ﺖﻣوﺎﻘﻣ يﻮﮕﻟا ﻲﺳرﺮﺑ
ﺘﻧآ ﻲ ﻲﻜﻴﺗﻮﻴﺑ ﻛ يﺎﻫ ﻪﻳﻮﺳ
ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠ هﺪﺷاﺪﺟ
زا ﻪﻧﻮﻤﻧ ﺎﻫ ي
رد يراردا ﺑ
نﺎﺘﺳرﺎﻤﻴ يﺎﻫ
دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﺷزﻮﻣآ
نﺎﮔﺪﻨﺴﻳﻮﻧ :
ﻲﻛﻮﻛدﺎﻨﺑ نﺎﻘﻫد ﻦﻴﻣا ﻲﻣﻼﺳا اﺪﻠﻴﮔ ،1
،2
يﺪﻧز ﻪﻣﺎﮕﻨﻫ ﻲﻛﻮﻛدﺎﻨﺑ نﺎﻘﻫد ﻲﻠﻋ ،3
قﺪﺼﻣ ﺪﻤﺣا ،4
،5
يﺮﻴﻣا ﻪﻴﺳآ
6
1 . ﺪﺷرا ﻲﺳﺎﻨﺷرﺎﻛ يﻮﺠﺸﻧاد ﻣ
بوﺮﻜﻴ ﻲﺳﺎﻨﺷ ﻲﻜﺷﺰﭘ ﻧاد ، ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸ ﻲﻧﺎﻣرد ﻲﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ و
دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ
2 . رﺎﻳدﺎﺘﺳا ﻞﮕﻧا ﺳﺎﻨﺷ ﻲ و چرﺎﻗ ﺳﺎﻨﺷ ﻲ
،ﻲﻳاﺬﻏ داﻮﻣ تاﺮﻃﺎﺨﻣ ﻲﻟﻮﻜﻟﻮﻣ ﺺﻴﺨﺸﺗ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ
ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد
تﺎﻣﺪﺧ و
ﻲﻧﺎﻣرد ﻲﺘﺷاﺪﻬﺑ دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ
3 . لﻮﺌﺴﻣ هﺪﻨﺴﻳﻮﻧ :
رﺎﻳدﺎﺘﺳا ﻣ بوﺮﻜﻴ ﻲﺳﺎﻨﺷ ﻟﻮﻣ ﺺﻴﺨﺸﺗ تﺎﻘﻴﻘﺤﺗ ﺰﻛﺮﻣ ،ﻲﻳاﺬﻏ داﻮﻣ تاﺮﻃﺎﺨﻣ ﻲﻟﻮﻜ
ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد تﺎﻣﺪﺧ و
ﻲﻧﺎﻣرد ﻲﺘﺷاﺪﻬﺑ دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ
سﺎﻤﺗ ﻦﻔﻠﺗ : 09123088324
Email: [email protected]
4 . ،ﻲﻫﺎﮕﺸﻳﺎﻣزآ مﻮﻠﻋ سﺎﻨﺷرﺎﻛ جﺮﻛ ﻲﻨﻴﻤﺧ مﺎﻣا نﺎﺘﺳرﺎﻤﻴﺑ هﺎﮕﺸﻳﺎﻣزآ
5 . هوﺮﮔ ﻲﺑﺮﻣ ﻣ
بوﺮﻜﻴ ﻲﺳﺎﻨﺷ ، هﺎﮕﺸﻧاد ﻲﻜﺷﺰﭘ مﻮﻠﻋ ﻲﻧﺎﻣرد ﻲﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ و
دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ
6 . ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﻲﻳاﺬﻏ داﻮﻣ ﻲﻨﻤﻳا و ﺖﺷاﺪﻬﺑ ﺪﺷرا ﻲﺳﺎﻨﺷرﺎﻛ يﻮﺠﺸﻧاد ﻲﻧﺎﻣرد ﻲﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ و
دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ
هﺪﻴﻜﭼ
ﻪﻣﺪﻘﻣ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ : نژﻮﺗﺎﭘ ﻚﻳ
ﺖﺻﺮﻓ ﺐﻠﻃ و ﻢﻬﻣ ﻞﻣاﻮﻋ زا ﻲﻜﻳ ا
هﺪﻨﻨﻛدﺎﺠﻳ ﺖﻧﻮﻔﻋ
ﺎﻫ ي
،يراردا و ﻲﻤﻜﺷ ﻞﺧاد
ﺎﺑ ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ ﻒﻌﺿ ياراد نارﺎﻤﻴﺑ رد ﻲﻧﻮﻣﻮﻨﭘ ﺑ
يرﺎﻤﻴ يﺎﻫ ﻣز ﻪﻨﻴ يا ﺖﺳا . هدﺎﻔﺘﺳا ﺑ ﻲ ﻪﻳور زا ﻢﻈﻨﻣﺎﻧ و ﺘﻧآ
ﻲ ﻚﻴﺗﻮﻴﺑ ﺎﻫ
ﺖﻣوﺎﻘﻣ دﺎﺠﻳا ﺚﻋﺎﺑ ﺘﻧآ
ﻲ ﻲﻜﻴﺗﻮﻴﺑ ﻣ ﻲ ددﺮﮔ . ﺖﻣوﺎﻘﻣ ﻲﻧﺎﻬﺟ ﺖﺷاﺪﻬﺑ نﺎﻣزﺎﺳ ﺮﺘﻛﺎﺑ
ي ﺎﻫ ﻪﺑ ﺘﻧآ ﻲ ﻚﻴﺗﻮﻴﺑ ﺎﻫ ءﺰﺟ ار
ﻢﻬﻣ ﺮﺗ ﻦﻳ تاﺮﻄﺧ ﺪﻬﺗ هﺪﻨﻨﻛﺪﻳ ﺪﻬﺑ ﺖﺳا هدﺮﻛ ﻲﻓﺮﻌﻣ ﻲﻧﺎﻬﺟ ﺖﺷا .
ﺖﻣوﺎﻘﻣ يﻮﮕﻟا ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﺘﻧآ
ﻲ ﻲﻜﻴﺗﻮﻴﺑ يﺎﻫ ﻪﻳﻮﺳ
ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ هﺪﺷاﺪﺟ
زا ﻪﻧﻮﻤﻧ ﺎﻫ ي ﺪﺷ ﻲﺳرﺮﺑ يراردا .
ﻲﺳرﺮﺑ شور ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد :
- ﻲﻌﻄﻘﻣ
، داﺪﻌﺗ 130 ﻪﻟوﺰﻳا ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ زا
ﺖﻧﻮﻔﻋ ﺎﻫ ي نارﺎﻤﻴﺑ يراردا
رد يﺮﺘﺴﺑ ﺑ
نﺎﺘﺳرﺎﻤﻴ يﺎﻫ اد دﺰﻳ ﻲﻫﺎﮕﺸﻧ ﻊﻤﺟ
روآ ي ﺎﺑ و ﺎﻣزآ ﺶﻳ يﺎﻫ ﻲﻳﺎﻴﻤﻴﺷﻮﻴﺑ ﻲﻳﺎﺳﺎﻨﺷ
ﺪﻧﺪﺷ . ﺶﺠﻨﺳ ﺖﻴﺳﺎﺴﺣ
ﺘﻧآ ﻲ ﻲﻜﻴﺗﻮﻴﺑ شور ﻪﺑ رﺎﺸﺘﻧا دراﺪﻧﺎﺘﺳا زا
ﻚﺴﻳد ﻞﻜﺗوﺮﭘ ﻖﺒﻃ ﺎﺑ ﺞﻳﺎﺘﻧ و مﺎﺠﻧاCLSI
مﺮﻧ راﺰﻓا ﻪﺨﺴﻧSPSS
16 ﺰﻴﻟﺎﻧآ
ﺪﺷ . ﻪﺘﻓﺎﻳ ﺎﻫ زا : 130 ﻼﻴﺴﺒﻠﻛﻪﻳﻮﺳ
ﻪﻴﻧﻮﻣﻮﻨﭘ
، 72 ﻪﻳﻮﺳ ) 4 / 55 (%
ﺚﻧﻮﻣ نارﺎﻤﻴﺑ زا ﺪﺷ اﺪﺟ
. ﺖﻣوﺎﻘﻣ ﻦﻳﺮﺘﺸﻴﺑ ﺘﻧآ
ﻲ ﺑﻴ ﺗﻮ ﻴ ﻜ ﻲ ﻪﺑ
ﺗﺮﺗ ﻴ ﺐ ﻪﺑ ﺖﺒﺴﻧ ﺘﻧآ ﻲ ﺑﻴ ﺗﻮ ﻴ ﻚ ﺎﻫ ي ﻦﻴﻠﻴﺳ ﻲﺴﻛﻮﻣآ )
100 (%
ﻢﻴﺴﻛﺎﺗﻮﻔﺳ و )
5 / 41 (%
ﻪﺑ ﺖﺒﺴﻧ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ﻦﻳﺮﺘﻤﻛ و
ﻢﻨﭘوﺮﻣ ) 8 / 3 (%
ﻢﻨﭘﺎﺗرا و ) 8 / 3 (%
ﺪﺷ هﺪﻫﺎﺸﻣ .
