Abstract
Giriş: Son yıllarda Staphylococcus aureus’ta sınırlı sayıda vankomisin direncinin yanında vankomisine azalmış duyarlılıktan da söz edilmektedir. Çalışmamızda çeşitli klinik örneklerden izole edilen Stafilokokus suşlarında vankomisin duyarlılık testi çalışılması amaçlanmıştır.
Yöntem: Metisiline dirençli olan toplam 164 Staphylococcus aureus ve koagülaz negatif stafilokok suşunda vankomisin agar tarama ve E-test yöntemiyle vankomisin duyarlılığı çalışılmış ve sonuçlar Clinical and Laboratory Standart Institute ve Europian Committee on Antimicrobial Susceptibility Testing kriterlerince irdelenmiştir.
Bulgular: Hasta örneklerinden izole edilen 164 (93 Metisilin Dirençli Staphylococcus aureus ve 71 Metisilin Dirençli Koagulaz Negatif Stafilokok) stafilokok suşunun E-Test ile değerlendirmesinde Clinical and Laboratory Standart Institute'ye göre vankomisine hassasiyeti azalmış ya da dirençli suşa rastlanmadı. Europian Committee on Antimicrobial Susceptibility Testing'e göre Brain Heart infüzyon agarda üreyen 6 Metisilin Dirençli Staphylococcus aureus suşunun 3'ü, 7 Metisilin Dirençli Koagulaz Negatif Stafilokok suşunun 1'i Vankomisin'e dirençli tespit edilmiştir.
Sonuç: Minimum İnhibitör Konsantrasyon değerindeki küçük değişiklikler bile klinik olarak anlamlı olabileceğinden, Vankomisin Minimum İnhibitör Konsantrasyon değeri doğru tespit edilmelidir.
Keywords
References
- Ulusoy S, Usluer G, Ünal S. Gram Pozitif Bakteri Enfeksiyonları: Ankara 2004. 9-38
- Hawkes M, Barton M, Conly J, Nicolle L, Barry C, Ford-Jones EL. Community-associated MRSA: superbug at our doorstep CMAJ. Jan 2007;(176-1):54-6.
- Başustaoğlu A. Antibiyotiklere direnç mekanizmaları ve Çözüm Önerileri: Glikopeptitlere Direnç. Hastane İnfeksiyonları Dergisi 2001;(5) 202-9
- EUCAST Klinik ve/veya epidemiyolojik önemi olan direnç mekanizmaları ve direnç özelliklerini saptama kılavuzu. Temmuz 2013. Online erişim 21,04,2016. https://www.klimud.org/content/126/eucast
- Hawser SP, Bouchillon SK, Hoban DJ, Dowzicky M, Babinchak T. Rising incidence of Staphylococcus aureus with reduced susceptibility to vancomycin and susceptibility to antibiotics: a global analysis 2004-2009. Int J Antimicrob Agents 2011; 37(3): 219-24.
- Hanaki H, Hososaka Y, Yanagisawa C, et al. Occurrence of vancomycin-intermediate-resistant Staphylococcus aureus in Japan. J Infect Chemother 2007; 13(2): 118-21.
- National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992-April 2000, Issued June 2000. Am J Infect Control 2000;28(6):429-48.
- Arslan H, Tunçbilek S, Nazlıer S: Nosokomial infeksiyon etkeni olarak izole edilen stafilokoklarda glikopeptid antibiyotiklerin etkinliği, 8. Türk Mikrobiyoloji ve İnfeksiyon Hastalıkları Kongresi, Program ve Özet Kitabı Antalya 1997:784.
- Woodford N, Livermore D. Infections caused by gram-positive bacteria: a review of the global challenge 2009;59(S1) S4-S16.
- Taşova Y. Dirençli Gram Pozitif Bakteri İnfeksiyonlarında Güncel Tedavi. Yoğun Bakım Dergisi 2012; 10(3):147-64
- Boyce SM, William&Wilkins: Coagulase-negative Staphylococci, ‘Mayhall CG (ed): Hospital Epidemiology and Infection Control’ Baltimore 1996:360
- Malloval FO, Carricajo A, Delavenna F et al. Detection of an Outbreak of Methicillin-Resistant Staphylococcus aureus with Reduced Susceptibility to Glycopeptides in a French Hospital. Clin Microbiol Infect 2004; 10:459-61.
- Griethysen AV, Veen AV, Buiting A, Walsh T, Kluytmans J. High percentage of methicillin-resistant Staphylococcus aureus isolates with reduced susceptibility to glycopeptides in the Netherlands. J Clin Microbiol. 2003(41):2487–91.
- Trakulsomboon S, Danchaivijitr S, Rongrungruang Y. First report of Methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in Thailand. J Clin Microbiol. 2001(39):591–5.
