title: Multidrug resistance pattern of bacterial agents isolated from patient with chronic sinusitis.
abstract: BACKGROUND
  Treatment of chronic sinusitis is complicated due to increase of antibiotic-resistant bacteria. The aim of this study was to determine the multidrug resistance (MDR) pattern of the bacteria causing chronic sinusitis in north of Iran.
  
  
  METHODS
  This cross-sectional study was carried out on patients with chronic sinusitis. Bacterial susceptibility to antimicrobial agents was determined according to the CLSI 2013 standards. Double-disk synergy (DDS) test was performed for the detection of extended-spectrum beta-lactamase (ESBL) producing bacteria; also methicillin-resistant Staphylococcus (MRSA) strains were identified by MRSA screen agar. The MDR isolates were defined as resistant to 3 or more antibiotics. Data were analyzed using SPSS 17 software. Descriptive statistics was used to describe the features of the data in this study.
  
  
  RESULTS
  The rate of ESBL-producing bacteria was 28.75-37.03% among enterobacteriaceae and the rate of MRSA was 42.75%-60% among Staphylococcus strains. The most detectable rate of the MDR bacterial isolates was Gram-negative bacteria 39 (76.47%) and Enterobacter spp. 19(70.37%) was the most multidrug resistant isolate among Gram negative bacteria. Also 36 (73.46%) of the gram positive bacterial isolated were multidrug resistance and Staphylococcus aureus 9(90%) was the most MDR among Gram positive bacteria.
  
  
  CONCLUSIONS
  Antimicrobial resistance is increasing in chronic bacterial sinusitis. The emergence of MRSA and ESBL bacteria causing chronic sinusitis is increasing.
authors.affiliation: Infection Diseases Research Center with Focus on Nosocomial Infection, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mohammad Sadegh
authors.initials: MS
authors.lastname: Rezai
authors.affiliation: Infection Diseases Research Center with Focus on Nosocomial Infection, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Rostam
authors.initials: R
authors.lastname: Pourmousa
authors.affiliation: Infection Diseases Research Center with Focus on Nosocomial Infection, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Roksana
authors.initials: R
authors.lastname: Dadashzadeh
authors.affiliation: Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Ahangarkani
keywords: Antibiotic resistance; Bacteria; Chronic sinusitis; ESBL; MDR; MRSA