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KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI

Year 2012, Volume: 21 Issue: 3, 153 - 163, 01.12.2012

Abstract

Koagülaz negatif stafilakoklar (KNS) klinik mikrobiyoloji laboratuvarlarında en sık izole edilen bakterilerdir. Tıpta uygulanan invaziv teknikler ve protez kullanımının artması nedeniyle insan vücudunun normal florasının bir üyesi olan bu bakterilerin önemi gittikçe artmaktadır. Bu çalışmada, Erciyes Üniversitesi Hastanesi Merkez Laboratuvarı bakteriyoloji biriminde kan kültürle-rinden soyutlanan S.epidermidis dışında KNS'lerin tiplendirilmesi ve antibiyotik duyarlılıklarının araştırılması amaçlanmıştır.Erciyes Üniversitesi Tıp Fakültesi Hastanesi kliniklerine başvuran ve bakteriyolojik kültür istenilen hastalardan alınan kan örneklerinden soyutlanan S.epidermidis dışında 150 KNS izolatı çalışma kapsamına alındı. Tüp koagülaz ve trehaloz-mannitol testleri ile doğrulandıktan sonra API STAPH (bio Mérieux) tanımlama sistemi ile üretici firma kılavuzuna göre tür düzeyinde tanımlandı. Tanımlanan suşların antibiyotik duyarlılık profili CLSI önerileri doğrultusunda Mueller-Hinton agar kullanılarak Kirby-Bauer Disk Difüzyon yöntemiyle belirlendi. S.epidermidis dışı 150 KNS izolatın %48.7’si S.hominis, %17.3’ü S.haemolyticus, %17.3’ü S.xylosus, %3.3’ü S.saprophyticus, %3.3’ü S.simulans, %2.6’sı S.lentus, %2.1’i S.warneri, %2.1’i S.chromogenes, %1.3’ü S.eguorum, %1.3’ü S.capitis ve %0.7’si S.cohnii olarak saptandı.S.hominis, S.haemolyticus, S.xylosus, S.warneri, S.lentus ve S.chromogenes türlerinin %46.1-%76.9’u ampisillin-sulbaktam, sefazolin ve metisiline; S.warneri, S.saprophyticus ve S.simulans türlerinin %100’ü gentamisine; S.xylosus ile S.saprophyticus’un %100’ü novobiosine, bütün türlerin %33.3-%66.7’si sefazoline, %33.3-%100’ü sülfametoksazola dirençli; S.simulans ampisillin-sulbaktam, sefazolin ve metisiline, S.chromogenes gentamisine, S.xylosus dışında izole edilen bütün türler teikoplanin ve vankomisine, S.xylosus ile S.saprophyticus dışında bütün türler novobiosine duyarlı bulundu. Sıkça izole edilen bakteri gruplarından KNS’lerin, antibiyotiklere direnç oranların yüksek olması nedeniyle KNS enfeksiyonlarında tür düzeyinde tanımlama ve uygun antibiyotik seçimi için antibiyogram testi yapılmalıdır