ﺘﻧ ﻴ ﻪﺠ ﮔ ﻴ ﺮ ي نﺎﺸﻧ ﻪﺑﺎﺸﻣ تﺎﻌﻟﺎﻄﻣ و ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ : ﻣ
ﻲ ﺪﻨﻫد ﻪﻛ ﻧﺎﻔﺳﺄﺘﻣ ﻪ ﻪﺑ ﺖﻣوﺎﻘﻣ ﺘﻧآ
ﻲ ﺑﻴ ﺗﻮ ﻴ ﻚ ﺎﻫ ي ﻪﺑ ور ﻒﻠﺘﺨﻣ
ﺶﻳاﺰﻓا ﻣ ﻲ ﺪﺷﺎﺑ ﻪﻴﺻﻮﺗ اﺬﻟ ، ﻣ
ﻲ دﻮﺷ و دﻮﺷ مﺎﺠﻧا ﻲﺑوﺮﻜﻴﻣ ﺪﺿ ﺖﻴﺳﺎﺴﺣ ﺶﺠﻨﺳ ﻲﺘﺴﻳﺎﺑ نﺎﻣرد زا ﻞﺒﻗ يﻮﮕﻟا ﻪﻧﺎﻴﻟﺎﺳ
ﺖﻣوﺎﻘﻣ ﺘﻧآ ﻲ ﺑﻴ ﺗﻮ ﻴ ﻜ ﻲ ﺞﻳﺎﺘﻧ و ﻲﺳرﺮﺑ و نﺎﻜﺷﺰﭘ ﻪﺑ
ﻤﻛ ﻴ ﻪﺘ ﺎﻫ ي ددﺮﮔ شراﺰﮔ ﺖﻧﻮﻔﻋ لﺮﺘﻨﻛ .
هژاو ﺎﻫ ي يﺪﻴﻠﻛ : ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ
، ،يراردا ﺖﻧﻮﻔﻋ ﺖﻣوﺎﻘﻣ
ﻲﺘﻧآ ﻲﻜﻴﺗﻮﻴﺑ
ﺎﭘ زا ﻪﺘﻓﺮﮔﺮﺑ ﻪﻟﺎﻘﻣ ﻦﻳا نﺎﻳ
ﻪﻣﺎﻧ ﻣ ﺪﺷرا ﻲﺳﺎﻨﺷرﺎﻛ بوﺮﻜﻴ
ﻲﺳﺎﻨﺷ ﻣ دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد بﻮﺼﻣ ﻲﻜﺷﺰﭘ ﻲ
ﺪﺷﺎﺑ .
ﺖﺷاﺪﻬﺑ عﻮﻠﻃ
ﻪﻣﺎﻨﻫﺎﻣود ﻲﺸﻫوﮋﭘ ﻲﻤﻠﻋ
دﺰﻳ ﺖﺷاﺪﻬﺑ هﺪﻜﺸﻧاد لﺎﺳ ﻢﻫدﺰﻧﺎﭘ
هرﺎﻤﺷ : مﻮﺳ رﻮﻳﺮﻬﺷ و دادﺮﻣ 1395
ﺎﻤﺷ ﻞﺴﻠﺴﻣ هر :
57
لﻮﺻو ﺦﻳرﺎﺗ :
23 / 2 / 1394
شﺮﻳﺬﭘ ﺦﻳرﺎﺗ :
10 / 5 / 1394
ﻪﻣﺪﻘﻣ ءﺰﺟ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ ﺮﺘﻛﺎﺑ
ي يﺎﻫ ءﺎﻀﻋا زا و ﻲﻔﻨﻣ مﺮﮔ هداﻮﻧﺎﺧ
ﻪﻴﺳﺎﻳﺮﺘﻛﺎﺑوﺮﺘﻧا ﻣ
ﻲ ﺪﺷﺎﺑ و ﻪﺑ ترﻮﺻ و ﺲﻜﻧرﺎﻓوزﺎﻧ رد ﺖﻴﻓوﺮﭘﺎﺳ
دراد دﻮﺟو نﺎﺴﻧا شراﻮﮔ هﺎﮕﺘﺳد )
1 (.
ﻚﻳ ﻢﺴﻴﻧﺎﮔراوﺮﻜﻴﻣ ﻦﻳا
نژﻮﺗﺎﭘ ﺖﺻﺮﻓ ﺐﻠﻃ دﺎﺠﻳا رد ﻞﻴﺧد ﻞﻣاﻮﻋ زا و ﺖﻧﻮﻔﻋ
ﺎﻫ ي
ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ ﻣ
ﻲ ﺪﺷﺎﺑ ) 3
، 2 ( . ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ ﻢﻬﻣ ﻞﻣاﻮﻋ زا ﻲﻜﻳ
ا هﺪﻨﻨﻛدﺎﺠﻳ ﺖﻧﻮﻔﻋ
ﺎﻫ ي يراردا رد ﻲﻧﻮﻣﻮﻨﭘ و ﻲﻤﻜﺷ ﻞﺧاد ،
ﺎﺑ ﻲﻨﻤﻳا ﻢﺘﺴﻴﺳ ﻒﻌﺿ ياراد نارﺎﻤﻴﺑ ﺑ
يرﺎﻤﻴ يﺎﻫ ﻣز ﻪﻨﻴ يا ﺖﺳا
) 4 ( . ﺶﻫوﮋﭘ ﺎﻫ ي مﺎﺠﻧا هﺪﺷ نﺎﺸﻧ ﻒﻠﺘﺨﻣ ﻊﻣاﻮﺟ رد ﻣ
ﻲ ﺪﻨﻫد ﻪﻛ
ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ ﻞﻣﺎﻋ
17 - 11 % ﺖﻧﻮﻔﻋ ﺎﻫ ي يراردا هﺎﮕﺘﺳد
Urinary Tract Infection (UTI) ﻣ
ﻲ ﺪﻨﺷﺎﺑ ) 6
، 5 ( . ﺖﻧﻮﻔﻋ
يراردا هﺎﮕﺘﺳد ﺎﺷ
ﻊﻳ ﻦﻳﺮﺗ ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ ﺖﻧﻮﻔﻋ عﻮﻧ ﺖﺳا
) 7 (.
رد
دوﺪﺣ 50 - 40 % ﻪﺑ دﻮﺧ ﺮﻤﻋ لﻮﻃ رد رﺎﺒﻜﻳ ﻞﻗاﺪﺣ ﻎﻟﺎﺑ نﺎﻧز
يراردا هﺎﮕﺘﺳد ﺖﻧﻮﻔﻋ رﺎﭼد
ﻣ ﻲ ﺪﻧﻮﺷ هرود لﻮﻃ رد ﻪﻛ
ﻦﻳا ﻲﮕﻠﻣﺎﺣ ﺖﻧﻮﻔﻋ
ﺎﻫ دوﺪﺣ 7 % ﺶﻳاﺰﻓا ﻣ ﻲ ﺪﺑﺎﻳ ) 8 ( .
مﺪﻋ ﺨﺸﺗ ﺺﻴ نﺎﻣرد و ﻪﺑ ﻊﻗﻮﻣ ﺖﻧﻮﻔﻋ ﺎﻫ ي دﺎﺠﻳا ﺚﻋﺎﺑ يراردا
يﺪﻳﺪﺷ ضراﻮﻋ ﻪﻠﻤﺟزا
تﻻﻼﺘﺧا ،ﻲﻣروا ،يﻮﻴﻠﻛ تﻻﻼﺘﺧا
و سردوز نﺎﻤﻳاز ﻦﻴﻨﭽﻤﻫ و يراردا هﺎﮕﺘﺳد ﻂﻘﺳ
ﻨﺟ ﻦﻴ نﺎﻧز رد
ﻪﻠﻣﺎﺣ ﻣ ﻲ ددﺮﮔ ) 9 (.
