Volume 83, Issue 6 (September 2025)
Tehran Univ Med J 2025, 83(6): 446-455 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Hajati K, Deihim B. Pattern of antibiotic resistance in bacterial infections
of cutaneous leishmaniasis wounds. Tehran Univ Med J 2025; 83 (6) :446-455
URL: http://tumj.tums.ac.ir/article-1-13677-en.html
URL: http://tumj.tums.ac.ir/article-1-13677-en.html
1- Student Research Committee, Dezful University of Medical Sciences, Dezful, Iran.
2- Infectious and Tropical Diseases Research Center, Dezful University of Medical Sciences, Dezful, Iran. ,Deihim.b@dums.ac.ir
2- Infectious and Tropical Diseases Research Center, Dezful University of Medical Sciences, Dezful, Iran. ,
Abstract: (181 Views)
Background: Leishmaniasis is one of the most significant parasitic diseases and is susceptible to secondary bacterial infections, which can result in increased inflammation, delayed tissue repair, and increased drug resistance. Given the importance of this phenomenon, the present study was designed to identify bacterial agents and determine their antibiotic resistance patterns in lesions of patients with cutaneous leishmaniasis.
Methods: The present cross-sectional study was conducted in Dezful, Iran, from May 2022 to December 2022 among 173 patients with suspected cutaneous leishmaniasis. In addition to sampling skin lesions for the diagnosis of leishmaniasis, wound exudates were collected using sterile swabs and cultured on blood agar and MacConkey agar plates. Bacteria were identified by Gram staining and biochemical tests. Antibiotic susceptibility patterns were determined by disk diffusion, according to the CLSI 2024 guidelines. SPSS version 20 software was used for data analysis. In Staphylococcus aureus isolates, methicillin resistance was determined using a cefoxitin disk (30 μg), and vancomycin resistance was determined by broth microdilution. In vancomycin-resistant Enterococcus isolates, a vancomycin disk (30 μg) was used. In Enterobacteriaceae, the extended-spectrum beta-lactamase (ESBL) phenotype was performed using ceftazidime (30 μg) and the ceftazidime/clavulanic acid combination disk (30/10 μg).
Results: Cutaneous leishmaniasis was detected in 65.3% of cases, of which 46 cases (26.6%) had secondary bacterial infection. Staphylococcus aureus (67.4%) and Klebsiella pneumoniae (13%) were the most common isolates. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 13 cases, accounting for 41.9% of the isolates. The frequency of Multidrug-resistant (MDR) Staphylococcus aureus among leishmaniasis patients was 38.7%, but all isolates were susceptible to vancomycin and teicoplanin. Two ESBL-producing Escherichia coli were isolated from leishmaniasis foot ulcers. Leg and back wounds were more frequently involved in bacterial infection (P<0.05).
Conclusion: Inappropriate environmental conditions and lack of treatment facilities play an important role in the occurrence and exacerbation of infectious leishmaniasis lesions. An integrated treatment approach and medical staff training can improve disease control and wound healing.
Methods: The present cross-sectional study was conducted in Dezful, Iran, from May 2022 to December 2022 among 173 patients with suspected cutaneous leishmaniasis. In addition to sampling skin lesions for the diagnosis of leishmaniasis, wound exudates were collected using sterile swabs and cultured on blood agar and MacConkey agar plates. Bacteria were identified by Gram staining and biochemical tests. Antibiotic susceptibility patterns were determined by disk diffusion, according to the CLSI 2024 guidelines. SPSS version 20 software was used for data analysis. In Staphylococcus aureus isolates, methicillin resistance was determined using a cefoxitin disk (30 μg), and vancomycin resistance was determined by broth microdilution. In vancomycin-resistant Enterococcus isolates, a vancomycin disk (30 μg) was used. In Enterobacteriaceae, the extended-spectrum beta-lactamase (ESBL) phenotype was performed using ceftazidime (30 μg) and the ceftazidime/clavulanic acid combination disk (30/10 μg).
Results: Cutaneous leishmaniasis was detected in 65.3% of cases, of which 46 cases (26.6%) had secondary bacterial infection. Staphylococcus aureus (67.4%) and Klebsiella pneumoniae (13%) were the most common isolates. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 13 cases, accounting for 41.9% of the isolates. The frequency of Multidrug-resistant (MDR) Staphylococcus aureus among leishmaniasis patients was 38.7%, but all isolates were susceptible to vancomycin and teicoplanin. Two ESBL-producing Escherichia coli were isolated from leishmaniasis foot ulcers. Leg and back wounds were more frequently involved in bacterial infection (P<0.05).
Conclusion: Inappropriate environmental conditions and lack of treatment facilities play an important role in the occurrence and exacerbation of infectious leishmaniasis lesions. An integrated treatment approach and medical staff training can improve disease control and wound healing.
Keywords: antibiotic resistance, bacterial infection, cutaneous leishmaniasis, methicillin-resistant staphylococcus aureus.
Type of Study: Original Article |
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