References

  • Baldassarri L, Doneli G, Gelosia A, et al. Puri fication and characterization of the staphylo coccal slime-associated antigen and its occur rence among Staphylococcus epidermidis clini cal isolates. Infect Immun, 1996; 64: 3410-5.
  • Yazgı H, Ayyıldız A, Aktaş AE, et.al. Böl- gemizde çeşitli klinik örneklerden soyutlanan Staphylococcus suşlarının "slime faktör ve protein A" yönünden incelenmesi. Türk Mikro- biyol Cem Derg, 1997; 27:10-3.
  • Bouza E, San Juan R, Munoz p et al. Coopera- tive Group of the European Study Group on Nosocomial Infections (ESGNI). A European perspective on intravascular catheter-related infections: report on the microbiology work- load, aetiology and antimicrobial susceptibility (ESGNI-005 Study). Clin Microbiol Infect, 2004; 10: 838-842.
  • Meriç M, Wilke A, Çağlayan C, Toker K. Inten- sive care unit-acquired infections: incidence, risk factors and associated mortality in a Turk- ish university hospital. Jpn J Infect Dis, 2005; 58: 297-302.
  • Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstrean infections in US hospi- tals: analysis of 24, 179 cases from a prospec- tive nationwide surveillance study. Clin Infect Dis, 2004; 39(3): 309-17.
  • Raad I, Kassar R, Ghannam D. et al. Manage- ment of the catheter in documented catheter- rejated coaglase- negative staphylococcal bac- teremia: Remove or retain? CID, 2009; 49: 1187-97
  • De Paulis AN, Predari SC, Chazarreta CD, Santoianni JE. Five- test simple scheme for species-level identification of clinically signifi- cant coagulase-negative staphylococci. J Clin Microbiol, 2003; 41: 1219-24.
  • Christensen GD, Simpson WA, Younger JJ.et al. Adherence of coagulase-negative staphylo- cocci to plastic tissue culture plates: a quanti- tative model for the adherence of staphylo- cocci to medical devices. J Clin Microbiol. 1985; 22: 996-1006.
  • Jones JW, Scott RCD, Morgan J, Pether JVS. A study of coagulase negative staphylococci with refernce tos lime production, adherence, resis- tance patterns and clinical siginificance. J Hos- pital Infection, 1992; 22: 217-227.
  • Cheistensen GD, Parisi JT, Parisi AL, et.al. Characterization of clinically significant strains of coagulase negative staphylococci. J Clin Microbiol, 1983; 18: 258-269.
  • Ponce J, Leons S, Guenthner SH, Wenzel RP. Microbiologic studies of coagulase negative staphylococci isolated faem patients with naso- comial bacteraemias J Hospital Infection, 1986; 7: 121-129.
  • Akova M, Gür D, Akalın HE, Baykal M. Klinik önemi olan Staphylococcus epidermidis suşlarının saptanmasında slime testinin yeri. İnfeksiyon Derg, 1989; 3: 321-326.
  • Mohan U, Jindal N, Aggarwal P, Species distribution and antibiotic sensitivity pattern of coagulase negative staphylococci isolated from various clinical specimens. Indian J Medical Microbiol, 2002; 20: 45-46.
  • Kaymakçı G ve Özbal Y. Çeşitli klinik örnekler- den izole edilen stafilokokların biyokimyasal özelliklerine göre tiplendirilmesi, İnfeksiyon Derg, 1997; 11:107-111.
  • Katayama Y, Takeuchi F, et al. Identification in methicillin-susceptible Staphylococcus hominis of an active primordial mobile genetic element for the staphylococcus cassette chro- mosome mec of methicillin-resistant Staphylo- coccus aureus. J Bacteriol, 2003; 185: 2711- 2722.
  • Fang H, Hedin G. Rapid screening and identi- fication of methicillin-resistant Staphylococ- cus aureus from clinical samples by selective- broth and real-time PCR assay. J Clin Micro- biol, 2003; 41: 2894-2899
  • Anon. 9. National Nosocomial Infections Sur- veillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004.Am J Infect Control, 2004;32:470-85.
  • Khadri H. and Alzohairy M. Prevalence and antibiotic susceptibility pattern of methicillin- resistant and coagulase-negative staphylo- cocci in a tertiary care hospital in India. Int J Medicine and Medical Sci. 2010; 2: 116-120
  • Fajardo Olivares M, Hidalgo Orozco R,
  • Rodríguez Gutierrez S, et.al. Activity of dapto- mycin, ciprofloxacin,clindamycin and cotri- moxazole against coagulase-negative Staphy- lococcus strains with diminished susceptibility to vancomycin, 2010;23:81-86
  • Çavuşoğlu C, Badak Z, Tünger A, et al. Kan kültürlerinden soyutlanan Staphylococcus aureus ve koagülaz negatif stafilokok izolat- larının fusidik aside in vitro duyarlılıkları. İnfeksiyon Derg, 1998; 12: 467-470.
  • Yüce P, Demirdağ K, Kalkan A, et al. Kan kültürlerinde izole edilen mikroorganizmalar ve antibiyotik duyarlılıkları. The microorganisms isolated from blood samples and their suscepti- bility to antibiotics. ANKEM Derg. 2005; 19: 17-21.
  • Doğruman F, Akça G, Sipahi B, Sultan N. Kan örneklerinden soyutlanan stafilokok suşlarının antibiyotiklere direnç durumları. ANKEM der- gisi, 2005; 19: 14-16.
  • Doğan Ö, Çırak M, Engin D, Türet S. Klinik örneklerden izole edilen stafilokoklarda metis- ilin direnci ve çeşitli antibiyotiklere in vitro duyarlılıkları. ANKEM Derg, 2005; 19:39-42.
  • Derbentli Ş. Stafilokoklarda antibiyotik direnci: 2003-2004 Türkiye haritası. ANKEM Derg, 2005; 19: 54-60.
  • Qu Y, Daley AJ, Istivan TS, Garland SM, Deighton MA. Antibiotic susceptibility of co- agulase-negative staphylococci isolated from very low brith weight babies: comprehensive comparisons of bacteria at different stages of biofilmformation, Annals of Clinical Microbiol- ogy and Antimicrobials, 2010; 9: 16-21.
  • Kassis C, Rangaraj G, Jiang Y, Hachem RY, Raad I. Differentiating culture samples repre- senting coagulase- negative staphylococcal bacteremia from those representing contamina- tion by use of time-to-positivity and quantitative blood culture methods, J Clin Microbiol, 2009; 47: 3255-3260.

