High-level resistance to aminoglycoside, vancomycin, and linezolid in enterococci strains

Year 2013, , 100 - 103, 01.09.2013

Gulcin Baldir Derya Ozturk Engin Metin Kucukercan Asuman Inan Seniha Akcay Seyfi Ozyurek Sebahat Aksaray

https://doi.org/10.5799/ahinjs.02.2013.03.0090

Cited By: 5

Abstract

Amaç: Bu çalışmada, enterokok suşlarının antibiyotik duyarlılık oranlarının saptanması, vankomisin duyarlı enterokok (VSE) ve vankomisin dirençli enterokok (VRE) suşlarındaki yüksek düzey aminoglikozid direncinin karşılaştırılması amaçlandı. Yöntemler: Haydarpaşa Numune Eğitim ve Araştırma Hastanesi kliniklerinden gönderilen örneklerden, laboratuvarımızda izole edilen 100 adet VRE, 100 adet VSE suşu çalışma kapsamına alındı.Bulgular: VRE suşlarının tümü Enterococcus faecium olarak tanımlanmış olup, VSE suşlarının ise %53’ü Enterococcus faecalis, %42’si E. faecium, %3’ü Enterococcus durans, %2’si Enterococcus avium olarak tespit edildi. VRE suşlarının tümünde yüksek düzey vankomisin direnci (MİK, >256 µg/ml) belirlendi, teikoplanin MİK değerleri incelendiğinde beş suş orta duyarlı (MİK, 16µg/ml), 95 suş dirençli (MİK, >32 µg/ml) olarak saptandı. VRE suşlarından biri linezolid dirençli (MİK, 12 µg/ml), biri ise orta duyarlı (MİK, 4 µg/ml) olarak saptandı, diğer suşlar duyarlı (MİK, <2 µg/ml) olarak değerlendirildi. VRE suşlarında yüksek düzey gentamisin direnci (YDGD) %83, yüksek düzey streptomisin direnci (YDSD) %89, YDSD ve YDGD birlikteliği %78 olarak bulundu. VSE suşlarında YDGD %42, YDSD %48, YDSD ve YDGD birlikteliği %36 olarak tespit edilmiştir. VRE’lerde YDAD’nin VSE suşlarına göre yüksek olduğu belirlendi (p<0,005). Sonuç: Enterokok suşlarında antimikrobiyal direnç artmaktadır. Bu yüzden hem YDAD hem de vankomisin içeren direnç paternlerinin izlenmesi gereklidir

Keywords

Enterococcus spp, vankomisin, linezolid, aminoglikozid, direnç

High-level resistance to aminoglycoside, vancomycin, and linezolid in enterococci strains

Abstract

Objective: This study sought to identify antibiotic susceptibility rates of enterococcal strains, and to compare the high-level resistance to aminoglycosides (HLAR) in vancomycin-sensitive enterococcal species (VSE) and vancomycin-resistant enterococcal species (VRE). Materials and Methods: The study included 100 VRE and 100 VSE strains recovered from the samples sent to laboratory from various departments of Haydarpasa Numune Training and Research Hospital. Results: All VRE strains were defined as Enterococcus faecium, although of the VSE strains, 53% were identified to be as Enterococcus faecalis, 42% E. faecium, 3% Enterococcus durans, and 2% Enterococcus avium. High-level resistance to vancomycin (MIC, >256 &micro;g/ml) was determined in all VRE strains and when analyzing MIC values for teicoplanin, five strains were found to be moderately susceptible (MIC, 16 &micro;g/ml) and 95 strains were resistant (MIC, >32 &micro;g/ml). Of the VRE strains, one was linezolid-resistant (MIC, 12 &micro;g/ml) and the other was intermediately susceptible (MIC, 4 &micro;g/ml) and remainders were evaluated to be susceptible (MIC, <2 &micro;g/ml). In VRE strains, high-level gentamicin resistance (HLGR) was found to be 83% and high-level streptomycin resistance (HLSR) 89%, association of HLSR with HLGR was 78%. In VSE strains, HLGR was found to be 42% and, HLSR 48%, the association of HLSR with HLGR was found to be 36%. HLAR in VRE strains was found to be higher as compared with VSE strains (p <0.005). Conclusion: Antimicrobial resistance is increasing in enterococci strains. Therefore a follow-up is required resistance pattern including both vancomycin resistance and HLAR.

Keywords

Enterococcus spp. , vancomycin, linezolid, aminoglycoside, resistance

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