Tehran University Medical Journal

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Background: Staphylococcus aureus is one of the most common causes of nosocomial infections with high morbidity and mortality rate. Traditionally, methicillin resistant staphylococcus aureus has been considered a major nosocomial pathogen in healthcare facilities, but in the past decade, it has been observed emerging in the community as well. Informations regarding hospital microbial colonization could be an important step for prevention of nosocomial infections. Our objective was clarifying the prevalence of methicillin resistant and vancomycin resistant staphylococcus aureus colonization in nasopharynx.
Methods: A descriptive cross sectional study was carried on 106 patients and nursing staff of surgery and hemodialysis wards in Amir-Alam hospital from April 2005 to July 2005. The samples were collected from nasal region of cases using cotton swab by two experienced technician and were sent to laboratory for culture and antibiogram.
Results: Twenty six (29.5%) out of 106 cases were nasopharyngeal carriers of staphylococcus aureus. Eight cases (7.5%) had methicillin resistant staphylococcus aureus. The most frequent colonization rate was seen in hemodialysis nursing staff and in all of them methicillin resistant staphylococcus aureus was reported. Carrier rates in hemodialysis patients were twice compared to surgery ward patients. The interesting point was that no sample of vancomycin resistant staphylococcus aureus was isolated.
Conclusion: Prevalence of methicillin resistant staphylococcus aureus colonization seems to be increased therefore proper management for controlling this problem is mandatory. The results of the present study suggest that the prevalence of methicillin resistant staphylococcus aureus infections is higher than was expected in Iran and vigorous preventive strategies should therefore be taken to stop the growth of this major health problem.

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Background: Infectious diseases are usually treatable however, infectious disease is one of the most common causes of mortality in hospitals. Furthermore, an apparent functional stagnation around the weekends in hospitals can increase the mortality rate. The goal of this study is to describe the causes and predisposing factors of mortality and to evaluate the role of holidays on patient mortality in infectious disease wards.

Methods: In this retrospective descriptive-analytic study, we examined the files of patients who had expired while hospitalized in the infectious disease ward of Imam Khomeini Hospital from 2002 to 2004. All of the information was gathered from patient files and the mortality committee of Imam Khomeini Hospital. Patient mortality rates were determined for each year. Mortality rates for the various days of the week were estimated and compared for 2004.

Results: The total number of patients included in this study was 3979. Of these, 216 cases had expired, 143 of whom were male (66%). The common causes of mortality were sepsis (26%) bacterial pneumonia (22%) and tuberculosis (19%). The mortality rates were 5.08%, 5.31% and 5.84% in 2002, 2003 and 2004, respectively. In 2004, mortality rates were 9.21%, 10.21% and 4.56% for holidays, pre-holidays and other days of week, respectively. A significantly higher rate of mortality was observed for holidays and pre-holidays compared to the other days of week. (P value <0.05).

Conclusions: Fortunately, the mortality rate of 5.43% in this infectious disease ward was not high. Since sepsis, bacterial pneumonia and tuberculosis were the most common causes of mortality, extra care of patients with these diseases is necessary. As a result of the findings of this study, we recommend increasing expert hospital staff and improving the quality of diagnostic and treatment services during holidays and pre-holidays.