ﻟد فﺮﺼﻣ ﻞﻴ ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ ﺎﻫ نﺎﻣرد و ندﻮﻤﻧ هﺎﺗﻮﻛ ﺑ
يرﺎﻤﻴ ﺎﻫ
ﺖﺳا ) 10 ( ﺎﻣا ، نﺎﺸﻧ ﻒﻠﺘﺨﻣ تﺎﻌﻟﺎﻄﻣ هداد
ﺪﻧا هدﺎﻔﺘﺳا ﻪﻛ
ﺑ ﻲ ﻪﻳور ﺎﻧ و زا ﻢﻈﻨﻣ ﺘﻧآ
ﻲ ﻚﻴﺗﻮﻴﺑ ﺎﻫ ﺖﻣوﺎﻘﻣ دﺎﺠﻳا ﺚﻋﺎﺑ
ﺘﻧآ ﻲ ﻲﻜﻴﺗﻮﻴﺑ ﻣ ﻲ ددﺮﮔ ) 12
، 11 ( . ﻲﻧﺎﻬﺟ ﺖﺷاﺪﻬﺑ نﺎﻣزﺎﺳ
(WHO) ﺖﻣوﺎﻘﻣ
ﺮﺘﻛﺎﺑ ي ﺎﻫ ﻪﺑ ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ ءﺰﺟ ار ﻢﻬﻣ ﻦﻳﺮﺗ
تاﺮﻄﺧ هﺪﻨﻨﻛﺪﻳﺪﻬﺗ ﻪﻛ ﺖﺳا هدﺮﻛ ﻲﻓﺮﻌﻣ ﻲﻧﺎﻬﺟ ﺖﺷاﺪﻬﺑ
زا ﻲﻳﻻﺎﺑ ناﺰﻴﻣ گﺮﻣ
ﺮﻴﻣو ﺖﺳا هداد صﺎﺼﺘﺧا دﻮﺧ ﻪﺑ ار ﻪﻧﺎﻴﻟﺎﺳ )
13 (.
رد لﺎﺳ 1984 ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ وراد ﺪﻨﭼ ﻪﺑ موﺎﻘﻣ
،
ﻪﺑ ناﻮﻨﻋ ﻞﻣﺎﻋ ﺖﻧﻮﻔﻋ يﺎﻫ ﺪﺷ ﻪﺘﺧﺎﻨﺷ ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ ﻲﺑﺎﺴﺘﻛا )
14 ( .
ﻪﻛ ﻲﻳﺎﺟ ،نﺎﺘﺳرﺎﻤﻴﺑ ﻂﻴﺤﻣ رد ،يﺮﺘﻛﺎﺑ ﻦﻳا ﻦﻴﻠﻣﺎﺣ ناﺰﻴﻣ رد نﺪﺷ يﺮﺘﺴﺑ تﺪﻣ لﻮﻃ ﺎﺑ ﻲﻤﻴﻘﺘﺴﻣ طﺎﺒﺗرا نﻮﻴﺳاﺰﻴﻧﻮﻠﻛ ،دراد نﺎﺘﺳرﺎﻤﻴﺑ ﻪﺑ
رﻮﻃ ﺶﻳاﺰﻓا يﺮﻴﮕﻤﺸﭼ ﻲﻣ
ﺪﺑﺎﻳ .
ﻦﻴﻠﻣﺎﺣ ناﺰﻴﻣ ﻼﻴﺴﺒﻠﻛ
يﺮﺘﺴﺑ نارﺎﻤﻴﺑ رد رد
و ﺲﻜﻧرﺎﻓ ،عﻮﻓﺪﻣ
يور ﺖﺳد ﺎﻫ ﺐﻴﺗﺮﺗ ﻪﺑ 77
% ، 19 % و 42 % هدﻮﺑ ﻛ ﺖﺳا طﺎﺒﺗرا ﻪ
فﺮﺼﻣ ﺎﺑ ﻲﻤﻴﻘﺘﺴﻣ ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ دراد . ﺖﻧﻮﻔﻋ يﺎﻫ زا ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ
ﻢﻬﻣ ﻞﻣاﻮﻋ گﺮﻣ
ﺮﻴﻣو و ﻲﻧاﻮﺗﺎﻧ ،يﺮﺘﺴﺑ تﺪﻣ لﻮﻃ ﺶﻳاﺰﻓا ،
ﺶﻳاﺰﻓا ﻪﻨﻳﺰﻫ يﺎﻫ ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ ﻲﻣ
ﺪﻨﺷﺎﺑ . دﻮﺟوﺎﺑ ناواﺮﻓ تﺎﻣاﺪﻗا
لﺮﺘﻨﻛ ﻪﻨﻴﻣز رد ﻪﺘﻓﺮﮔ ترﻮﺻ ﺖﻧﻮﻔﻋ
يﺎﻫ فﺮﺼﻣ ،ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ
ﻊﻴﺳو ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ ﺐﺟﻮﻣ ﻪﻌﺳﻮﺗ ﺖﻣوﺎﻘﻣ يﺎﻫ ﻞﺑﺎﻗ لﺎﻘﺘﻧا رد
ﻞﻣاﻮﻋ يرﺎﻤﻴﺑ از ﺖﺳا هدﺮﻛ راﻮﺷد ار نارﺎﻤﻴﺑ نﺎﻣرد و ﺖﺳا هﺪﺷ
) 15 ( .
ﺖﻧﻮﻔﻋ يﺎﻫ و نﺎﻛدﻮﻛ ﺶﺨﺑ رد نآ زا ﻲﺷﺎﻧ ﺖﺒﻗاﺮﻣ
يﺎﻫ هﮋﻳو
دﺎﺠﻳا ﻲﮔرﺰﺑ ﻞﻀﻌﻣ ﻲﻣ
ﺪﻳﺎﻤﻧ ) 17
، 16 ( .
ﻪﻜﻨﻳادﻮﺟوﺎﺑ نﺎﻣرد بﺎﺨﺘﻧا
ﻪﺑﺮﺠﺗ سﺎﺳا ﺮﺑ ،ﺖﻧﻮﻔﻋ ﻪﻴﻟوا
ترﻮﺻ ﻲﻣ دﺮﻴﮔ ﺎﻣا ، ﺞﻳﺎﺘﻧ دﻮﺟو ﺶﻳﺎﻣزآ
يﺎﻫ ﺖﻴﺳﺎﺴﺣ ﻦﻴﻴﻌﺗ
ﻴﻣ ﺪﺿ ﺑ ﻲﺑوﺮﻜ ﻚﻤﻛ نﺎﻣرد حﻼﺻا ﻪ ﻲﻣ
ﺪﻨﻛ . ﺮﺑﺎﻨﺑ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻦﻳا
ﺖﻴﺳﺎﺴﺣ يﻮﮕﻟا ﻦﻴﻴﻌﺗ ﺖﻴﻤﻫا ﻲﺘﻧآ
ﻜﻴﺗﻮﻴﺑ ﻲ هدﺎﻔﺘﺳا ﺖﻬﺟ
ﺢﻴﺤﺻ ﺮﺗ زا ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ و يراردا ﺖﻧﻮﻔﻋ ﻲﺑﺮﺠﺗ نﺎﻣرد رد
ﺗ ﺎﺑ ﻦﻴﻨﭽﻤﻫ ﻪﺑ ﺎﻫ نژﻮﺗﺎﭘ ﻦﻳا ﺖﻣوﺎﻘﻣ ﺶﻳاﺰﻓا ﻪﺑ ﻪﺟﻮ
ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ ﻒﻠﺘﺨﻣ ي )
8 ( ﻪﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد ، يﻮﮕﻟا ﻲﺳرﺮﺑ
ﺖﻣوﺎﻘﻣ ﻲﺘﻧآ ﻜﻴﺗﻮﻴﺑ ﻲ ﻪﻳﻮﺳ يﺎﻫ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ هﺪﺷاﺪﺟ
زا
ﻪﻧﻮﻤﻧ يﺎﻫ رد يراردا نﺎﺘﺳرﺎﻤﻴﺑ
يﺎﻫ مﻮﻠﻋ هﺎﮕﺸﻧاد ﻲﺷزﻮﻣآ
ﻲﻗوﺪﺻ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ دﺰﻳ
ﺘﺧادﺮﭘ ﺪﺷ ﻪ .
