The Ilizarov paradigm: thirty years with the Ilizarov method, current concerns and future research
The level of antibiotic resistance of 365 S.aureus strains, isolated from chronic osteomyelitis patients in 1990 and 2000, was determined. As revealed in this study, over 10 years the isolation rate of strains adapted to the antimicrobial action of all tested preparations increased in some degree. The increase of the resistance level to aminoglycosides was most significant. The proportion of polyresistant strains was 9.1% in 1990 and 30.5% in 2000. The isolation rate of methicillin-resistant S. aureus (MRSA) did not increase during these 10 years, but the range of preparations suitable for the treatment of MRSA-infected patients was shown to become essentially narrower. These data confirm the view on the possibility of further decrease in the effectiveness of the conservative treatment of chronic osteomyelitis due to the rapid growth of the antibiotic resistance of S. aureus.