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Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran?
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 an...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3587867/ https://www.ncbi.nlm.nih.gov/pubmed/23483042 http://dx.doi.org/10.5812/ircmj.2165 |
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author | Izadi, Morteza Zamani, Mohammad Mahdi Mousavi, Seyed Ahmad Sadat, Seyed Mir Mostafa Siami, Zeinab Vais Ahmadi, Noushin Jonaidi Jafari, Nematollah Shirvani, Shahram Majidi Fard, Mojgan Imani Fooladi, Abbas Ali |
author_facet | Izadi, Morteza Zamani, Mohammad Mahdi Mousavi, Seyed Ahmad Sadat, Seyed Mir Mostafa Siami, Zeinab Vais Ahmadi, Noushin Jonaidi Jafari, Nematollah Shirvani, Shahram Majidi Fard, Mojgan Imani Fooladi, Abbas Ali |
author_sort | Izadi, Morteza |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-3587867 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-35878672013-03-08 Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? Izadi, Morteza Zamani, Mohammad Mahdi Mousavi, Seyed Ahmad Sadat, Seyed Mir Mostafa Siami, Zeinab Vais Ahmadi, Noushin Jonaidi Jafari, Nematollah Shirvani, Shahram Majidi Fard, Mojgan Imani Fooladi, Abbas Ali Iran Red Crescent Med J Research Article 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. Kowsar 2012-12-06 2012-12 /pmc/articles/PMC3587867/ /pubmed/23483042 http://dx.doi.org/10.5812/ircmj.2165 Text en Copyright © 2012, Iranian Red Crescent Medical Journal http://creativecommons.org/licenses/by/3/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Izadi, Morteza Zamani, Mohammad Mahdi Mousavi, Seyed Ahmad Sadat, Seyed Mir Mostafa Siami, Zeinab Vais Ahmadi, Noushin Jonaidi Jafari, Nematollah Shirvani, Shahram Majidi Fard, Mojgan Imani Fooladi, Abbas Ali Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? |
title | Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? |
title_full | Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? |
title_fullStr | Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? |
title_full_unstemmed | Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? |
title_short | Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran? |
title_sort | is vancomycine still a choice for chronic osteomyelitis empirical therapy in iran? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3587867/ https://www.ncbi.nlm.nih.gov/pubmed/23483042 http://dx.doi.org/10.5812/ircmj.2165 |
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