Background
Early detection of Antimicrobials Resistance outbreaks is one of the most important goals of the World Health Organization. In this study, by comparing the observed cases of resistance with its expected cases, the outbreak of these resistances was investigated. It should be noted that this subject was not done in the country until the time of the study.
Methods
This study is a hospital-based study. Data related to all the university general of Iran (57 hospitals) were used. In these hospitals, all the patients who were infected by E.coli in time period of March 21 2017 to March 20 2018 were enrolled in the study. Then, using an index called the SIR; the observed cases of resistant E.coli were compared with the expected ones. This index is achieved from dividing the observed cases by its expected cases. If the obtained number is greater than one, it indicates the greater observed cases rather than the expected cases, which can represent Emerging. In order to compute SIR index, we divided the number of observed cases of Antimicrobials Resistance E.coli by the number of expected cases of each Antimicrobials Resistance E coli. To predict the expected cases of each Antimicrobials Resistance E coli, we developed one compartmental model. In this model, the number of patients is estimated using equations. Berkeley Madonna version 8.3.23 software was used to manipulate these equations.
Results
The SIR index for E.coli resistant to Ampicillin, Ceftazidime and Colistin were 1.2(1.1–1.3), 1.1(1.02–1.2) and 1.7(1.02–2.3) respectively. This index for E.coli resistant to Meropenem was .8 (.6-.9). In other cases, the calculated index was not statistically significant.
Conclusions
Ampicillin-resistant E.coli and Ceftazidime-resistant E.coli observed cases among nosocomial infections were greater than the expected cases. Hence it is necessary to reconsider using such type of antibiotics in treatment of nosocomial infections caused by E.coli. The results of this study could be important for health policy makers. In the future, outbreaks of this type of infection can be investigated with the help of the results of this study.