Source: International Congress 2014 – Different interesting issues in respiratory infections: 1
Disease area: Respiratory critical care, Respiratory infections

Abstract

IntroductionMethicillin-resistant Staphylococcus aureus(MRSA) assumes paramount importance in nosocomial pneumonia, particularly in mechanically ventilated patients. The mortality rate due to MRSA infections is highest among pneumonia cases.ObjectivesThe aim of this study was to characterize the antibiotic resistance pattern and to detect outbreak strains isolated from the teaching hospitals of Tehran. This can help physicians to start appropriate initial therapy in patients with suspected nosocomial pneumonia.Methods269 lower respiratory tract (LTR) samples were collected from ICUs of three teaching hospitals in Tehran,Iran, during 2009 –2011.A semi-quantitative threshold of >10⁴ cfu/ml was considered to be diagnostic for S. aureus ventilator associated pneumonia(VAP). Antibacterial resistance patterns of S. aureus isolates to 13 antimicrobial agents were analyzed according to EUCAST. Pulsed Field Gel Electrophoresis was performed as described previously (Feizabadi, M.M. et al. J Microbiol Methods 2011; 84:144 –146).Results Of 269 cultured LRT specimens 84 yielded S. aureus >10⁴ cfu/ml. Oxacillin and vancomycin resistances were seen in 80.9% and 12.3% of isolates, respectively. Linezolid, teicoplanin and vancomycin were found to be the most effective drugs. Seventeen different DNA banding patterns were identified, which grouped in 4 clusters named as A-D.Discussion Mechanical ventilation is one of the most important risk factors for nosocomial MRSA pneumonia. MRSA-VAP ranged between 78 % in Asian and 54 % in Latin American ICUs. Consistently, in our study prevalence of methicillin resistance was 80.5%. This is the first report on S. aureus VAP from Iran.

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A. Ghodousi, M. Omrani, M. M. Feizabadi (Tehran, Islamic Republic Of Iran). Methicillin-resistant staphylococcus aureus: The most prevalent cause of ventilator associated pneumonia in Tehran hospitals. Eur Respir J 2014; 44: Suppl. 58, 2558

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