ﻲﺳرﺮﺑ شور
يد زا ﻲﻌﻄﻘﻣ ﻲﻔﻴﺻﻮﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد 1392
ﺎﺗ رﻮﻳﺮﻬﺷ 1393 ،
داﺪﻌﺗ 130 ﻪﻳﻮﺳ ﻠﻛ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒ زا
ﺖﻧﻮﻔﻋ يﺎﻫ نارﺎﻤﻴﺑ يراردا
يﺮﺘﺴﺑ رد ﺶﺨﺑ يﺎﻫ نﻮﮔﺎﻧﻮﮔ نﺎﺘﺳرﺎﻤﻴﺑ يﺎﻫ هﺎﮕﺸﻧاد ﻲﺷزﻮﻣآ
ﻲﻗوﺪﺻ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ ﺪﺷ اﺪﺟ دﺰﻳ
. راردا ﻪﻧﻮﻤﻧ يور ﺮﺑ
ﻂﻴﺤﻣ يﺎﻫ رﺎﮔآ ﻮﻠﺑ ﻦﻠﻴﺘﻣ ﻦﻳزﻮﺋا و راﺪﻧﻮﺧ رﺎﮔآ (EMB)
ﺖﺸﻛ هداد هﺪﺷ زا ﺪﻌﺑ و 24 يﺎﻣد رد يراﺪﻬﮕﻧ ﺖﻋﺎﺳ 37°C
،
د اردا ﺖﺸﻛ ندﻮﺑ ﺖﺒﺜﻣ ترﻮﺻ ر ر
ﻞﻴﺳﺎﺑ يﺎﻫ ﻪﻨﮔﺮﭘ ﺪﺷر و
ﮔ
،ﺖﺒﺜﻣ زﻮﺘﻛﻻ و ﻲﻔﻨﻣ مﺮ مﺎﺠﻧا ﺎﺑ
ﺶﻳﺎﻣزآ يﺎﻫ ﻲﻳﺎﻴﻤﻴﺷﻮﻴﺑ
ﺎﻫﺪﻨﻗ ﺮﻴﻤﺨﺗ ﻞﻣﺎﺷ ﻲﻗاﺮﺘﻓا زﻮﺘﻛﻻ و ﺰﻛﻮﻠﮔ ي
رد ﺖﺸﻛ ﻂﻴﺤﻣ
،TSI ﻲﮕﻧﻮﮕﭼ لوﺪﻧا ﺪﻴﻟﻮﺗ
و ﻂﻴﺤﻣ رد ﺖﻛﺮﺣ هﻮﺤﻧ ،SIM
ﻂﻴﺤﻣ رد ﺶﻨﻛاو وMR
و تاﺮﺘﻴﺳ نﻮﻤﻴﺳ ﻂﻴﺤﻣ رد ﺪﺷر ،VP
ﻂﻴﺤﻣ رد زآ هروا ﻢﻳﺰﻧآ ﺪﻴﻟﻮﺗ رﺎﮔآ هروا
ﻲﻳﺎﺳﺎﻨﺷ ﺪﻧﺪﻳدﺮﮔ
) 18 ( . ﻪﻴﻠﻛ ﻂﻴﺤﻣ يﺎﻫ ﺖﺸﻛ هدﺎﻔﺘﺳادرﻮﻣ
و ﺖﺸﻛ ﺖﻬﺟ
ﻲﻳﺎﺳﺎﻨﺷ ﺖﻛﺮﺷ ﺖﺧﺎﺳ ، Merck, Darmstadt
نﺎﻤﻟآ رﻮﺸﻛ
دﻮﺑ . ﺲﭙﺳ ﺮﺘﻛﺎﺑ ي يﺎﻫ ﻂﻴﺤﻣ رد هﺪﺷ يزﺎﺳاﺪﺟ ﻊﻳﺎﻣ
ﻲﺘﭙﻳﺮﺗ زﺎﻛ
يوﺎﺣ يﻮﺳ 20
% رد لوﺮﺴﻴﻠﮔ 70°C
- مﺎﺠﻧا نﺎﻣز ﺎﺗ
ﺶﻳﺎﻣزآ يﺎﻫ ﺪﻧﺪﺷ هﺮﻴﺧذ يﺪﻌﺑ .
يﺎﻫ ﻪﻟوﺰﻳا ﺖﻴﺳﺎﺴﺣ ﺶﺠﻨﺳ
ﺴﺒﻠﻛ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴ ﻪﺑ ﺖﺒﺴﻧ
ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ شور ﻪﺑ ﻒﻠﺘﺨﻣ ي
ﻚﺴﻳد زا رﺎﺸﺘﻧا دراﺪﻧﺎﺘﺳا Kirby-Bauer)
( ﻞﻜﺗوﺮﭘ ﻖﺒﻃ
ﺪﺷ مﺎﺠﻧا CLSI )
19 (.
ﻣ يﺎﻫ ﻚﺴﻳد
ﻲﺴﻛﻮﻣآ ﻞﻣﺎﺷ ﻲﻓﺮﺼ
ﻦﻴﻠﻴﺳ μg ) 25 ( ﻢﻳﺪﻳزﺎﺘﻔﺳ ، μg )
30 ( ﻢﻴﺴﻛﺎﺗﻮﻔﺳ ، μg )
30 ( ،
نﻮﺴﻛﺎﻳﺮﺘﻔﺳ μg )
30 ( ﻢﻴﭙﻔﺳ ، μg ) 30 ( ﻦﻴﺘﻴﺴﻛﻮﻔﺳ ، μg )
30 ( ،
ﺪﻴﺳا ﻚﻴﺴﻜﻳﺪﻴﻟﺎﻧ μg )
30 ( ﻦﻴﺳﺎﺴﻛﻮﻠﻓوﺮﭙﻴﺳ ، μg )
5 ( ،
ﻦﻴﺳﺎﺴﻛﻮﻠﻓرﻮﻧ μg )
10 ( ﻢﻨﭘ ﻲﻤﻳا ، μg )
10 ( ﻢﻨﭘوﺮﻣ ، μg )
10 ( ،
ﻢﻨﭘﺎﺗرا μg ) 10 ( ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ ، μg)
10 ( ﻦﻴﻠﻜﻴﺳاﺮﺘﺗ و μg )
30 ( دﻮﺑ
. هزﺎﺗ يﺮﺘﻛﺎﺑ ﺖﺸﻛ زا )
24 ﻪﺘﻋﺎﺳ ( لدﺎﻌﻣ ﻲﻧﻮﻴﺴﻧﺎﭙﺳﻮﺳ ،
ﻓ ﻚﻣ ﻢﻴﻧ ﻪﻟﻮﻟ تروﺪﻛ ﺪﺷ ﻪﻴﻬﺗ ﻚﻳژﻮﻟﻮﻳﺰﻴﻓ مﺮﺳ رد ﺪﻨﻟرﺎ
و
نﻮﺘﻨﻴﻫ ﺮﻟﻮﻣ ﺖﺸﻛ ﻂﻴﺤﻣ ﻪﺑ پاﻮﺳ ﻪﻠﻴﺳﻮﺑ Merck, )
Darmstadt, Germany (
ﺪﻳدﺮﮔ ﺢﻴﻘﻠﺗ .
ﺲﭙﺳ
يﺎﻫ ﻚﺴﻳد
ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺖﺸﻛ ﻂﻴﺤﻣ يوﺮﺑ راﺮﻗ
هداد ﺪﺷ و تﺪﻤﺑ 18
يﺎﻣد رد ﺖﻋﺎﺳ 37°C
يراﺪﻬﮕﻧ ﺪﻳدﺮﮔ
. ،نﻮﻴﺳﺎﺑﻮﻜﻧا زا ﺪﻌﺑ
ﺑ ﻚﺴﻳد فاﺮﻃا رد يﺮﺘﻛﺎﺑ ﺪﺷر مﺪﻋ ﻪﻟﺎﻫ ﺮﻄﻗ سﺎﻴﻘﻣ ﺎ
ﻣ ﻲﻠﻴ ﺮﺘﻣ
هزاﺪﻧا ﮔ يﺮﻴ ﺪﺷ و دراﺪﻧﺎﺘﺳا لواﺪﺟ ﺎﺑ ﻖﺑﺎﻄﺗ ﺎﺑ ﻧ
ﺞﻳﺎﺘ ﻪﺑ ترﻮﺻ
ﻲﻔﻴﻛ ﺪﻳدﺮﮔ شراﺰﮔ موﺎﻘﻣ و سﺎﺴﺣ ﻪﻤﻴﻧ ،سﺎﺴﺣ .
ﺖﻬﺟ
زا ﻲﻔﻴﻛ لﺮﺘﻨﻛ ﺎﺘﺳا ﻪﻳﻮﺳ
دراﺪﻧ ﻲﻠﻛ ﺎﻴﺸﻳﺮﺷا ATCC 25922
ﺪﻳدﺮﮔ هدﺎﻔﺘﺳا .
يﺎﻫ ﻚﺴﻳد ﻪﻴﻠﻛ ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ ﺖﺧﺎﺳ ﺖﻛﺮﺷ
نﺎﺘﺴﻠﮕﻧاMast دﻮﺑ . هداد ﺎﻫ زا ﺲﭘ ﻊﻤﺟ روآ ي ﻂﺳﻮﺗ مﺮﻧ راﺰﻓا
ﻪﺨﺴﻧSPSS 16 ﺰﺠﺗ ﻪﻳ ﻞﻴﻠﺤﺗو ﺪﻧﺪﺷ .
