Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1393
8
1
gregorian
2014
11
1
21
125
online
1
fulltext
fa
شناسایی و تعیین الگوی مقاومت دارویی هموفیلوس آنفلوانزای جدا شده در مبتلایان به عفونت حادگوش میانی
Identification and determination antimicrobial resistance pattern of Haemophilus influenza isolated from patients with otitis media
میکروبیولوژی
Microbiology
پژوهشي
Research
<font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt text-align: justify unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">زمینه و
هدف: </span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">عفونت حاد گوش میانی</span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Nazanin" font-size: 14pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 12.0pt"> </span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">یکی از
شایع ترین عفونت های باکتریال <font size="3"><font face="B Zar"><span style="mso-spacerun: yes"> </span>درکودکان است.
<span style="mso-spacerun: yes"> </span>هشتادوپنج درصد از کودکان حداقل یک
بار<span style="mso-spacerun: yes"> </span>تا سه ماهگی و تقریباً 50 % <span style="mso-spacerun: yes"> </span>از آنان سه بار یا بیشتر به <span style="mso-spacerun: yes"> </span>به عفونت با این میکروب مبتلا میشوند. هدف از
این پژوهش بررسی</font></font></span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA"> هموفیلوس آنفلوانزا </span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">و تعیین حساسیت دارویی آن بوده
است.<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt text-align: justify unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><font size="3"><font face="B Zar"><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria"><span style="mso-spacerun: yes"> </span>روش کار: </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">در این
مطالعه مقطعی <span style="mso-spacerun: yes"> </span>از 102 بیمار مبتلا به عفونت
حاد گوش میانی مراجعه کننده به بیمارستان امیراعلم تهران طی 6 ماه نمونه جمع آوری
گردید.</span></font><span dir="ltr"></span><span dir="ltr"></span><span lang="FA" style="color: black line-height: 115% font-family: "Cambria","serif" font-size: 12pt mso-bidi-language: FA mso-bidi-font-family: "B Zar" mso-ansi-language: EN-GB" dir="ltr"><span dir="ltr"></span><span dir="ltr"></span> </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">نمونه
ها توسط آزمایش میکروسکوپی و کشت، از <font face="B Zar"><span style="mso-spacerun: yes"> </span>نظر وجود
هموفیلوس آنفلوانزا مورد بررسی قرار گرفتند. سپس آزمون حساسیت آنتی بیوتیکی با روش
استاندارد </font></span></font><span style="color: black line-height: 115% font-family: "Cambria","serif" font-size: 12pt mso-bidi-language: FA mso-bidi-font-family: "B Zar"" dir="ltr">Kirby-Bauer</span><span dir="rtl"></span><span dir="rtl"></span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA"><span dir="rtl"></span><span dir="rtl"></span> انجام گردید و
میزان حساسیت هموفیلوس آنفلوانزا به آنتی بیوتیک های مختلف بر حسب هاله تولید شده
به سه صورت حساس، نیمه حساس و مقاوم تعیین شد</span><span dir="ltr"></span><span dir="ltr"></span><span style="color: black line-height: 115% font-family: "Cambria","serif" font-size: 12pt mso-bidi-language: FA mso-bidi-font-family: "B Zar"" dir="ltr"><span dir="ltr"></span><span dir="ltr"></span>.</span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt text-align: justify unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><font size="3"><font face="B Zar"><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria"><span style="mso-spacerun: yes"> </span>یافته ها: </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">از 102
نمونه بررسی شده،7 <span style="mso-spacerun: yes"> </span>جدایه(9/6%) هموفیلوس آنفلوانزا
جداسازی گردید. هموفیلوس های جدا شده در این مطالعه نسبت به تری متوپریم (100%)،
ونکومایسین (85%)، استرپتومایسین (57%)، تتراسیکلین (57%) و داکسی سیکلین (56%)
حساس بودند. این جدایه ها مقاومت متوسطی به جنتامایسین (85%)،</span></font></font><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">
کاربنی سیلین </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">(70%) </span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">و سف</span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">یکسیم
(70%) </span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">داشتند.</span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA"> همچنین هموفیلوس های جدا شده نسبت به</span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">
کلیندامایسین </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">(70%)</span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">، آمیکاسین </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">(57%) </span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">و آموکسی سیلین </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">(57%) </span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">مقاوم بودند.<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt text-align: justify unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria">نتیجه گیری: </span><span lang="FA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria mso-bidi-language: FA">با توجه به ظهور سویه های مقاوم هموفیلوس آنفلوانزا نسبت به
درمان های آنتی بیوتیکی رایج به ویژه مقاومت به کلیندامایسین، آمیکاسین و آموکسی
سیلین، توصیه می شود پس از انجام مطالعات تکمیلی وسیع تر و تایید این الگوی مقاومت
قبل از شروع درمان آنتی بیوتیکی برای هموفیلوس آنفلوانزا ، کشت و آنتی بیوگرام
انجام شود.</span><span lang="AR-SA" style="color: black line-height: 115% font-family: "B Zar" font-size: 12pt mso-ascii-font-family: Cambria mso-hansi-font-family: Cambria"> <o:p /></span></p><font face="Times New Roman" size="3"> </font>
<font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">Otitis media is one of the most <font size="3"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span>common infectious diseases in children.
