Volume 10, Issue 3 (9-2022)                   JoMMID 2022, 10(3): 129-134 | Back to browse issues page

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Saeedi M, Fozouni L. Detection of Nosocomial Respiratory Infections among Hospitalized Patients in Intensive Care Unit: a Survey in Northern Iran. JoMMID 2022; 10 (3) :129-134
URL: http://jommid.pasteur.ac.ir/article-1-478-en.html
Department of Microbiology, Gorgan Branch, Islamic Azad University, Gorgan, Iran
Abstract:   (986 Views)
Introduction: Nosocomial respiratory infections are a significant cause of mortality in hospitalized patients in Middle East countries. This study assesses the prevalence of nosocomial respiratory infection and associated factors as a tool for early diagnosis among intensive care unit (ICU) patients at risk for mortality. Methods: From January to November 2021, 357 patients with more than 72 h hospitalization in ICU were monitored. Respiratory samples were examined for the presence of microbial isolates using clinical microbiology procedures based upon microscopic morphology, cultural and PCR methods. Demographic data were collected, including age, gender, date of hospitalization, underlying diseases, date of death, and laboratory data. Results: Out of fifty-three positive cultures, 18 samples (34%) were positive for fungal isolates, and the rest were positive for bacterial isolates. The most common bacterial and fungal isolates were Streptocossus Pyogenes (17.9%) and Candida albicans (22.5%). Of the infected patients, 67.9% were male, 39.62 % had kidney diseases, and 15.09% died due to nosocomial infections. The results also showed that the tumor necrosis factor α and complement component 3 levels were significantly associated with the incidence of respiratory fungal or bacterial infections (P<0.05). Conclusions: The rate of respiratory nosocomial infection in ICU patients was high. It is essential to implement control measures such as managing the length of hospital stay and examining the patient's immune factors to reduce the risk of these infections in ICU patients. Also, ICU patients should be prescribed appropriate antibiotics to prevent respiratory infections.
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Type of Study: Original article | Subject: Infectious diseases and public health
Received: 2022/06/13 | Accepted: 2022/09/19 | Published: 2022/10/12