- Kim MN, Hwang SH, Pyo YJ, Mun HM, Pai CH. Clonal Spread of Staphylococcus Heterogenously Resistant to Vancomycin in a University Hospital in Korea. Journal of Clinical Microbiology, Apr. 2002: 1376–80.
- Aminzadeh Z., Yadegarynia D., Fatemi A.,Tahmasebian D. E., Armak S.A. Vancomycin Minimum Inhibitory Concentration for Methicillin-Resistant Staphylococcus aureus Infections; Is There Difference in Mortality Between Patients? Jundishapur J Microbiol. 2014 October; 7(10): e12831.
- Gülay Z, Biçmen M, Atay T, Öktem İMA, Yuluğ N: Staphylococcus aureus suşlarının Fusidik asit ve Glikopeptid antibiyotiklere duyarlılığının incelenmesi, Dokuz Eylül Üniv Tıp Fak Derg 2000;14(3):227-31.
- Sancak B, Ercis S, Menemenlioğlu D, Çolakoğlu S, Hasçelik G: Methicillin-resistant Staphylococcus aureus heterogeneously resistant to vancomycin in a Turkish University Hospital, J Antimicrob Chemother 2005;56(3):519-23.
- Derbentli Ş. Stafilokoklarda Antibiyotik Direnci 2003-2004 Türkiye Haritası. Ankem Dergisi 2005;19(Ek-2):54-67.
- Dinç F, Dinç F.T.,Akca B., Sınırtaş A.M., Özakın C. Kandan İzole Edilen Metisiline Dirençli Staphylococcus aureus (MRSA) Suşlarının CLSI ve EUCAST Kriterlerine Göre Vankomisin, Tigesiklin, Linezolid ve Daptomisin İn Vitro Duyarlılık Sonuçları. Türk Mikrobiyol Cem Derg 41(3):120-126, 2011
- Tekin A. Dal T., Deveci Ö.,at all. Invitro susceptibility to methicillin, vancomycin and linezolid of staphhylococci isolatted from bloodstream infections in eastern Turkey. Braz. J. Microbiol.July/Spt. 2014 45(3) 829-33
- Atmaca Ö., Zarakoğlu Köşker P., Karahan C., Çakır B., Ünal S. Risk Factors and Antibiotic Use in Methicillin-Resistant Staphylococcus aureus Bacteremia in Hospitalized Patients at Hacettepe University Adult and Oncology Hospitals (2004-2011) and Antimicrobial Susceptibilities of the Isolates: A Nested Case-Control Study.
Investigation of vancomycin resistance in staphylococcus strains isolated from various clinical samples
Abstract
Introduction: Besides the few investigation demonstrating the vancomycin resistance towards Staphylococcus aureus in recent years, it has been also reported a decreased sensitivity of these bacteria to vancomycin. In the present study, it was aimed to evaluate sensitivity test in staphylococcus strains isolated from various clinical samples.
Methods: A total of 164 staphylococcus strains consisting of Methicillin Resistant Staphylococcus aureus (n=93), and Methicillin Resistant Coagulase Negative Staphylococcus (n=71) were included in this study. The vancomycin agar screening and E-test methods were used to assess vancomycin sensitivity, and results were interpreted to Clinical and Laboratory Standard Institute and European Committee on Antimicrobial Susceptibility Testing criteria.
Results: After assessing the strains by using E-Test, neither decreased sensitivity, nor resistance to vancomycin was determined according to Clinical and Laboratory Standard Institute. However, 3 of 6 Methicillin Resistant Staphylococcus aureus, and 1 of 7 Methicillin Resistant Coagulase Negative Staphylococcus reproduced in Brain Heart Infusion Agar were found to be resistant to vancomycin according to European Committee on Antimicrobial Susceptibility Testing.
Conclusion: Because even small changes can be clinically significant, Minimum İnhibition Concentration value of vancomycin should be correctly determined.
References
- Ulusoy S, Usluer G, Ünal S. Gram Pozitif Bakteri Enfeksiyonları: Ankara 2004. 9-38
- Hawkes M, Barton M, Conly J, Nicolle L, Barry C, Ford-Jones EL. Community-associated MRSA: superbug at our doorstep CMAJ. Jan 2007;(176-1):54-6.
- Başustaoğlu A. Antibiyotiklere direnç mekanizmaları ve Çözüm Önerileri: Glikopeptitlere Direnç. Hastane İnfeksiyonları Dergisi 2001;(5) 202-9
- EUCAST Klinik ve/veya epidemiyolojik önemi olan direnç mekanizmaları ve direnç özelliklerini saptama kılavuzu. Temmuz 2013. Online erişim 21,04,2016. https://www.klimud.org/content/126/eucast
- Hawser SP, Bouchillon SK, Hoban DJ, Dowzicky M, Babinchak T. Rising incidence of Staphylococcus aureus with reduced susceptibility to vancomycin and susceptibility to antibiotics: a global analysis 2004-2009. Int J Antimicrob Agents 2011; 37(3): 219-24.