Identification of Coagulase Negative Stphylococci Isolated From Blood Cultures and Determination and Investigation of Antibiotic Susceptibility

Year 2012, Volume: 21 Issue: 3, 153 - 163, 01.12.2012

Abstract

Coagulase Negative Staphylococci (CNS) are the most frequently isolated bacteria in clinical microbiology laboratories. The importance of these bacteria that are the component of normal flora of human body have been increasing by means of applications of invasive techniques in medicine and increasing the usage of prosthetic devices. The aim of this study is to identify and investigate the antibiotic susceptibility of CNS except S.epidermidis which are isolated from blood cultures in bacteriology unit of Central Laboratory S.epidermidis, 150 CNS isolates are involved in this study. They were isolated from the requested blood cultures of bacteriologic culture of the patients who had applied to Erciyes University Medical Faculty Hospitals. After confirming with tube coagulase and trehalose-manitol tests; isolates were identified at species level with API STAPH (bio Mérieux) manufacturers guideline’s. Antibiotic susceptibility profile of identified subspecies were determined by Kirby-Bauer Disc Diffusion Method using Muler-Hinton agar and following CLSI recommendations. Besides S.epidermidis, 150 CNS isolates was determined as follows; 48.7% S.hominis, 17.3% S.haemolyticus, 17.3% S.xylosus, 3.3% S.saprophyticus, 3.3% S.simulans, 2.6% S.lentus, 2.1% S.warneri, 2.1% S.chromogenes, 1.3% S.eguorum, 1.3% S.capitis and 0.7% S.cohnii.46.1%-76.9% S.xylosus, S.warneri, S.lentus ve S.chromogenes species were found resistant to ampicillin-sulbactam, cefazolin and meticillin; and also 100% of S.warneri, S.saprophyticus and S.simulans to gentamicin; %100 of S.xylosus and S.saprophyticus to novobiocin, 33.3%-66.7% of all species to cefazolin, 33.3%-100% to erythromycin, 20.0%-72.6% to trimethoprim-sulfamethoxazole. S.simulans were found susceptible to ampicillin-sulbactam, cefazolin and meticillin, and also S.chromogenes to gentamicin, all isolated species except S.xylosus to teicoplanin and vancomycin, and all species except S.xylosus and S.saprophyticus to novobiocin. Because of the high rates of resistance to antibiotics of CNS, frequently isolated bacteria, identification at species level and antibiogram test must be performed for the selection of convenient antibiotic in CNS infections

