Comparison of Antimicrobial Resistance Pattern in Hospital Versus Community-acquired Infections in Pediatric Patients

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.

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 16.

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.

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.