ﻪﺘﻓﺎﻳ ﺎﻫ ﻖﻴﻘﺤﺗ ﻦﻳا رد داﺪﻌﺗ
130 ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ ﻪﻳﻮﺳ
زا ﻪﻧﻮﻤﻧ يﺎﻫ
نارﺎﻤﻴﺑ راردا ﺑﻼﺘﺒﻣ
ﻪ ﺪﺷ اﺪﺟ يراردا ﺖﻧﻮﻔﻋ .
ظﺎﺤﻟزا ﺖﻴﺴﻨﺟ
58 ﻪﻳﻮﺳ ) 6 / 44 (%
زا نارﺎﻤﻴﺑ و ﺮﻛﺬﻣ 72 ﻪﻳﻮﺳ ) 4 / 55 (%
زا
نارﺎﻤﻴﺑ ﺚﻧﻮﻣ ﺪﺷ اﺪﺟ . ﻲﻧاواﺮﻓ ﻦﻳﺮﺘﺸﻴﺑ ﻪﻳﻮﺳ
ﻼﻴﺴﺒﻠﻛ يﺎﻫ
ﻪﻴﻧﻮﻣﻮﻨﭘ ﻲﻠﺧاد ﺶﺨﺑ ﻪﺑ طﻮﺑﺮﻣ )
3 / 32 (%
دﻮﺑ ) لوﺪﺟ 1 ( .
ناﺰﻴﻣ ﻦﻳﺮﺘﺸﻴﺑ ﻦﻴﻨﭽﻤﻫ ﻪﻳﻮﺳ
يﺎﻫ هﺪﺷاﺪﺟ ﺎﺑ داﺮﻓا ﻪﺑ طﻮﺑﺮﻣ
دوﺪﺤﻣ ﻲﻨﺳ ه 35 - 25 لﺎﺳ ) 8 / 20 (%
دﻮﺑ ) لوﺪﺟ 2 .(
ﻲﻣﺎﻤﺗ
ﻪﻳﻮﺳ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ يﺎﻫ
ﻦﻴﻠﻴﺳ ﻲﺴﻛﻮﻣآ ﻪﺑ )
100 (%
موﺎﻘﻣ
ﺪﻧدﻮﺑ . ﻪﺑ ﺖﺒﺴﻧ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ﻦﻳﺮﺘﺸﻴﺑ ﻦﻴﻠﻴﺳ ﻲﺴﻛﻮﻣآ زا ﺲﭘ
ﻢﻴﺴﻛﺎﺗﻮﻔﺳ )
5 / 41 (%
دﻮﺑ . ناﺰﻴﻣ ﻦﻳﺮﺘﻤﻛ ﻪﻛ ﺖﺳا ﻲﻟﺎﺣ رد ﻦﻳا
ﻪﺑ ﺖﺒﺴﻧ ﺖﻣوﺎﻘﻣ ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ ﺎﻫ ﻢﻨﭘوﺮﻣ ي )
8 / 3 (%
ﻢﻨﭘﺎﺗرا و
) 8 / 3 (%
ﺪﺷ هﺪﻫﺎﺸﻣ )
لوﺪﺟ 3 .(
لوﺪﺟ 1 : ﻪﻳﻮﺳ ﻲﻧاواﺮﻓ ﺮﺑ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ يﺎﻫ
سﺎﺳا ﺶﺨﺑ يﺎﻫ ﻒﻠﺘﺨﻣ نﺎﺘﺳرﺎﻤﻴﺑ يﺎﻫ ﻪﻌﻟﺎﻄﻣدرﻮﻣ
داﺪﻌﺗ
(%) ﺶﺨﺑ مﺎﻧ
) 3 / 32 (
42 ﻲﻠﺧاد
) 8 / 23 (
31 ICU
) 4 / 15 (
20 نﺎﻧز
) 6 / 14 (
19 ﻲﺣاﺮﺟ
) 9 / 6 (
9 NICU
) 9 / 6 (
9 ﺎﻫﺶﺨﺑﺮﻳﺎﺳ
) 100 (
130 عﻮﻤﺠﻣ
لوﺪﺟ 2 : ﻪﻳﻮﺳ ﻲﻧاواﺮﻓ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ يﺎﻫ
سﺎﺳا ﺮﺑ ﻲﻨﺳ هدوﺪﺤﻣ
ﻦﺳ ) لﺎﺳ ( داﺪﻌﺗ
(%)
5 - 0 )
2 / 9 ( 12
15 - 5 )
1 / 13 ( 17
25 - 15 )
20 ( 26
35 - 25 )
8 / 20 ( 27
45 - 35 )
8 / 13 ( 18
55 - 45 )
3 / 12 ( 16
55 ﻻﺎﺑ ﻪﺑ )
8 / 10 ( 14
عﻮﻤﺠﻣ )
100 ( 130
لوﺪﺟ 3 : ا يﻮﮕﻟ ﺖﻴﺳﺎﺴﺣ ﻲﺘﻧآ ﻜﻴﺗﻮﻴﺑ ﻪﻳﻮﺳ ﻲ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛيﺎﻫ
سﺎﺴﺣ
داﺪﻌﺗ (%) سﺎﺴﺣ ﻪﻤﻴﻧ
داﺪﻌﺗ (%) موﺎﻘﻣ
داﺪﻌﺗ (%) عﻮﻤﺠﻣ
داﺪﻌﺗ (%)
ﻢﻨﭘوﺮﻣ )
3 / 92 ( 120 )
8 / 3 ( 5 )
8 / 3 ( 5 )
100 ( 130
ﻢﻨﭘﺎﺗرا )
8 / 90 ( 118 )
4 / 5 ( 7 )
8 / 3 ( 5 )
100 ( 130
ﻦﻴﺘﻴﺴﻛﻮﻔﺳ )
4 / 85 ( 111 )
1 / 3 ( 4 )
5 / 11 ( 15 )
100 ( 130
ﻛﻮﻠﻓرﻮﻧ ﻦﻴﺳﺎﺴ )
1 / 73 ( 95 )
6 / 4 ( 6 )
3 / 22 ( 29 )
100 ( 130
ﻦﻴﺳﺎﺴﻛﻮﻠﻓوﺮﭙﻴﺳ
) 5 / 71 ( 93 )
6 / 4 ( 6 )
8 / 23 ( 31 )
100 ( 130
ﺪﻴﺳا ﻚﻴﺴﻜﻳﺪﻴﻟﺎﻧ )
5 / 71 ( 93 )
8 / 3 ( 5 )
6 / 24 ( 32 )
100 ( 130
ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ )
8 / 70 ( 92 -
) 2 / 29 ( 38 )
100 ( 130
ﻢﻴﭙﻔﺳ )
6 / 64 ( 84 )
5 / 1 ( 2 )
8 / 33 ( 44 )
100 ( 130
ﻦﻴﻠﻜﻴﺳاﺮﺘﺗ )
6 / 64 ( 84 -
) 4 / 35 ( 46 )
100 ( 130
ﻢﻳﺪﻳزﺎﺘﻔﺳ )
60 ( 78 -
) 40 ( 52 )
100 ( 130
نﻮﺴﻛﺎﻳﺮﺘﻔﺳ )
2 / 59 ( 77 )
8 / 0 ( 1 )
40 ( 52 )
100 ( 130
ﻢﻨﭘ ﻲﻤﻳا )
1 / 53 ( 69 )
20 ( 26 )
9 / 26 ( 35 )
100 ( 130
ﻢﻴﺴﻛﺎﺗﻮﻔﺳ
) 5 / 51 ( 67 )
9 / 6 ( 9 )
5 / 41 ( 54 )
100 ( 130
ﻦﻴﻠﻴﺳ ﻲﺴﻛﻮﻣآ -
- )
100 ( 130 )
100 ( 130
ﺤﺑ ﺚ و ﺘﻧ ﻪﺠﻴ يﺮﻴﮔ
رد ﻲﺳﺎﺳا ﻞﻜﺸﻣ ﻚﻳ ﻲﻳوراد ﺖﻣوﺎﻘﻣ ﻪﻌﺳﻮﺗ و رﻮﻬﻇ ﺑ نﺎﺘﺳرﺎﻤﻴ ﺎﻫ و ﺖﺳا ﺖﻧﻮﻔﻋ ﻳﺎﻫ ﻂﺳﻮﺗ ﻪﻛ ﻲ ﺮﺘﻛﺎﺑ
ي يﺎﻫ ﻪﺑ موﺎﻘﻣ
دﺎﺠﻳا وراد ﻣ
ﻲ ﺪﻧدﺮﮔ
، يﻻﺎﺑ ﺪﺻ رد ﺐﺒﺳ گﺮﻣ
ﺮﻴﻣو ﻣ ﻲ ﺪﻧﻮﺷ
) 20 ( . ﺮﺘﻛﺎﺑ ي يﺎﻫ يرﺎﻤﻴﺑ از ﺚﻋﺎﺑ ﻪﻛ ﺖﻧﻮﻔﻋ
يﺎﻫ ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ
ﻣ ﻲ ﺪﻧﻮﺷ زا يرﺎﻴﺴﺑ ﻪﺑ ﻲﺘﻧآ
ﺗﻮﻴﺑ ﻚﻴ ﺎﻫ موﺎﻘﻣ هﺪﺷ ﺪﻧا ﻦﻳاﺮﺑﺎﻨﺑ ،
لﺮﺘﻨﻛ و ﺺﻴﺨﺸﺗ شﺮﺘﺴﮔ
ﺖﻧﻮﻔﻋ يﺎﻫ ﺪﻨﭼ ﻪﺑ موﺎﻘﻣ ﻲﺑوﺮﻜﻴﻣ
ﺖﺳا رادرﻮﺧﺮﺑ ﻲﻳاﺰﺴﺑ ﺖﻴﻤﻫا زا وراد .