References

  • Baldassarri L, Doneli G, Gelosia A, et al. Puri fication and characterization of the staphylo coccal slime-associated antigen and its occur rence among Staphylococcus epidermidis clini cal isolates. Infect Immun, 1996; 64: 3410-5.
  • Yazgı H, Ayyıldız A, Aktaş AE, et.al. Böl- gemizde çeşitli klinik örneklerden soyutlanan Staphylococcus suşlarının "slime faktör ve protein A" yönünden incelenmesi. Türk Mikro- biyol Cem Derg, 1997; 27:10-3.
  • Bouza E, San Juan R, Munoz p et al. Coopera- tive Group of the European Study Group on Nosocomial Infections (ESGNI). A European perspective on intravascular catheter-related infections: report on the microbiology work- load, aetiology and antimicrobial susceptibility (ESGNI-005 Study). Clin Microbiol Infect, 2004; 10: 838-842.
  • Meriç M, Wilke A, Çağlayan C, Toker K. Inten- sive care unit-acquired infections: incidence, risk factors and associated mortality in a Turk- ish university hospital. Jpn J Infect Dis, 2005; 58: 297-302.
  • Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstrean infections in US hospi- tals: analysis of 24, 179 cases from a prospec- tive nationwide surveillance study. Clin Infect Dis, 2004; 39(3): 309-17.
  • Raad I, Kassar R, Ghannam D. et al. Manage- ment of the catheter in documented catheter- rejated coaglase- negative staphylococcal bac- teremia: Remove or retain? CID, 2009; 49: 1187-97
  • De Paulis AN, Predari SC, Chazarreta CD, Santoianni JE. Five- test simple scheme for species-level identification of clinically signifi- cant coagulase-negative staphylococci. J Clin Microbiol, 2003; 41: 1219-24.
  • Christensen GD, Simpson WA, Younger JJ.et al. Adherence of coagulase-negative staphylo- cocci to plastic tissue culture plates: a quanti- tative model for the adherence of staphylo- cocci to medical devices. J Clin Microbiol. 1985; 22: 996-1006.
  • Jones JW, Scott RCD, Morgan J, Pether JVS. A study of coagulase negative staphylococci with refernce tos lime production, adherence, resis- tance patterns and clinical siginificance. J Hos- pital Infection, 1992; 22: 217-227.
  • Cheistensen GD, Parisi JT, Parisi AL, et.al. Characterization of clinically significant strains of coagulase negative staphylococci. J Clin Microbiol, 1983; 18: 258-269.
  • Ponce J, Leons S, Guenthner SH, Wenzel RP. Microbiologic studies of coagulase negative staphylococci isolated faem patients with naso- comial bacteraemias J Hospital Infection, 1986; 7: 121-129.
  • Akova M, Gür D, Akalın HE, Baykal M. Klinik önemi olan Staphylococcus epidermidis suşlarının saptanmasında slime testinin yeri. İnfeksiyon Derg, 1989; 3: 321-326.
  • Mohan U, Jindal N, Aggarwal P, Species distribution and antibiotic sensitivity pattern of coagulase negative staphylococci isolated from various clinical specimens. Indian J Medical Microbiol, 2002; 20: 45-46.
  • Kaymakçı G ve Özbal Y. Çeşitli klinik örnekler- den izole edilen stafilokokların biyokimyasal özelliklerine göre tiplendirilmesi, İnfeksiyon Derg, 1997; 11:107-111.
  • Katayama Y, Takeuchi F, et al. Identification in methicillin-susceptible Staphylococcus hominis of an active primordial mobile genetic element for the staphylococcus cassette chro- mosome mec of methicillin-resistant Staphylo- coccus aureus. J Bacteriol, 2003; 185: 2711- 2722.
  • Fang H, Hedin G. Rapid screening and identi- fication of methicillin-resistant Staphylococ- cus aureus from clinical samples by selective- broth and real-time PCR assay. J Clin Micro- biol, 2003; 41: 2894-2899
  • Anon. 9. National Nosocomial Infections Sur- veillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004.Am J Infect Control, 2004;32:470-85.
  • Khadri H. and Alzohairy M. Prevalence and antibiotic susceptibility pattern of methicillin- resistant and coagulase-negative staphylo- cocci in a tertiary care hospital in India. Int J Medicine and Medical Sci. 2010; 2: 116-120
  • Fajardo Olivares M, Hidalgo Orozco R,
  • Rodríguez Gutierrez S, et.al. Activity of dapto- mycin, ciprofloxacin,clindamycin and cotri- moxazole against coagulase-negative Staphy- lococcus strains with diminished susceptibility to vancomycin, 2010;23:81-86
  • Çavuşoğlu C, Badak Z, Tünger A, et al. Kan kültürlerinden soyutlanan Staphylococcus aureus ve koagülaz negatif stafilokok izolat- larının fusidik aside in vitro duyarlılıkları. İnfeksiyon Derg, 1998; 12: 467-470.
  • Yüce P, Demirdağ K, Kalkan A, et al. Kan kültürlerinde izole edilen mikroorganizmalar ve antibiyotik duyarlılıkları. The microorganisms isolated from blood samples and their suscepti- bility to antibiotics. ANKEM Derg. 2005; 19: 17-21.
  • Doğruman F, Akça G, Sipahi B, Sultan N. Kan örneklerinden soyutlanan stafilokok suşlarının antibiyotiklere direnç durumları. ANKEM der- gisi, 2005; 19: 14-16.
  • Doğan Ö, Çırak M, Engin D, Türet S. Klinik örneklerden izole edilen stafilokoklarda metis- ilin direnci ve çeşitli antibiyotiklere in vitro duyarlılıkları. ANKEM Derg, 2005; 19:39-42.
  • Derbentli Ş. Stafilokoklarda antibiyotik direnci: 2003-2004 Türkiye haritası. ANKEM Derg, 2005; 19: 54-60.
  • Qu Y, Daley AJ, Istivan TS, Garland SM, Deighton MA. Antibiotic susceptibility of co- agulase-negative staphylococci isolated from very low brith weight babies: comprehensive comparisons of bacteria at different stages of biofilmformation, Annals of Clinical Microbiol- ogy and Antimicrobials, 2010; 9: 16-21.
  • Kassis C, Rangaraj G, Jiang Y, Hachem RY, Raad I. Differentiating culture samples repre- senting coagulase- negative staphylococcal bacteremia from those representing contamina- tion by use of time-to-positivity and quantitative blood culture methods, J Clin Microbiol, 2009; 47: 3255-3260.
There are 27 citations in total.

