Resistant Gram-Positive Bacterial Infections

Öz

With the developing technology, the life expectancy of people such as immunosuppressive and elderly patients have increased, but the treatments and invasive procedures applied have increased with age. Thus, the emergence of healthcare-associated, hospital-acquired infections in these individuals has emerged as an inevitable result. In nosocomial infections and epidemics, the importance and contribution of the microbiology laboratory is great in terms of identifying the agent, determining the antibiotic resistance profile, determining the source, and taking the necessary precautions. Resistant Gram-positive bacterial infections are common infections in these individuals and have led to increased antibiotic-resistant treatment failures and even deaths over the years. In this review, we planned to classify resistant Gram-positive bacterial infections, review them in the light of the literature, and discuss what can be done to prevent them.

Anahtar Kelimeler

• Gram-Positive
• Resistant
• Gram-Positive Bacteria
• Infections

Dirençli Gram Pozitif Bakteri Enfeksiyonları

Öz

Gelişen teknoloji ile birlikte immünsüpresif ve yaşlı hastalar gibi kişilerin yaşam beklentisi uzamış ancak yaşla birlikte uygulanan tedaviler ve invaziv işlemler uzamıştır. Böylece bu bireylerde sağlık hizmeti ilişkili, hastane kaynaklı enfeksiyonların ortaya çıkması kaçınılmaz bir sonuç olarak ortaya çıkmıştır. Hastane enfeksiyonlarında ve salgınlarda etkenin belirlenmesi, antibiyotik direnç profilinin belirlenmesi, kaynağın belirlenmesi ve gerekli önlemlerin alınması açısından mikrobiyoloji laboratuvarının önemi ve katkısı büyüktür. Dirençli Gram-pozitif bakteriyel enfeksiyonlar, bu bireylerde sık görülen enfeksiyonlardır ve yıllar içinde antibiyotiğe dirençli tedavi başarısızlıklarının ve hatta ölümlerin artmasına neden olmuştur. Bu derlemede dirençli Gram pozitif bakteriyel enfeksiyonları sınıflandırmayı, literatür ışığında gözden geçirmeyi ve önlemek için neler yapılabileceğini tartışmayı planladık.

Anahtar Kelimeler

• Gram-Positive Bacteria
• Infections
• Resistant

Kaynakça

1. 1. Yilmaz M, Elaldi N, Balkan İİ, Arslan F, Batırel AA, Bakıcı MZ, et al. Mortality predictors of Staphylococcus aureus bacteremia: a prospective multicenter study. Ann Clin Microbiol Antimicrob. 2016;15:7. doi: 10.1186/s12941-016-0122-8.
2. 2. Erdem H, Hargreaves S, Ankarali H, Caskurlu H, Ceviker SA, Bahar-Kacmaz A,et al. Managing adult patients with infectious diseases in emergency departments: international ID-IRI study. J Chemother. 2021:1-17. doi: 10.1080/1120009X.2020.1863696. Epub ahead of print.
3. 3. Alkan Çeviker S, Elmaslar Mert HT, Yıldız Hİ, Yıldız E. Necrotizing fasciitis and necrotizing pneumonia caused by Streptococcus pyogenes after intramuscular injection in a diabetic patient: A case report. D J Med Sci 2019;5(4):4-7.
4. 4. Büke Ç. Gram-Pozitif Bakterilerde Antibiyotik Direnci. Klimik Dergisi 2010; 23: 34.
5. 5. Aydın M, Kaşıkçıoğlu C, Nargiz-Koşucu S, Timurkaynak F, Arslan H. Kan dolaşımı infeksiyonu etkenleri ve antibiyotik direnç oranları. Klimik Derg. 2016; 29(2): 82-5.
6. 6. Bryant KA, Woods CR. Healthcare-acquired infections due to Gram-positive bacteria. Pediatr Infect Dis J. 2008;27(5):455-6. doi: 10.1097/INF.0b013e3181757cf9.
7. 7. Woodford N, Livermore DM. Infections caused by Grampositive bacteria: a review of the global challenge. J Infect. 2009; 59 (Suppl. 1): S4-16.
8. 8. Avcıoğlu F, Öztürk C, Şahin İ, Öksüz Ş, Kızılırmak A, Akar N . Metisiline Dirençli Stafilokoklarda Azalmış Vankomisin Duyarlılığının Araştırılması. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi. 2020; 10(1): 81-86.