1. Canning B, Senanayake RV, Burns D, Moran E, Dedicoat M. Post-influenza Aspergillus ventriculitis. Clin Infect Pract. 2020; 7-8: 100026. [DOI:10.1016/j.clinpr.2020.100026]
2. Papazian L, Klompas M, Luyt C. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020; 46 (5): 888-906. [DOI:10.1007/s00134-020-05980-0]
3. Medell M, Medell M, Martínez A, Valdés R. Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units. Braz J Infect Dis. 2012; 16 (1): 45-51. [DOI:10.1016/S1413-8670(12)70273-8]
4. Möhlenkamp S, Thiele H. Ventilation of COVID-19 patients in intensive care units. Herz. 2020;1-3. [DOI:10.1007/s00059-020-04923-1]
5. Jia L, Zhao J, Yang C, Liang Y, Long P, Liu X, et al. Severe pneumonia caused by coinfection with influenza virus followed by methicillin-resistant Staphylococcus aureus induces higher mortality in mice. Front Immunol. 2019; 9: 1-8. [DOI:10.3389/fimmu.2018.03189]
6. Liu WJ, Zou R, Hu Y, Zhao M, Quan C, Tan S, et al. Clinical, immunological and bacteriological characteristics of H7N9 patients nosocomially co-infected by Acinetobacter Baumannii: a case control study. BMC Infect Dis. 2018;18 (1): 664. [DOI:10.1186/s12879-018-3447-4]
7. WHO. 2020. Available from: https://covid19.who.int/region/emro/country/eg. Accessed September23, 2020.
8. Ku YH, Chan KS, Yang CC, Tan CK, Chuang YC, Yu WL. Higher mortality of severe influenza patients with probable aspergillosis than those with and without other coinfections. J Formos Med Assoc. 2017; 116 (9): 660 - 70. [DOI:10.1016/j.jfma.2017.06.002]
9. Thompson D. Methicillin-resistant Staphylococcus aureus in a general intensive care unit. J R Soc Med. 2004; 97 (11): 521-6. [DOI:10.1177/014107680409701103]
10. Nasir N, Farooqi J, Mahmood SF, Jabeen K. COVID-19-associated pulmonary aspergillosis (CAPA) in patients admitted with severe COVID-19 pneumonia: an observational study from Pakistan. Mycoses. 2020; 63 (8): 766- 70. [DOI:10.1111/myc.13135]
11. Mahendra M, Jayaraj B, Lokesh K, Chaya S, Veerapaneni VV, Limaye S, et al. Antibiotic prescription, organisms and its resistance pattern in patients admitted to respiratory ICU with respiratory infection in Mysuru. Indian J Crit Care Med. 2018; 22 (4): 223-30. [DOI:10.4103/ijccm.IJCCM_409_17]
12. Patterson TF. Advances and challenges in management of invasive mycoses. Lancet. 2005; 366 (9490): 1013-25. [DOI:10.1016/S0140-6736(05)67381-3]
13. Isenberg H. Clinical microbiology procedures handbook. Washington, DC: American Society for Microbiology. 2007;1: 294-10.
14. Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE, et al. Clinical practice guidelines for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016; 62(4): e1-e50. [DOI:10.1093/cid/civ933]
15. FDA. Drug shortages. 2020, [cited 24 March 2020]. Available from: https://www.fda.gov/drugs/drug-safety-andavailability/drugshortages.
16. Afhami S, Hadadi A, Khorami E, Seifi A, Bazaz NE. Ventilator-associated pneumonia in a teaching hospital in Tehran and use of the Iranian Nosocomial Infections Surveillance Software. East Mediterr Health J. 2013; 19 (10): 883-7. [DOI:10.26719/2013.19.10.883]
17. Timsit JF, Azoulay E, Schwebel C, Charles PE, Cornet M, Souweine B, et al. Empirical micafungin treatment and survival without invasive fungal infection in adults with ICU-acquired sepsis, candida colonization, and multiple organ failure: the EMPIRICUS randomized clinical trial. JAMA. 2016; 316 (15): 1555-64. [DOI:10.1001/jama.2016.14655]
18. Ponce de León-Rosales SP, Molinar-Ramos F, Domín- guez-Cherit G, Rangel-Frausto MS, Vázquez-Ramos VG. Prevalence of infections in intensive care units in Mexico: a multicenter study. Crit Care Med .2000; 28: 1316-21. [DOI:10.1097/00003246-200005000-00010]
19. Hassanzadeh P, Motamedifar M, Hadi N. Prevalent bacterial infections in intensive care units of Shiraz university of medical sciences teaching hospitals, Shi- raz, Iran. Jpn J Infect Dis. 2009; 62 (4): 249-53.
20. Mosadeghrad A, Afshari M, Isfahani P. Prevalence of Nosocomial Infection in Iranian Hospitals: A Systematic Review and Meta- Analysis. irje. 2021; 16 (4) :352-362.[Persian]
21. Khodavaisy S, Hedayati MT, Alialy M, Habibi MR, Badali H. Detection of galactomannan in bronchoalveolar lavage of the intensive care unit patients at risk for invasive aspergillosis. Curr Med Mycol .2015; 1 (1): 12-7. [DOI:10.18869/acadpub.cmm.1.1.12]
22. Anoushiravani AA, Moini A, Hajihossein R, Alimoradian A, Didehdar M. Investigation of pulmonary fungal infections in immunocompromised patients. Tehran Univ Med J. 2019; 77 (5) :308-13. [Persian]
23. Ayatollahi Mousavi S A, Karami Robati A, Madani M, Hadizadeh S. Prevalence of Systemic fungal Infections in Kerman Teaching Hospitals. J Mazandaran Univ Med Sci. 2013; 22 (97) :105-12. [Persian]
24. Sharifi A, Kavoosi F, Hosseini SMJ, Mosavat A, Ahmadi A. Prevalence of Streptococcus pneumoniae in ventilator-associated pneumonia by real-time PCR. Arch Clin Infect Dis. 2019; 14 (3): e86416. [DOI:10.5812/archcid.86416]
25. Qorbanalizadehgan M, ranjbar R, joneidi N, ali akbat esfahani A, esmaeili D, goodarzi Z. A Study on the Prevalence of Nosocomial Infections in ICU Patients Admitted at Baqyiatallah Hospital. Sjimu. 2008; 16 (1) :1-6. [Persian]
26. Despotovic A, Milosevic B, Milosevic I, Mitrovic N, Cirkovic A , Jovanovic S, et al. Hospital-acquired infections in the adult intensive care unit Epidemiology, antimicrobial resistance patterns and risk factors for acquisition and mortality. Am J Infect Control .2020; 48 (10): 1211-5. [DOI:10.1016/j.ajic.2020.01.009]
27. Hughes S, Troise O, Donaldson H, Mughal N, Moore LSP. Bacterial and fungal coinfection among hospitalized patients with COVID-19: a retrospective cohort study in a UK secondary-care setting. Clin Microbiol Infect. 2020; 26 (10): 1395-99. [DOI:10.1016/j.cmi.2020.06.025]
28. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020; 395 (10223): 507-13. [DOI:10.1016/S0140-6736(20)30211-7]
29. Karam-Allah Ramadan H, Mahmoud M, Aburahma MZ, Elkhawaga A, El-Mokhtar M, Sayed I, et al. Predictors of Severity and Co-Infection Resistance Profile in COVID-19 Patients: First Report from Upper Egypt. Infect Drug Resist. 2020; 13: 3409-22. [DOI:10.2147/IDR.S272605]
30. Lansbury L, Lim B, Baskaran V, Lim WS. Co-infections in people with COVID-19: A systematic review and meta-analysis. J Infect. 2020; 81 (2): 266-75. [DOI:10.1016/j.jinf.2020.05.046]
31. He Y, Li W, Wang Z, Chen H, Tian L, Liu D. Nosocomial infection among patients with COVID-19: A retrospective data analysis of 918 cases from a single center in Wuhan, China. Infect Control Hosp Epidemiol. 2020; 41 (8): 982-3. [DOI:10.1017/ice.2020.126]

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.