نﺎﺸﻧ تﺎﻌﻟﺎﻄﻣ ﻣ
ﻲ ﺪﻫد فﺮﺼﻣ لﺮﺘﻨﻛ ﻪﻛ ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ ﺎﻫ
ﻣ ﻲ ﺪﻧاﻮﺗ ﺖﻣوﺎﻘﻣ ﺶﻫﺎﻛ ﺐﺒﺳ ﻲﺘﻧآ
ﻜﻴﺗﻮﻴﺑ ﻲ و ﺖﻧﻮﻔﻋ يﺎﻫ
ﻣا ،ددﺮﮔ ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ فﺮﺼﻣ ﺮﮕﻳد فﺮﻃ زا ﺎ
ﺑ ﻲ ﻪﻳور ﺎﻧ و ﺐﺳﺎﻨﻣ
ﻣ ﻲ ﺪﻧاﻮﺗ ﺖﻣوﺎﻘﻣ ﺶﻳاﺰﻓا ﺐﺒﺳ ﻲﺘﻧآ
ﻜﻴﺗﻮﻴﺑ ﻲ ددﺮﮔ . ﻦﻳاﺮﺑﺎﻨﺑ
يﻮﮕﻟا ﻦﻴﻴﻌﺗ ﺖﻣوﺎﻘﻣ
ﻲﺘﻧآ ﻜﻴﺗﻮﻴﺑ ﻲ رد ﺮﺘﻛﺎﺑ ي يﺎﻫ يزﺎﺳاﺪﺟ
زا هﺪﺷ ﺖﻧﻮﻔﻋ ﺎﻫ
، ﻪﺑ و هﮋﻳ ﺖﻧﻮﻔﻋ يﺎﻫ يروﺮﺿ ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ
ﻣ ﻲ ﺪﺷﺎﺑ ) 21 (.
ﻪﺑ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ ﺎﻫ ي ﻢﻳﺪﻳزﺎﺘﻔﺳ
40
% ﻢﻴﺴﻛﺎﺗﻮﻔﺳ ، 5
/ 41
% ﻢﻨﭘ ﻲﻤﻳا ، 9
/ 26
% ﻢﻨﭘوﺮﻣ ، 8 / 3
% ،
ﻢﻨﭘﺎﺗرا 8 / 3
% ﻦﻴﺳﺎﺴﻛﻮﻠﻓوﺮﭙﻴﺳ ، 8
/ 23
% ﻦﻴﺳﺎﺴﻛﻮﻠﻓرﻮﻧ ، 3
/ 22
% ﺳا ﻚﻴﺴﻛﺪﻴﻟﺎﻧ ، ـ
ﺪﻴ 6 / 24
% ﺴﻛﻮﻣآ ، ـ ﻴﺳ ﻲ ـ ﻴﻠ ـ ﻦ 100
% ،
ﺴﻛﺎﻳﺮﺘﻔﺳ ــ نﻮ 40
% ﭙﻔﺳ ، ـ ﻢﻴ 8 / 33
% ﻔﺳ ، ـ ﺴﻛﻮ ــ ﻦﻴﺘﻴ 5 / 11
% ،
ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ 2
/ 29 % ﻦﻴﻠﻜﻴﺳاﺮﺘﺗ و 4
/ 35 % دﻮﺑ . رد ﻪﻌﻟﺎﻄﻣ ا ي ﻪﻛ
ﻲﻔﺳﻮﻳ ﻂﺳﻮﺗ فﻮﻌﺸﻣ
نارﺎﻜﻤﻫو لﺎﺳ رد
2014 ﺮﺑ ناﺪﻤﻫ رد
يور ﻪﻳﻮﺳ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ يﺎﻫ
زا هﺪﺷ يزﺎﺳاﺪﺟ ﻪﻧﻮﻤﻧ
يﺎﻫ
ﺖﻓﺮﻳﺬﭘ ترﻮﺻ ﻲﻨﻴﻟﺎﺑ
، ﻪﺑ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ
ﻳﺮﺘﻔﺳ نﻮﺴﻛﺎ 3 / 43
%
، ﻢﻴﺴﻛﺎﺗﻮﻔﺳ 7
/ 41
% ﻢﻳﺪﻳزﺎﺘﻔﺳ ، 7
/ 36
% ،
ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ 7
/ 26
% ﻢﻴﭙﻔﺳ ، 25
% ﻦﻴﺳﺎﺴﻛﻮﻠﻓوﺮﭙﻴﺳ ، 7
/ 16 % ﻲﻤﻳا و ﻢﻨﭘ
0
% ﺪﻳدﺮﮔ شراﺰﮔ )
22 ( ﺞﻳﺎﺘﻧ و نآ ﺎﻫ ﻪﺑ ﻏ زاﺮﻴ ناﺰﻴﻣ
ﻪﺑ ﺖﻣوﺎﻘﻣ ﻢﻨﭘ ﻲﻤﻳا
ﻪﻌﻟﺎﻄﻣﺎﺑ ﺖﺷاد ﻲﻧاﻮﺨﻤﻫ ًﺎﺒﻳﺮﻘﺗ ﺮﺿﺎﺣ .
رد
ﻪﻌﻟﺎﻄﻣ فﻮﻌﺸﻣ ﻲﻔﺳﻮﻳ )
20 ( ناﺰﻴﻣ ﻦﻳﺮﺘﺸﻴﺑ ﻲﻧاواﺮﻓ
ﻪﻳﻮﺳ
ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ لﺎﻔﻃا ﺶﺨﺑ زا
يزﺎﺳاﺪﺟ هﺪﺷ
،ﺖﺳا
ﻟﺎﺣرد ﻲ ﻪﻛ رد ﺶﻫوﮋﭘ ﺎﻣ ﺮﺘﺸﻴﺑ ﻣ ﻦﻳ ناﺰﻴ ﻪﻳﻮﺳ ﻲﻧاواﺮﻓ ﻼﻴﺴﺒﻠﻛ
ﻪﻴﻧﻮﻣﻮﻨﭘ ﻪﺑ طﻮﺑﺮﻣ دﻮﺑ ﻲﻠﺧاد ﺶﺨﺑ
. ﺖﻣوﺎﻘﻣ ﻦﻴﺑ توﺎﻔﺗ ﻞﻴﻟد
ﻲﻤﻳا ﻪﺑ ﺖﺒﺴﻧ ﻢﻨﭘ
ﻣ ﻲ ﺪﻧاﻮﺗ ﻊﻴﺳو هدﺎﻔﺘﺳا ﺖﻠﻋ ﻪﺑ زا
ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ ﻢﻨﭘﺎﺑرﺎﻛ هداﻮﻧﺎﺧ ي ﻲﻠﺧاد ﺶﺨﺑ رد
ﺪﺷﺎﺑ .
