American Journal of Medical Case Reports. 2014, 2(6), 126-132DOI:
Abstract: Aims: To isolate and identify the causative agents for chronic osteomyelitis in patients and understanding their virulence factors for identification of targets for novel drugs and design of new vaccines. Study Design: samples of swab and bone tissues biopsy from chronic osteomylitis patients were collected in order to study the infectious agents by investigating their virulence factors. Place and Duration of study: Twenty five specimens of osteomyelitis were collected from chronic osteomyelitis patients at Surgical Specialist Hospital, Al-Yarmook Teaching Hospital and Baghdad Teaching Hospital during June 2010 to May 2011. Methodology: a form was designed to be filled by each patient, which included information about their age, sex, duration of infection, infection site. Specimens were collected using a sterile cotton swab and bunch of biopsy. The pus was taken before the surgery by swabbing an open infected area and from the deeper part of the infected bone, while, biopsies were taken from osteomyelitis patients during surgical management at the operation theater. Results: from fifty swab and twenty-five bone tissue biopsy samples, the results showed high prevalence of osteomyelitis in male patients with 84% (21), and 16% (4) in females. It was found that chronic osteomyelitis has a high prevalence among males with 84%, and the highest incidence was recorded at the age group of 30-39 years. Cultural, microscopic examination and bioc-hemical characterization of both swab and biopsy specimens, showed that 50% of the isolates were Staphylococcus aureus, 26% Enterobacter cloacae, 14% Pseudomonas aeruginosa, 6% Escherichia coli, and 4% Klebseilla sp. From the results of the antimicrobial susceptibility test using different (11) antibiotic discs against S. aureus, Enterobacter cloacae, Pseudomonas aeruginosa, E.coli, and Klebsiella sp. six isolates of S. aureus were selected and designated as (S1, S3, S4, S7) which showed multiple resistances to antibiotics. Conclusion: It was found that multiple resistances S. aureus isolates were able to produce haemolysin enzyme, capsules, slime layer, biofilm and hyaluronidase enzyme.