Klinik koagülaz negatif stafilokok kökenlerinin antibiyotik duyarlılıklarının ve bazı virülans faktörlerinin araştırılması
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Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Koagülaz Negatif Stafilokok (KNS) türleri deri ve mukozal yüzeylerde mikrobiyota
üyeleri arasında yer almasına karşın, özellikle kateter gibi tıbbi araçlarla ilişkili
enfeksiyonlara neden olmaktadır. Biyofilm oluşturabilme özellikleri ve birçok
antibiyotiğe dirençli olabilmeleri, neden oldukları enfeksiyonların tedavisini
güçleştirmektedir. Antibiyotik direncinin önemli bir toplumsal sağlık sorunu olduğu
günümüzde, KNS türlerinin sıklıkla etken olduğu kan dolaşımı enfeksiyonlarının
tedavisinde doğru antibiyotik seçimi büyük önem taşımaktadır. Bu çalışmada,
kateter ilişkili bakteriyemi etkeni KNS kökenlerinin, çeşitli antibiyotiklere direnç
profilinin ve virülansla ilişkili bazı genlerin araştırılması amaçlanmıştır.
Çalışmamızda Manisa Celal Bayar Üniversitesi Hastanesi’nde yatan hastalardan
izole edilen 43 adetKNS suşunun ampisilin, klindamisin, mupirosin, linezolid,
tigesiklin, tetrasiklin, sefotaksim, gentamisin, vankomisin, siprofloksasin, eritromisin
ve fusidik asit antibiyotiklerine karşı duyarlılıkları, klonal yakınlıkları ve bazı
virülans faktörlerinin varlığı araştırıldı. Bu suşlarda sefoksitin duyarlılığı disk
difüzyon, diğerantibiyotiklerinin duyarlılıkları ise mikrodilüsyon yöntemi ile
belirlendi. Aminoglikozid direnci için aacA-aphD ve aphA3, metisilin direnci için
mecA ve mecC, tetrasiklin direnci için tetK ve tetM, makrolid-linkozamidstreprogramin
(MLS) tip B direnci için ermA, ermB, ermC ve msrA genleri ile
virülansta etkili icaA, IS256, nucA ve sasX genleri polimeraz zincir reaksiyonu
(PZR) ile araştırıldı. Tür düzeyinde klonal yakınlıklar, Enterobacterial Repetitive
Intergenic Consensus (ERIC)-PZR ile incelendi. Tüm KNS türleri dikkate
alındığında, en yüksek direncin %93 (40 suş) ile ampisiline, en düşük direncin ise
%2 (1 suş) ile linezolide karşı olduğu saptandı. Tigesiklin ve vankomisin
antibiyotiklerine hiçbir KNS türünde direnç gözlenmedi. Klonal yakınlıkları
incelenen KNS türlerinin, kendi içlerinde genellikle farklı klonlaraait oldukları
saptandı. PZR analizlerinde ise suşlarda mecA, aacA-aphD, aphA3 ermB, ermC,
mrsA antibiyotik direnç genlerinin ve bunlara ek olarak icaA, IS256 ve sasX virülans
genlerinin varlığı tespit edildi. Çalışmamızın sonuçları, incelenen kateter ilişkili
enfeksiyon etkeni KNS’lerin yaygın olarak kullanılan antibiyotiklere karşı direnç kazanmış olduklarını ve çeşitli virülans genlerini barındıran bu suşların dikkatle
izlenmesi gerektiğini ortaya koymuştur.
