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

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

Aevar Khorshed Yusuf Özbal

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

Keywords

Antibiyotik duyarlılık, Disk difüzyonu, KNS, Kan kültürü

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

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

Keywords

Antibiotic susceptibility, Blood culture, CNS, Disc diffusion

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