Details

Other ID JA29HU44BV
Journal Section Research Article
Authors

Aevar Khorshed This is me

Yusuf Özbal This is me

Publication Date December 1, 2012
Submission Date December 1, 2012
Published in Issue Year 2012 Volume: 21 Issue: 3

Cite

APA Khorshed, A., & Özbal, Y. (2012). KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI. Sağlık Bilimleri Dergisi, 21(3), 153-163.
AMA Khorshed A, Özbal Y. KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI. JHS. December 2012;21(3):153-163.
Chicago Khorshed, Aevar, and Yusuf Özbal. “KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI”. Sağlık Bilimleri Dergisi 21, no. 3 (December 2012): 153-63.
EndNote Khorshed A, Özbal Y (December 1, 2012) KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI. Sağlık Bilimleri Dergisi 21 3 153–163.
IEEE A. Khorshed and Y. Özbal, “KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI”, JHS, vol. 21, no. 3, pp. 153–163, 2012.
ISNAD Khorshed, Aevar - Özbal, Yusuf. “KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI”. Sağlık Bilimleri Dergisi 21/3 (December 2012), 153-163.
JAMA Khorshed A, Özbal Y. KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI. JHS. 2012;21:153–163.
MLA Khorshed, Aevar and Yusuf Özbal. “KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI”. Sağlık Bilimleri Dergisi, vol. 21, no. 3, 2012, pp. 153-6.
Vancouver Khorshed A, Özbal Y. KAN KÜLTÜRLERİNDE İZOLE EDİLEN KOAGÜLAZ NEGATİF STAFİLOKOKLARIN TİPLENDİRİLMESİ VE ANTİBİYOTİK DUYARLILIKLARININ ARAŞTIRILMASI. JHS. 2012;21(3):153-6.