- Hanaki H, Hososaka Y, Yanagisawa C, et al. Occurrence of vancomycin-intermediate-resistant Staphylococcus aureus in Japan. J Infect Chemother 2007; 13(2): 118-21.
- National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992-April 2000, Issued June 2000. Am J Infect Control 2000;28(6):429-48.
- Arslan H, Tunçbilek S, Nazlıer S: Nosokomial infeksiyon etkeni olarak izole edilen stafilokoklarda glikopeptid antibiyotiklerin etkinliği, 8. Türk Mikrobiyoloji ve İnfeksiyon Hastalıkları Kongresi, Program ve Özet Kitabı Antalya 1997:784.
- Woodford N, Livermore D. Infections caused by gram-positive bacteria: a review of the global challenge 2009;59(S1) S4-S16.
- Taşova Y. Dirençli Gram Pozitif Bakteri İnfeksiyonlarında Güncel Tedavi. Yoğun Bakım Dergisi 2012; 10(3):147-64
- Boyce SM, William&Wilkins: Coagulase-negative Staphylococci, ‘Mayhall CG (ed): Hospital Epidemiology and Infection Control’ Baltimore 1996:360
- Malloval FO, Carricajo A, Delavenna F et al. Detection of an Outbreak of Methicillin-Resistant Staphylococcus aureus with Reduced Susceptibility to Glycopeptides in a French Hospital. Clin Microbiol Infect 2004; 10:459-61.
- Griethysen AV, Veen AV, Buiting A, Walsh T, Kluytmans J. High percentage of methicillin-resistant Staphylococcus aureus isolates with reduced susceptibility to glycopeptides in the Netherlands. J Clin Microbiol. 2003(41):2487–91.
- Trakulsomboon S, Danchaivijitr S, Rongrungruang Y. First report of Methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in Thailand. J Clin Microbiol. 2001(39):591–5.
- Kim MN, Hwang SH, Pyo YJ, Mun HM, Pai CH. Clonal Spread of Staphylococcus Heterogenously Resistant to Vancomycin in a University Hospital in Korea. Journal of Clinical Microbiology, Apr. 2002: 1376–80.
- Aminzadeh Z., Yadegarynia D., Fatemi A.,Tahmasebian D. E., Armak S.A. Vancomycin Minimum Inhibitory Concentration for Methicillin-Resistant Staphylococcus aureus Infections; Is There Difference in Mortality Between Patients? Jundishapur J Microbiol. 2014 October; 7(10): e12831.
- Gülay Z, Biçmen M, Atay T, Öktem İMA, Yuluğ N: Staphylococcus aureus suşlarının Fusidik asit ve Glikopeptid antibiyotiklere duyarlılığının incelenmesi, Dokuz Eylül Üniv Tıp Fak Derg 2000;14(3):227-31.
- Sancak B, Ercis S, Menemenlioğlu D, Çolakoğlu S, Hasçelik G: Methicillin-resistant Staphylococcus aureus heterogeneously resistant to vancomycin in a Turkish University Hospital, J Antimicrob Chemother 2005;56(3):519-23.
- Derbentli Ş. Stafilokoklarda Antibiyotik Direnci 2003-2004 Türkiye Haritası. Ankem Dergisi 2005;19(Ek-2):54-67.
- Dinç F, Dinç F.T.,Akca B., Sınırtaş A.M., Özakın C. Kandan İzole Edilen Metisiline Dirençli Staphylococcus aureus (MRSA) Suşlarının CLSI ve EUCAST Kriterlerine Göre Vankomisin, Tigesiklin, Linezolid ve Daptomisin İn Vitro Duyarlılık Sonuçları. Türk Mikrobiyol Cem Derg 41(3):120-126, 2011
- Tekin A. Dal T., Deveci Ö.,at all. Invitro susceptibility to methicillin, vancomycin and linezolid of staphhylococci isolatted from bloodstream infections in eastern Turkey. Braz. J. Microbiol.July/Spt. 2014 45(3) 829-33
- Atmaca Ö., Zarakoğlu Köşker P., Karahan C., Çakır B., Ünal S. Risk Factors and Antibiotic Use in Methicillin-Resistant Staphylococcus aureus Bacteremia in Hospitalized Patients at Hacettepe University Adult and Oncology Hospitals (2004-2011) and Antimicrobial Susceptibilities of the Isolates: A Nested Case-Control Study.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | August 30, 2016 |
| Submission Date | April 21, 2016 |
| Acceptance Date | April 22, 2016 |
| Published in Issue | Year 2016Volume: 1 Issue: 2 |
