The aims of this study was to detect the clinical and microbiological criteria used in the diagnosis of impetigo addition to understand the susceptibility pattern of the bacterial causative agents of impetigo to selected antimicrobial agents.
A total of Fourty five patients infected with impetigo were included in this study. Microbiological examination was performed based on direct examination, staining with Gram stain, biochemical test and culture. The antimicrobial susceptibility test was performed by standardized Kirbey-Bauer disc diffusion method.
Out of 45 specimens obtained, 15(33.3%) were diagnosed bullous impetigo and 30 (66.7%) as impetigo contagiosa. Out of 30 patients of non bullous impetigo, 25 (83.3%) were appeared as a primary infection while five (16.7%) of them followed other infection like scabies. The study results showed that Staphylococci were the main bacterial causative agents of bullous impetigo. In non-bullous impetigo, staphylococci isolated in 17 cases and Streptococcus pyogenes in 10 (33.3%) of patients. With regard to antimicrobial susceptibility tests, staphylococcal isolates were appeared 100% of sensitivity against ciprofloxacin, vancomycin, rifampicin and amikacin. Cloxacillin alone and ampicillin/cloxacillin combination revealed resistance in 4 (28.6) and 3 (21.4%) respectively. Three (12%) of isolates were resistant to third generation cephalosporines (cefotaxime, ceftriaxone and ceftazidime) respectively.
Staphylococci were the main bacterial causative agents of bullous impetigo while in non-bullous impetigo, Streptococcus pyogenes in addition to staphylococci predominantly S aureus were the predominant causative agents. Further, ciprofloxacin, vancomycin, rifampicin and amikacin were the most effective antimicrobial agents against study isolates of S aureus.
الأستاذ الدكتور مشتاق طالب صالح الندا | Dr. Mushtak T. S. Al-Neda | 8223