Although Coagulase Negative Staphylococci (CoNS) species are among the microbiota members on the skin and mucosal surfaces, they cause infections especially related to medical devices such as catheters. Biofilm formation and resistance to many antibiotics make it difficult to treat the infections they cause. Nowadays, antibiotic resistance is an important social health problem and the right antibiotic selection is of great importance in the treatment of bloodstream infections, which are frequently caused by CoNS species. The aim of this study was to investigate the resistance profile to various antibiotics and some virulence related genes of catheter related clinical CoNS isolates. In our study, 43 CoNS strains isolated from patients hospitalized in Manisa Celal Bayar University Hospital were evaluated for their susceptibility to ampicillin, clindamycin, mupirocin, linezolid, tigecycline, tetracycline, cefotaxime, gentamicin, vancomycin, ciprofloxacin, erythromycin and fusidic acid antibiotics. The presence of clonal relationships and some virulence factors were also investigated. Susceptibilities of cefoxitin and other antibiotics in these strains were determined by disk diffusion and microdilution method, respectively. AacA-aphD and aphA3 for aminoglycoside resistance, mecA and mecC for methicillin resistance, tetK and tetM for tetracycline resistance, ermA, ermB, ermC, msrA for macrolide-lincosamide-streptogramin (MLS) type B resistance, icaA, IS256, nucA and sasX genes, which are important for virulence, were investigated by polymerase chain reaction (PCR). Clonal relationships at species level were examined by Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR. When we consider all our CoNS isolates, the highest and the lowest resistance rates were observed for ampicilin (%93) and linezolid (%2), respectively. There wasn’t any resistant CoNS isolate to tigecycline and vancomycin. It was determined that the CoNS species, whose clonal relationships were examined, were generally belonged to different clones. Also we detected the existence of mecA, aacA-aphD, aphA3, ermB, ermC, msrA antibiotic resistance genes and icaA, IS256 and sasX virulance factor genes. The results of our study revealed that the examined catheter related clinical CoNS isolates had acquired resistance to commonly used antibiotics and that these strains harboring various virulence genes. Therefore, those isolates and their infections should be carefully monitored.
Although Coagulase Negative Staphylococci (CoNS) species are among the microbiota members on the skin and mucosal surfaces, they cause infections especially related to medical devices such as catheters. Biofilm formation and resistance to many antibiotics make it difficult to treat the infections they cause. Nowadays, antibiotic resistance is an important social health problem and the right antibiotic selection is of great importance in the treatment of bloodstream infections, which are frequently caused by CoNS species. The aim of this study was to investigate the resistance profile to various antibiotics and some virulence related genes of catheter related clinical CoNS isolates. In our study, 43 CoNS strains isolated from patients hospitalized in Manisa Celal Bayar University Hospital were evaluated for their susceptibility to ampicillin, clindamycin, mupirocin, linezolid, tigecycline, tetracycline, cefotaxime, gentamicin, vancomycin, ciprofloxacin, erythromycin and fusidic acid antibiotics. The presence of clonal relationships and some virulence factors were also investigated. Susceptibilities of cefoxitin and other antibiotics in these strains were determined by disk diffusion and microdilution method, respectively. AacA-aphD and aphA3 for aminoglycoside resistance, mecA and mecC for methicillin resistance, tetK and tetM for tetracycline resistance, ermA, ermB, ermC, msrA for macrolide-lincosamide-streptogramin (MLS) type B resistance, icaA, IS256, nucA and sasX genes, which are important for virulence, were investigated by polymerase chain reaction (PCR). Clonal relationships at species level were examined by Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR. When we consider all our CoNS isolates, the highest and the lowest resistance rates were observed for ampicilin (%93) and linezolid (%2), respectively. There wasn’t any resistant CoNS isolate to tigecycline and vancomycin. It was determined that the CoNS species, whose clonal relationships were examined, were generally belonged to different clones. Also we detected the existence of mecA, aacA-aphD, aphA3, ermB, ermC, msrA antibiotic resistance genes and icaA, IS256 and sasX virulance factor genes. The results of our study revealed that the examined catheter related clinical CoNS isolates had acquired resistance to commonly used antibiotics and that these strains harboring various virulence genes. Therefore, those isolates and their infections should be carefully monitored.
Açıklama
Anahtar Kelimeler
KNS, Antibiyotik Direnci, Virülans, CoNS, Antibiotic Resistance, Virulence
