Author/Authors :
Izadi, Morteza Health Research Center (HRC) - Baqiyatallah University of Medical Sciences, Tehran, IR Iran , Zamani, Mohammad Mahdi Health Research Center (HRC) - Baqiyatallah University of Medical Sciences, Tehran, IR Iran , Mousavi, Ahmad Subspeciality Clinic of Osteomyelitis, Sasan Hospital, Tehran, IR Iran , Sadat, Mir Mostafa Orthopedics Department - Medicine faculty - Tehran University of Medical Sciences, Tehran, IR Iran , Siami, Zeinab Health Research Center (HRC) - Baqiyatallah University of Medical Sciences, Tehran, IR Iran , Vais Ahmadi, Noushin Health Research Center (HRC) - Baqiyatallah University of Medical Sciences, Tehran, IR Iran , Jonaidi Jafari, Nematollah Health Research Center (HRC) - Baqiyatallah University of Medical Sciences, Tehran, IR Iran , Shirvani, Shahram Applied Microbiology Research Center - Baqiyatallah University Medical of Sciences, Tehran, IR Iran , Majidi Fard, Mojgan Applied Microbiology Research Center - Baqiyatallah University Medical of Sciences, Tehran, IR Iran , Imani Fooladi, Abbas Ali Applied Microbiology Research Center - Baqiyatallah University Medical of Sciences, Tehran, IR Iran
Abstract :
Background: Pyogenic bacteria and especially Staphylococcus aurous (S. aurous) are the most common cause of chronic osteomyelitis. Not only
treatment protocol of chronic osteomyelitis occasionally is amiss but also this malady responds to treatment difficultly. Objectives: This study investigates antibiotic resistance pattern of S. aurous isolated from Iranian patients who suffer from chronic osteomyelitis
by two methods: disk diffusion (Kirby bauyer) and E-test (Epsilometer test) to find Vancomycin susceptibility and MIC (Minimum inhibitory
concentration). Patients and Methods: One hundred and thirty one patients who suffer from chronic osteomyelitis which have been referred to both
governmental and private hospitals at 2010 were tried out for culturing of osteomyelitis site (sites). Antibiotic susceptibility and MIC of
isolated bacteria were investigated by Kirby bauyer and E-test respectively. Results: Samples were collected from bone (73.4%), surrounding tissue (14.6%) and wound discharge (12%). S. aureus was isolated from 49.6% of
the samples. According to disc diffusion, methicillin resistance S. aureus (MRSA) was 75% and Vancomycin resistance S. aurous (VRSA) was 0%
and based on MIC, MRSA was 68.5% and VRSA was 0%. According to MIC experiments, maximum sensitivity was against to Vancomycin (90.2%)
and ciprofloxacin (54.4%) respectively but based on disc diffusion, maximum sensitivity was against to Vancomycin (97.7%) and ciprofloxacin
(43.2%), respectively (P = 0.001). E-test (9.8%) in comparison with Disc diffusion (2.3%) showed higher percent of intermediate susceptibility to
Vancomycin (P = 0.017). Conclusions: Comparison of antibiograms and MICs showed that Kirby bauyer technique especially for detection of VISA strains is not
reliable comparison with E-test. Already VRSA strains have not detected in Iranian chronic osteomyelitis, Thus Vancomycin is the first choice
for chronic osteomyelitis empirical therapy in Iran yet.
Keywords: Iran; Methicillin-Resistant; Osteomyelitis; Staphylococcus
Keywords :
Iran , Methicillin-Resistant , Osteomyelitis , Staphylococcus Aurous , Vancomycin Resistance
