, respectively. Conclusion: The obtained results indicated the high resistance to several antibiotics that can be used as promising choices in the treatment of both CA and HA-infections. It is recommended that region-specific monitoring studies be carried out in order to assist the clinician to select the accurate empirical therapy.