Approximately 85% of children will have otitis media at least once by the age of
3 months, and nearly 50% of children would have more than three times. The
objective of the this </font></font></span><span lang="EN-GB" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-ansi-language: EN-GB">research </span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">was to detect <i>Haemophilus
influenza,</i> the most common cause of otitis media in children ,and to
determine the antibiotic susceptibility pattern of this organism.<font size="3"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span><o:p /></font></font></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt"><!--stripped--><font size="3"> </font><!--stripped--></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><b><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">Methods:<o:p /></span></b></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><u><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">In this cross-sectional
study</span></u><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 10pt">,</span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">a total of 102
specimens w<a name="_GoBack"></a>ere collected during 6 months period from
patients with otitis media referred to Amir Alam Hospital in Tehran</span><span lang="EN-GB" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-ansi-language: EN-GB">.</span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">Specimens were evaluated for</span><i><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt"> </span></i><i><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">Haemophilus influenzae</span></i><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA"> by microscopic examination and culture<i>. </i>The
antibiotic susceptibility test was performed by disk diffusion method of
Kirby-Bauer</span><span lang="EN-GB" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA mso-ansi-language: EN-GB"> and </span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">sensitivity
rate<font size="3"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span>of tested</font></font></span><span lang="EN-GB" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA mso-ansi-language: EN-GB"> antibiotics </span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">were assessed by<font size="3"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span>evaluation diameter of the growth inhibitory
zone.<o:p /></font></font></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><b><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">Results:<o:p /></span></b></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span lang="EN-GB" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-ansi-language: EN-GB">Out
of 102 tested specimens, 7 </span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">(6.9%) were identified
as <i>Haemophilus influenzae</i> . <o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">The rate of sensitivity of isolated <i>Haemophilus
influenzae</i><font size="3"><font face="Times New Roman"><span style="mso-spacerun: yes"> </span>to different antibiotics was
trimethoprim (100%), vancomycin (85%), streptomycin (57%), tetracycline (57%),
and doxycycline (56%),and the rate of resistance </font></font></span><span lang="EN-GB" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-ansi-language: EN-GB">to </span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">gentamycin
(85%), </span><span lang="EN-GB" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-ansi-language: EN-GB">c</span><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">arbenicillin (70%) and cefixime (70%), clindamycin (70%) amikacin
(57%) amoxicillin (57%)<span dir="rtl"></span><span dir="rtl"></span><span lang="AR-SA" dir="rtl"><span dir="rtl"></span><span dir="rtl"></span><font face="Times New Roman" size="3">.</font></span></span><span lang="AR-SA" style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-ansi-language: EN-GB" dir="rtl"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><b><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt">Conclusion:<o:p /></span></b></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">With respect to appearance
of new resistance species especially to clinidomycin , amikiacin and amoxicilin
it is recommended to perform antibiotic susceptibility tests before the
initiation of treatment.<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0cm 0cm 10pt"><span style="color: black line-height: 115% font-family: "Times New Roman","serif" font-size: 12pt"><!--stripped--><font size="3"> </font><!--stripped--></span></p><font face="Times New Roman" size="3"> </font>
عفونت گوش میانی, هموفیلوس آنفلوانزا, تری متوپریم
Otitis media, Haemophilus influenzae, Trimethoprim
17
24
http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1592&slc_lang=fa&sid=1
Mohammad Mehdi
Soltan Dallal
محمدمهدی
سلطان دلال
3900319475328460027430
3900319475328460027430
No
Tehran University of Medical Sciences
دانشکده بهداشت، دانشگاه علوم پزشکی تهران
Abbas
Rahimi Forushani
عباس
رحیمی فروشانی
3900319475328460027431
3900319475328460027431
No
Tehran University of Medical Sciences
دانشکده بهداشت، دانشگاه علوم پزشکی تهران
Siamak
Heidarzadeh
سیامک
حیدرزاده
3900319475328460027432
3900319475328460027432
No
Tehran University of Medical Sciences
، دانشکده بهداشت، دانشگاه علوم پزشکی تهران
Hossein
Jabbari
حسین
جباری
3900319475328460027433
3900319475328460027433
No
Univ. Department of Dermatology, Department of Clinical Immunology, Allergy and Infectious Diseases, Wien, Austria
دانشگاه علوم پزشکی تهران، بیمارستان دانشگاهی وین، گروه پوست،گروه کلینیکال ایمونولوژی، آلرژی و بیماری های عفونی، ویناتریش
Shahnam
Sedigh Maroufi
شهنام
صدیق معروفی
3900319475328460027434
3900319475328460027434
No
Tehran University of Medical Sciences
دانشکده پیراپزشکی، دانشگاه علوم پزشکی تهران
Mohammad Kazem
Sharifi Yazdi
محمدکاظم
شریفی یزدی
3900319475328460027435
3900319475328460027435
Yes
Tehran University of Medical Sciences
دانشکده پیراپزشکی، دانشگاه علوم پزشکی تهران