رد ﻪﻌﻟﺎﻄﻣ ا ي ﻂﺳﻮﺗ ﻪﻛ ﺎﻨﻴﺑ
نارﺎﻜﻤﻫو لﺎﺳ رد
2015 يور ﺮﺑ
ﻪﻳﻮﺳ ﻨﭘ ﻼﻴﺴﺒﻠﻛيﺎﻫ ﻪﻴﻧﻮﻣﻮ زا ﻪﻧﻮﻤﻧ يﺎﻫ ترﻮﺻ ناﺮﻬﺗ رد ﻲﻨﻴﻟﺎﺑ
ﻪﺑ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ،ﺖﻓﺮﻳﺬﭘ ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ ﺎﻫ ي ﻢﻨﭘﺎﺗرا ) 5 / 15 (%
،
ﻢﻨﭘوﺮﻣ ) 5 / 14 (%
ﻢﻴﺴﻛﺎﺗﻮﻔﺳ ، )
50 (%
ﻢﻳﺪﻳزﺎﺘﻔﺳ ، )
2 / 44 (%
،
ﻢﻴﭙﻔﺳ ) 4 / 36 (%
ﻦﻴﺘﻴﺴﻛﻮﻔﺳ ، )
9 / 20 (%
نﻮﺴﻛﺎﻳﺮﺘﻔﺳ ، )
50 (%
و
ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ )
3 / 41 ( و دﻮﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ زا ﺮﺗﻻﺎﺑ ﻪﺑ ﺖﻣوﺎﻘﻣ ﺎﻬﻨﺗ
ﻢﻨﭘ ﻲﻤﻳا ) 9 / 13 (%
ناﺰﻴﻣ ﺎﭘ ﻦﻴﻳ يﺮﺗ صﺎﺼﺘﺧا دﻮﺧ ﻪﺑ ار ﻣ
ﻲ داد
) 23 (.
هداز ﻲﻤﺷﺎﻫ نارﺎﻜﻤﻫو
رد ﻪﻌﻟﺎﻄﻣ ا ي لﺎﺳ رد ﻪﻛ 2012
ﺮﺑ
يﺎﻫ ﻪﻟوﺰﻳا يور ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ
هﺪﺷاﺪﺟ زا ﻪﻧﻮﻤﻧ يﺎﻫ رد ﻲﻨﻴﻟﺎﺑ
ﻧداد مﺎﺠﻧا دﺮﻛﺮﻬﺷ ﺪ
؛ ﻦﻴﻠﻴﺳ ﻲﺴﻛﻮﻣآ ﻪﺑ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ،
ﺳ ،ﻢﻴﺴﻛﺎﺗﻮﻔﺳ ،ﻦﻴﻠﻜﻴﺳاﺮﺘﺗ ،ﻢﻳﺪﻳزﺎﺘﻔﺳ نﻮﺴﻛﺎﻳﺮﺘﻔ
،ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ ،
ر ﻦﻴﺳﺎﺴﻛﻮﻠﻓوﺮﭙﻴﺳ و ﻢﻨﭘوﺮﻣ ،ﻢﻨﭘ ﻲﻤﻳا ﺐﻴﺗﺮﺗ ﻪﺑ ا
7 / 81
% ، 46
% ،
1 / 43
% ، 1 / 43
%
، 1 / 40
% ، 2 / 32
% ، 8 / 22
% ، 3 / 20 % و 3 / 15 %
ﺪﻧدﺮﻛ شراﺰﮔ )
24 (.
ﺞﻳﺎﺘﻧ ﻪﺴﻳﺎﻘﻣ ﻣﺎﺑ
ﻪﻌﻟﺎﻄ نﺎﺸﻧ ﺮﺿﺎﺣ ﻪﻛ داد
ظﺎﺤﻟزا نﻮﺴﻛﺎﻳﺮﺘﻔﺳ و ﻢﻴﺴﻛﺎﺗﻮﻔﺳ ﻪﺑ ﺖﻣوﺎﻘﻣ ﻢﻫﺎﺑ
ﻪﺑﺎﺸﻣ ﺪﻧا
، ﺎﻣا
درﻮﻣ رد و ﻢﻨﭘ ﻲﻤﻳا ،ﻦﻴﻠﻴﺳ ﻲﺴﻛﻮﻣآ ﻪﺑ ﺖﻣوﺎﻘﻣ
ار يﺮﺘﻤﻛ ناﺰﻴﻣ ﻦﻴﺳﺎﺴﻛﻮﻠﻓوﺮﭙﻴﺳ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﻪﺑ ﺖﺒﺴﻧ
دﻮﺧ ﻪﺑ
ﺪﻧدﻮﺑ هداد صﺎﺼﺘﺧا
؛ ﻪﺑ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ﻪﻛ دﻮﺑ ﻲﻟﺎﺣ رد ﻦﻳا
ﻠﻜﻴﺳاﺮﺘﺗ ،ﻢﻳﺪﻳزﺎﺘﻔﺳ دﻮﺑ ﺮﺘﺸﻴﺑ ﻢﻨﭘوﺮﻣ و ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ ،ﻦﻴ
. ﻪﺟﻮﺗ ﺎﺑ
عاﻮﻧا زا ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﻪﻜﻨﻳا ﻪﺑ ﻪﻧﻮﻤﻧ
يﺎﻫ رد ﻲﻨﻴﻟﺎﺑ ﺶﺨﺑ يﺎﻫ
ﻒﻠﺘﺨﻣ هدﺎﻔﺘﺳا هﺪﺷ
،ﺖﺳا ﻦﻳاﺮﺑﺎﻨﺑ ﺮﻈﻧ ﻪﺑ ﻣ ﻲ ﺪﺳر زا هدﺎﻔﺘﺳا ﻪﻛ
ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ رد ﻪﻛ ﻲﻳ ﺶﺨﺑ
يﺎﻫ نﻮﮔﺎﻧﻮﮔ ﻦﻴﻨﺳ ياﺮﺑ و
هدﺎﻔﺘﺳا نارﺎﻤﻴﺑ ﻒﻠﺘﺨﻣ ﻣ
ﻲ دﻮﺷ
، رد ﻲﻤﻬﻣ ﺶﻘﻧ يﻮﮕﻟا ﻦﻴﻴﻌﺗ
ﺖﻣوﺎﻘﻣ ﻲﺘﻧآ ﻜﻴﺗﻮﻴﺑ دراد ﻲ Manikandan. نارﺎﻜﻤﻫو
ﺪﻨﻫ رد
لﺎﺳ رد 2013 ﻪﻌﻟﺎﻄﻣ ا ي يﺎﻫ ﻪﻟوﺰﻳا يور ﺮﺑ ﻪﻴﻧﻮﻣﻮﻨﭘ ﻼﻴﺴﺒﻠﻛ
ﻊﻤﺟ يروآ هﺪﺷ زا ﻪﻧﻮﻤﻧ يﺎﻫ ﺞﻳﺎﺘﻧ ﻪﻛ ﺪﻧداد مﺎﺠﻧا يراردا نآ
ﺎﻫ
ﻦﻴﺳﺎﺴﻛﻮﻠﻓوﺮﭙﻴﺳ ﻪﺑ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ ﻪﻛ داد نﺎﺸﻧ )
6 / 23 (%
ﺎﺑ
ﻮﺑ نﺎﺴﻜﻳ ﺮﺿﺎﺣ ﺶﻫوﮋﭘ د
. ﻦﻴﻠﻴﺳ ﻲﺴﻛﻮﻣآ ﻪﺑ ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ
) 9 / 88 (%
ﻢﻴﺴﻛﺎﺗﻮﻔﺳ ، )
3 / 33 (%
نﻮﺴﻛﺎﻳﺮﺘﻔﺳ ، )
3 / 33 (%
،
ﻦﻴﺴﻳﺎﻣﺎﺘﻨﺟ )
4 / 19 (%
ﻢﻨﭘ ﻲﻤﻳا و )
9 / 13 (%
ﺖﻣوﺎﻘﻣ ناﺰﻴﻣ و ﺮﺘﻤﻛ
ﻪﺑ ﻔﺳ ــ ﻢﻳﺪﻳزﺎﺘ ) 8 / 45 (%
، ﺴﻜﻳﺪﻴﻟﺎﻧ ـﻴ ـ ﺳا ﻚ ـ ﺪﻴ ) 6 / 50 (%
ﻦﻴﺳﺎﺴﻛﻮﻠﻓرﻮﻧ )
25 (%
دﻮﺑ ﺮﺘﺸﻴﺑ ) 25 (.
