Journal of Research in Pharmacy Practice

Antibiotic resistance patterns of microorganisms isolated from nephrology and kidney transplant wards of a referral academic hospital

Authors

. Atieh Samanipour 1
. Simin Dashti-Khavidaki 2
. Mohammad-Reza Abbasi 2
. Alireza Abdollahi 3

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

Antibiotic resistance
Escherichia coli
hemodialysis catheter‑related infection
  kidney transplant
nephrology
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Journal of Research in Pharmacy Practice
Volume 5, Issue 1
Winter 2016
Pages 43-51

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