Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jan 31;62(4):E943-E949.
doi: 10.15167/2421-4248/jpmh2021.62.4.1801. eCollection 2021 Dec.

Health care-associated infections, including device-associated infections, and antimicrobial resistance in Iran: The national update for 2018

Maryam Masoudifar  1 , Mohammad Mehdi Gouya  1 , Zahra Pezeshki  1 , Babak Eshrati  1 , Shirin Afhami  2 , Marjan Rahnamaye Farzami  3 , Arash Seifi  2
Affiliations
Review

Health care-associated infections, including device-associated infections, and antimicrobial resistance in Iran: The national update for 2018

Maryam Masoudifar et al. J Prev Med Hyg. .

Abstract

Introduction: Surveillance of health care-associated infections (HAIs) is an essential part of an efficient healthcare system. This study is an update on incidence and mortality rates of HAIs in Iran in 2018.

Methods: Almost all hospitals across the country (940 hospitals) entered the data of HAIs and denominators to the Iranian Nosocomial Infections Surveillance (INIS) software. Statistics were derived from INIS.

Results: From 9,607,213 hospitalized patients, 127,953 suffered from HAI, 15.65% of whom died. The incidence rate of HAI was calculated as 4.2 per 1000 patient-days. Considering relative frequencies among HAIs, Pneumonia (29.1%) and UTIs (25.6%) were the most common types of infection. Ventilator-associated pneumonia (VAP) was the most frequent device-associated infection (DAI) 25.66 per 1000 ventilator-days, and had the highest mortality rate (43.08%). Incidence density of other DAIs was 5.43 for catheter-associated UTI and 2.86 for catheter-associated BSI per 1000 device-days. Medical ICUs had the highest incidence and percentage of deaths (15.35% and 37.63%, respectively). The most causative organisms were Escherichia coli, Acinetobacter baumannii, and Klebsiella pneumonia. The rate of methicillin-resistance Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria was about 49%, 57%, and 58% respectively.

Conclusion: This study provided an overview of HAIs in Iran and indicated that HAIs required special attention both in detection/reporting and in infection control measures. Future studies could be done on adherence rate of DAIs' preventive bundles, interventions via multimodal strategies, evaluating the effect of training, and effect of antibiotic stewardship programs.

Keywords: Infection Control; Mortality; Nosocomial infections; Resistance; Surveillance.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement None to declare.

Figures

Fig. 1.
Fig. 1.
Incidence of health care-associated infections (HAIs) in different wards in Iran, 2018.
Fig. 2.
Fig. 2.
Microorganisms in health care-associated infections (HAIs) in Iran, 2018.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ferreira E, Pina E, Sousa-Uva M, Sousa-Uva A. Risk factors for health care-associated infections: From better knowledge to better prevention. Am J Infect Control 2017;45:e103-7. http://dx.doi.org/10.1016/j.ajic.2017.03.036 10.1016/j.ajic.2017.03.036 - DOI - PubMed
    1. Shang J, Stone P, Larson E. Studies on nurse staffing and health care-associated infection: methodologic challenges and potential solutions. Am J Infect Control 2015;43:581-8. https://dx.doi.org/10.1016/j.ajic.2015.03.029 10.1016/j.ajic.2015.03.029 - DOI - PMC - PubMed
    1. World Health Organization. Health care-associated infections FACT SHEET. Available from https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf (Accessed: May 26, 2020).
    1. Suetens C, Latour K, Kärki T, Ricchizzi E, Kinross P, Moro ML, Jans B, Hopkins S, Hansen S, Lyytikäinen O, Reilly J, Deptula A, Zingg W, Plachouras D, Monnet DL. The Healthcare-Associated Infections Prevalence Study Group. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill 2018;23:1800516. https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800516 10.2807/1560-7917.ES.2018.23.46.1800516 - DOI - PMC - PubMed
    1. Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections - an overview. Infect Drug Resist 2018;11:2321-33. https://doi.org/10.2147/IDR.S177247 10.2147/IDR.S177247 - DOI - PMC - PubMed

MeSH terms

Substances