Antimicrobial resistance patterns of Clostridium difficile strains isolated from Marmara University Hospital

Yıl 2011, Cilt: 1 Sayı: 3, 162 - 165, 31.01.2014

Nurver Toprak Ülger , Arzu İlki Öncü Akgül Güner Soyletir

Öz

Objective: This study was designed to investigate antimicrobial resistance patterns of toxigenic Clostridium difficile strains isolated from Marmara University Hospital.
Methods: The stool specimens ordered for detection of Clostridium difficile toxin at the Microbiology Laboratory, between April 2008 and January 2010 were cultured anaerobically. The antimicrobial susceptibility of the isolated 50 toxigenic Clostridium difficile strains was determined using the agar dilution protocol in the CLSI guidelines (M11-A7). The investigated antibiotics were metronidazole, vancomycin, meropenem clindamycin, and ampicillin. Breakpoints of susceptibility for each drug were considered according to the levels listed by the CLSI, intermediate strains evaluated as resistant ones. 
Results: All isolates were sensitive to metronidazole, vancomycin and meropenem. Resistance rates to clindamycin and ampicillin were 62% and 68%, respectively. 
Conclusion: For now there seems to be no resistance risk for metronidazole and vancomycin, the two agents commonly used to treat Clostridium difficile-associated diarrhea. Our findings determine the current antibiotic susceptibility patterns of the Clostridium difficile isolates in our region and also in Turkey, where clinical laboratories do not routinely perform culture and susceptibility testing of the organism.

Key words: Clostridium difficile, antimicrobial resistance, vancomycin, metronidazole

Anahtar Kelimeler

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Marmara Üniversitesi Hastanesi’nde izole edilen Clostridium difficile kökenlerinin antibiyotiklere direnç durumu

Öz

Amaç: Bu çalışmada Marmara Üniversitesi Hastanesi’nde izole edilen toksijenik Clostridium difficile kökenlerinin antibiyotiklere direnç durumunun araştırılması amaçlanmıştır.
Yöntemler: Mikrobiyoloji Laboratuvarına Nisan 2008 - Ocak 2010 tarihleri arasında, Clostridium difficile toksini bakılması isteğiyle gönderilen dışkılardan anaerop kültür yapılmış, izole edilen 50 toksijenik kökenin, CLSI’nın önerdiği (M11-A7) agarda dilüsyon yöntemi ile antibiyotik duyarlılıkları çalışılmıştır Antibiyotiklerden metronidazol, vankomisin, meropenem, klindamisin ve ampisilin seçilmiştir. Orta düzeyde dirençli olanlar da dirençliler arasında gösterilmiştir. 
Bulgular: Tüm kökenler metronidazol, vankomisin ve meropeneme duyarlı bulunmuştur. Kökenlerin %62’sinde klindamisine, %68’inde ise ampisiline direnç saptanmıştır. 
Sonuç: Elde ettiğimiz sonuçlara göre hastanemizde şu ana kadar, Clostridium difficile’ye bağlı ishal tedavisinde en fazla kullanılan antibiyotiklerden metronidazol ve vankomisine karşı bir direnç tehlikesi görülmemektedir. Ayrıca, klinik mikrobiyoloji laboratuvarlarında rutinde kültürü ve antibiyotik duyarlılığı yapılmayan Clostridium difficile ile ilgili verilerimiz, ülkemizde yapılacak diğer çalışmalara da ışık tutacaktır.

Anahtar Kelimeler : Clostridium difficile, antibiyotiklere direnç, vankomisin, metronidazol

Anahtar Kelimeler

Clostridium difficile, antibiyotiklere direnç, vankomisin, metronidazol

Kaynakça

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