Authors
1 Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
2 Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran Center of Excellence in Nephrology, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Pathology, Vali‑e‑Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Objective: Antibiotic use pattern and emergence of resistant bacteria are major
concerns in clinical settings. This study aimed to detect common bacteria and their
antibiotic sensitivity patterns in nephrology and kidney transplant wards.
Methods: This 1‑year, observational study was performed in the nephrology and
kidney transplant wards of Imam Khomeini Hospital Complex, Tehran, Iran. All patients
treated with antimicrobial agents for confirmed or suspected infections were included.
Their demographic, clinical, and laboratory data (including biological media used for
microbial culture, growth organisms, and antibiograms) were collected. Adherence of
antimicrobial regimen to standard guidelines was also assessed.
Findings: About half of the patients received antibiotic. The most common infecting
bacteria were Escherichia coli followed by Enterococcus sp. and Staphylococcus aureus.
E. coli showed high rate of sensitivity to carbapenems and nitrofurantoin and high rate
of resistance to co‑trimoxazole and ciprofloxacin. Enterococcus sp. in both wards had
high rate of resistance to ampicillin and were all sensitive to linezolid. Unlike to the
nephrology ward, more than 50% of Enterococcus sp. from kidney transplant ward
was resistant to vancomycin. The most common type of S. aureus in this nephrology
ward was methicillin‑resistant S. aureus (MRSA). Most commonly‑prescribed
antibiotics were carbapenems followed by vancomycin, ciprofloxacin, and ceftriaxone.
Antibiotic regimens were 75% and 83%, 85% and 91%, and 80% and 87% compatible
with international guidelines in antibiotic types, dosages, and treatment durations,
respectively, in nephrology and kidney transplant wards, respectively.
Conclusion: MRSA, fluoroquinolone‑resistant E. coli, and vancomycin resistant
Enterococcus species are major threats in nephrology and kidney transplant wards.
Most commonly‑prescribed antibiotics were carbapenems that necessitate providing
internal guidelines by the teamwork of clinical pharmacist, infectious disease specialists,
and nephrologists to avoid the widespread use of broad‑spectrum antibiotics.
Keywords
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