[Antibiotic resistance of nosocomial staphylococcus infections with E test method]

Staphylococcus aureus is one of the most important etiologic agents causing severe infection in human. Extravagant use of vancomycin as first line treatment of infections caused by this organism, has led to production of vancomycin resistant staphylococci and enterococci, as an important health problem. The recommendations of international societies to control nosocomial infections, regarding making policies for vancomycin usage in health and treatment centers in order to prevent development and spread of vancomycin resistant Enterococcus and staphylococcus aureus. The goal of this study is determining sensitivity of S. aureus isolated from clinical specimens hospitalized patients using E-Test in order to find suitable primary therapeutic method. This study is Analytic descriptive, and 14 different antibiotics were evaluated using E-Test method at Al-Zahra hospital in Isfahan. Quality control was implemented using staphylococcus ATCC 29213. Data were analyzed by SPSS -13 software and WHOnet-5 after editing and entering into computer. This study was done on 72 patients, 25 of whom were women and the rest were men. There was no meaningful relation between patients sex and the place of isolation of organisms, but regarding ward of hospitalization and resistance rate, highest resistance was observed in ICU and surgical wards [P<0.05]. Highest sensitivity is to vancomycin [93.5%] and then to Rifampin [87%] and amikacin [71.4%]. Highest resistance is against doxycycline and oxacillin [75%] and then cotrimoxazole and ofloxacin with 69% resistance stand at next level. Because of inadvertent use of antibiotics, specially in hospitals ICU and surgical wards, the resistance of potentially dangerous and lethal bacteria like staphylococcus aureus is high and presently only a few drugs like vancomycin exist that can cover this Bacterium

[Common bacteria, infection area and appropriate treatment in hospitalized addicts]

The use of narcotics leads to immunodeficiency and infection these patients. Hence, recognition of common germs and appropriate antibiotics is of special importance. This cross-sectional study was performed among all patients hospitalized within 2002-2005, in the ward of infectious diseases, in Alzahra hospital. First, the patients were divided into 4 groups of skin, limb, heart and lung involvement, then microbial culture was obtained and type of bacterium and effective drug. Overall, 493 patients with a mean age of 27.75 years, and a minimum of 15 years. The number of deaths was 59 [11.96], of which, more than half have been affected by infective endocarditis. The most common complication [58.6%] was related to injection site complications. The lung was second [19%] followed by cardiac involvement equivalent to 13.8%. 60% of existing scopes were on tricuspid valve. The most common bacterium, staphylococcus aureus was obtained at a rate of 82.8% from these patients, which responded mostly to cefazolin and gentamicin. The need for vancomycin was present in 2% of patients, which were all hospitalized in the last year of the study [2005], and cefepime was used in only one case. Considering that the most common bacterium was Staphylococcus aureus, with a remarkable majority of patients has given appropriate response to simple and inexpensive drugs cefazolin, gentamicin, ceftriaxone and cloxacillin which are first line of treatment against this bacterium, therefore vancomilyn should be kept for special cases

Antibiotic resistance of community-acquired staphylococcus aureus

Extravagant use of vancomycin as first line treatment of infections caused by this organism, has led to production of vancomycin resistant staphylococci and enterococci, as an important health problem. The goal of this study was determining sensitivity of S.aureus isolated from clinical specimens outside hospital using E-Test in order to find suitable primary therapeutic method and to reduce vancomycin use. This cross-sectional study was performed in 2006 among 60 samples of community- acquired S.aureus Minimal Inhibitory Concentration [MIC] for various antibiotics against organisms was determined by E-test method. Qualitative control was performed by staphylococcus ATCC29213 and statistical analysis was done by SPSS ver 13 and WHONET- 5 softwares. Overall, 60 patients [including 10 women and 50 men] were included in the study. The specimen studied were 47% from blood, 30% from skin ulcer, 11.7% from evacuated abscess and 8.3% from synovial fluid. Sensitivity percentage of organisms based on break point used in CLSI M7A6 [Clinical and Laboratory Standard Institute] for various antibiotics was 88.6% for Co-Amoxiclav, 81.8% for Amikacin, 79.3% for Gentamicin, 82.1% for Cephalothin, 75% for Ciprofloxacin, 75% for Clindamycin, 76.7% for Oxacillin, 90.5% for Rifampin and 77.8% for Vancomycin. Highest resistance was noted against Oxacillin [p<0.01], Clinidomycin [p<0.01] and aminoglycosides [p<0.05] and definite resistance against Vancomycin was present in only one sample. Staphylococcus aureus is among the most prevalent agents of hospital infection which shows increasing resistance and still has acceptable sensitivity to Cephalothin, Oxacillin and other first- line treatment drugs in community-acquired infections and empirical use of Vancomycin is not necessary in these patients

Cutaneous myiasis

Myiasis is an infestation of tissues with larval stage of dipterous flies. This condition most often affects the skin and may also occur in certain body cavities. It is mainly seen in the tropics, though it may also be rarely encountered in non-tropical regions. Herein, we present a case of cutaneous furuncular myiasis in an Iranian male who had travelled to Africa and his condition was finally diagnosed with observation of spiracles of larvae in the lesions