ﻒﻠﺘﺨﻣ تﺎﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ رد توﺎﻔﺗ ﻣ
ﻲ ﺪﻧاﻮﺗ رد توﺎﻔﺗ ﺖﻠﻋ ﻪﺑ
ﻦﻳا ﺰﻳﻮﺠﺗ و فﺮﺼﻣ ﻲﻳﻮﮕﻟا ﻲﺘﻧآ
ﻚﻴﺗﻮﻴﺑ ﺎﻫ هﻮﺤﻧ و ﻪﺑ ﮔرﺎﻛ يﺮﻴ
رد ﺖﻧﻮﻔﻋ لﺮﺘﻨﻛ يﺎﻫراﺰﺑا ﺶﺨﺑ
يﺎﻫ ﻒﻠﺘﺨﻣ ﺑ نﺎﺘﺳرﺎﻤﻴ ﺎﻫ رد
ﺪﺷﺎﺑ ﻲﻳﺎﻴﻓاﺮﻐﺟ ﻒﻠﺘﺨﻣ ﻖﻃﺎﻨﻣ )
26 ( . هﺎﮕﺸﻳﺎﻣزآ ﻣ
بوﺮﻜﻴ ﻲﺳﺎﻨﺷ
ﺐﺳﺎﻨﻣ ﻲﺑوﺮﻜﻴﻣ ﺪﺿ ﻞﻣﺎﻋ بﺎﺨﺘﻧا رد ار ﻲﻠﺻا ﺶﻘﻧ
ﺮﺑ هﺪﻬﻋ
دراد
. ﻦﻳاﺮﺑﺎﻨﺑ اﺪﺟ ﻞﻣﺎﻋ ﺺﻴﺨﺸﺗ و يزﺎﺳ يرﺎﻤﻴﺑ
از مﺎﺠﻧا و
زا وراد ﺰﻳﻮﺠﺗ زا ﻞﺒﻗ ﻲﺑوﺮﻜﻴﻣ ﺪﺿ ﺖﻴﺳﺎﺴﺣ ﻦﻴﻴﻌﺗ ﺶﻳﺎﻣزآ بﺎﺨﺘﻧا رد ﻲﻳاﺰﺴﺑ ﺖﻴﻤﻫا ﺖﺳرد
،نﺎﻣرد ﺖﻧﻮﻔﻋ لﺮﺘﻨﻛ
ﺖﺷاد ﺪﻫاﻮﺧ ﻲﻳوراد ﺖﻣوﺎﻘﻣ و ﻲﻧﺎﺘﺳرﺎﻤﻴﺑ )
27 (.
ﻦﻴﻨﭽﻤﻫ
رد ﺗرﻮﺻ ﻲ ﻪﻛ رد ﺶﻫوﮋﭘ ﺎﻫ ﺶﺷﻮﻛ زا ﻂﻘﻓ ددﺮﮔ عﻮﻧ ﻚﻳ
ﻪﻧﻮﻤﻧ ﺎﻳ و هدﺮﻛ هدﺎﻔﺘﺳا ﻪﻧﻮﻤﻧ
يﺎﻫ ﺶﺨﺑ ﻚﻳ زا ﻂﻘﻓ ﻒﻠﺘﺨﻣ
نﺎﺘﺳرﺎﻤﻴﺑ دﻮﺷ ﻪﺘﻓﺮﮔ
، ﻣ ﻲ ناﻮﺗ تﺎﻋﻼﻃا ﻗد
ﻖﻴ يﺮﺗ درﻮﻣ رد
ﺖﻣوﺎﻘﻣ ﺖﻴﻌﺿو ﻲﺘﻧآ
ﻜﻴﺗﻮﻴﺑ رد ﻲ ﺑ نﺎﺘﺳرﺎﻤﻴ ﺎﻫ ﺖﺳد ﻪﺑ دروآ .
و ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺞﻳﺎﺘﻧ نﺎﺸﻧ ﻪﺑﺎﺸﻣ تﺎﻌﻟﺎﻄﻣ
ﻣ ﻲ ﺪﻨﻫد ﻛ ﻪ ﺖﻣوﺎﻘﻣ
ﻪﺑ ﻲﺘﻧآ ﻚﻴﺗﻮﻴﺑ ﺎﻫ ﻒﻠﺘﺨﻣ ي ا
هﺪﺷدﺎﺠﻳ و ﻪﻧﺎﻔﺳﺄﺘﻣ ﺶﻳاﺰﻓا ﻪﺑ ور
ﻣ ﻲ ﺪﺷﺎﺑ
، ﻦﻳاﺮﺑﺎﻨﺑ ﻪﻴﺻﻮﺗ ﻣ ﻲ دﻮﺷ نﺎﻣرد زا ﻞﺒﻗ ﻲﺘﺴﻳﺎﺑ
ﺶﺠﻨﺳ
و دﻮﺷ مﺎﺠﻧا ﻲﺑوﺮﻜﻴﻣ ﺪﺿ ﺖﻴﺳﺎﺴﺣ ﻪﺑ
رﻮﻃ ﻪﺘﺳﻮﻴﭘ ﻪﻧﺎﻴﻟﺎﺳ و رد
ﺖﻣوﺎﻘﻣ يﻮﮕﻟا نﺎﺘﺳرﺎﻤﻴﺑ ﺮﻫ ﻲﺘﻧآ
ﻜﻴﺗﻮﻴﺑ و ددﺮﮔ ﻲﺳرﺮﺑ ﻲ ﺞﻳﺎﺘﻧ
ﻪﺑ نﺎﻜﺷﺰﭘ و ﺎﻫ ﻤﻛ ﻴ ﻪﺘ يﺎﻫ ددﺮﮔ شراﺰﮔ ﺖﻧﻮﻔﻋ لﺮﺘﻨﻛ .
ﻲﻧادرﺪﻗ و ﺮﻜﺸﺗ
زا ﻪﺘﻓﺮﮔﺮﺑ ﻪﻟﺎﻘﻣ ﻦﻳا ﺎﭘ
نﺎﻳ ﻪﻣﺎﻧ ﺪﺷرا ﻲﺳﺎﻨﺷرﺎﻛ ﻣ
بوﺮﻜﻴ ﻲﺳﺎﻨﺷ
دﺰﻳ ﻲﻗوﺪﺻ ﺪﻴﻬﺷ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد بﻮﺼﻣ ﻲﻜﺷﺰﭘ ﻣ ﻲ ﺪﺷﺎﺑ و ﺪﺑ ﻦﻳ ﻪﻠﻴﺳو ﺖﻬﺟ هﺎﮕﺸﻧاد ﻲﺸﻫوﮋﭘ ﺖﻧوﺎﻌﻣ زا ﻣﺄﺗ
ﻦﻴ
ﺮﻳﺪﻘﺗ حﺮﻃ ﻦﻳا ﻪﻨﻳﺰﻫ ﻣ
ﻲ دﻮﺷ .
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Antibiotic Resistance Patterns of Klebsiella pneumoniae Strains Isolated from Urine Samples Collected from Shahid Sadoughi University Hospitals, Yazd, Iran
Dehghan Banadkouki A(MSc)1 Eslami G(PhD)2, Zandi H(PhD)3, Dehghan Banadkouki A(BSc)4, Mosadegh A(BS)5, Amiri A(MSc)6
1. MSc student of Medical Microbiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2. Assistant Professor in Department of Medical Parasitology and Mycology, Research Center for Molecular Identification of Food Hazards, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3. Corresponding Author: Assistant Professor in Department of Medical Microbiology, Research Center for Molecular Identification of Food Hazards, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4. BSc of Laboratory Science, Laboratory of Imam Khomeini Hospital, Karaj, Iran
5. Lecturer in Department of Medical Microbiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 6. MSc Student of Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract
Introduction: Klebsiella pneumoniae is an opportunistic pathogen that causes urinary tract Infection (UTI), intra-abdominal infection and pneumonia in patients with weakened immune systems or underlying diseases. Several studies have shown that the indiscriminate and irregular use of antibiotics can cause antibiotic resistance. Antimicrobial resistance has been introduced as one of the most important global health risks by the World Health Organization (WHO). Due to the increasing resistance of pathogens to antibiotics, antibiotic resistance patterns of Klebsiella pneumoniae strains isolated from urine samples have been investigated.
Methods: In this descriptive-sectional study, 130 isolates of Klebsiella pneumoniae were collected from hospitalized patients with urinary tract infections and identified by biochemical tests.
Antimicrobial susceptibility test was evaluated by standard disk diffusion method (Kirby-Bauer) that has been recommended by the CLSI.
Results: From 130 strains of Klebsiella pneumoniae, 72 strains (55.4%) were isolated from female patients. The results showed that the highest rate of resistance was belonged to amoxicillin (100%) and cefotaxime (41.5%) respectively and the lowest rate of resistance was for meropenem (3.8%) and ertapenem (3.8%).
Conclusion: The results of this study and other similar studies show that resistance to different antibiotics have been acquired, so it is recommended that antimicrobial susceptibility tests should be performed before treatment and the results are reported to the clinicians and infection control committees.
Keywords: Klebsiella pneumoniae, Urinary tract infection, Antibiotic resistance