9. 9. Doernberg SB, Lodise TP, Thaden JT, Munita JM, Cosgrove SE, Arias CA, et al; Gram-Positive Committee of the Antibacterial Resistance Leadership Group (ARLG). Gram-Positive Bacterial Infections: Research Priorities, Accomplishments, and Future Directions of the Antibacterial Resistance Leadership Group. Clin Infect Dis. 2017;64(suppl_1):24-29.
10. 10. Ak Ö, Diktaş H, Şenbayrak S, Saltoğlu N. [Skin and soft tissue infections: Diagnosis and therapy]. Klimik Derg. 2020; 33(3): 200- 12.
11. 11. Napolitano LM. Emerging issues in the diagnosis and management of infections caused by multi-drug-resistant, gram-positive cocci. Surg Infect (Larchmt). 2005;6 Suppl 2:S-5-22.
12. 12. Mediavilla JR, Chen L, Mathema B, Kreiswirth BN. Global epidemiology of community-associated methicillin resistant Staphylococcus aureus (CA-MRSA). Curr Opin Microbiol. 2012 Oct;15(5):588-95. doi: 10.1016/j.mib.2012.08.003.
13. 13. Salgado CD, Farr BM, Calfee DP. Community-acquired methicillinresistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis. 2003; 36(2): 131-9.
14. 14. Özgüven A, Tünger Ö, Çetin ÇB, Dinç G. İlköğretim ve lise öğrencilerinde toplum kökenli metisiline dirençli Staphylococcus aureus burun taşıyıcılığının araştırılması. Mikrobiyol Bül. 2008; 42(4): 661-7.
15. 15. Alkan Çeviker S, Günal Ö, Kılıç SS. Toplum Kökenli Metisiline Dirençli Staphylococcus aureus'un Neden Olduğu Diyabetik ayak Enfeksiyonu ve Nekrotizan Pnömoni. Klinik Tıp Solunum Aktüel Dergisi. 2019;10(1):1–4.
16. 16. Altunok ES, Meriç M, Karahan ZC, Deniz B, Ünal Ç, Willke A. Toplum kökenli metisiline dirençli Staphylococcus aureus’un neden olduğu bir nekrotizan fasiit olgusu, Klimik Derg. 2014; 27(1): 26-9.
17. 17. Dündar D, Willke A, Sayan M, et al. Metisiline dirençli Staphylococcus aureus izolatlarının epidemiyolojik ve moleküler özelliklerinin araştırılması: çok merkezli çalışma [Özet]. In: Akalın H, ed. XVI. Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Kongresi (13-17 Mart 2013, Antalya) Kongre Kitabı. İstanbul: Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği, 2013: 222.
18. 18. Willke A, Sayan M, Meriç M, Mutlu B. Kan kültürlerinde üreyen stafilokoklarda metisilin direncinin gerçek zamanlı PCR ile erken tanısı. Mikrobiyol Bul 2012; 46:671-5.
19. 19. Tarai B, Das P, Kumar D. Recurrent challenges for clinicians: emergence of methicillin-resistant Staphylococcus aureus, vancomycin resistance, and current treatment options. J Lab Physicians. 2013; 5(2): 71-8.
20. 20. Cepeda J, Hayman S, Whitehouse T, et al. Teicoplanin resistance in methicillin-resistant Staphylococcus aureus in intensive care unit. J Antimicrob Chemother. 2003; 52(3): 533-4.
21. 21. Hiramatsu K, Hanaki H, Ino T, Yabuta K, Oguri T, Tenover FC. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemoter 1997; 40(1): 135-6.
22. 22. Hiramatsu K. Vancomycin-resistant Staphylococcus aureus: a new model of antibiotic resistance. Lancet Infect Dis 2001; 1(3): 147-55.
23. 23. Appelbaum PC. MRSA- the tip of the iceberg. Clin Microbiol Infect 2006; 12(Suppl 2): 3-10.
24. 24. Kuşçu F, Öztürk D, Gürbüz Y, Tütüncü E, Şencan İ, Gül S. Metisiline dirençli stafilokoklarda azalmış vankomisin duyarlılığının araştırılması. Mikrobiyol Bul. 2011; 45(2): 248-57.
25. 25. Howden BP, Davies JK, Johnson PDR, Stinear TP, Grayson ML. Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin-intermediate and heterogeneous vancomycinintermediate strains: resistance mechanisms, laboratory detection and clinical implications. Clin Microbiol Rev 2010;1: 99-139.
26. 26. Howden BP, Davies JK, Johnson PDR, Stinear TP, Grayson ML. Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin-intermediate and heterogeneous vancomycinintermediate strains: resistance mechanisms, laboratory detection and clinical implications. Clin Microbiol Rev 2010;1: 99-139.
27. 27. Van Hal SJ, Lodise TP, Paterson DL. The clinical significance of vancomycin minimum inhibitory concentration in Staphylococcus aureus infections: a systematic review and meta-analysis. Clinical Infectious Diseases 2012; 54: 755-771.
28. 28. Chang HJ, Hsu PC, Yang CC, Siu LK, Kuo AJ, et al. Influence of teicoplanin MICs on treatment outcomes among patients with teicoplanin-treated methicillin resistant Staphylococcus aureus bacteraemia: a hospital based retrospective study. J. Antimicrob Chemother 2012; 67(3):736-41.
29. 29. Honda H, Doern CD, Michael-Dunne W Jr, Warren DK. The impact of vancomycin susceptibility on treatment outcomes among patients with methicillin resistant Staphylococcus aureus bacteremia. BMC Infect Dis. 2011; 5:11:335.
30. 30. Lodise TP, Graves J, Evans A, Graffunder E, Helmecke M, et al. Relationship between vancomycin MIC and failure among patients with methicillin-resistant Staphylococcus aureus bacteremia treated with vancomycin. Antimicrob Agents Chemother 2008; 52: 3315-20
31. 31. Rojas L, Bunsow E, Munoz P, Cercenado E, Rodrigueuz-Creixems, Bouza E. Vancomycin MICs do not predict the outcome of methicillin-resistant Staphylococcus aureus bloodstream infections in correctly treated patients. J. Antimicrob Chemother 2012;7: 1760-8.
32. 32. Sader HS, Jones RN, Rossi KL, Rybak MJ. Occurrence of vancomycin tolerant and heterogeneous vancomycin resistant strains (hVISA) among Staphylococcus aureus causing bloodstream infections in nine USA hospitals. Antimicrob Chemother. 2009; 64: 1024-8.
33. 33. Wootton M, Howe RA, Hillman R, Walsh TR, Bennett PM, MacGowan AP. A modified population analysis profile (PAP) method to detect hetero-resistance to vancomycin in Staphylococcus aureus in a UK hospital. J Antimicrob Chemother. 2001; 47: 399-403
34. 34. Sancak B, Ercis S, Menemenlioglu D, Colakoglu S, Hasçelik G. Methicillin-resistant Staphylococcus aureus heterogeneously resistant to vancomycin in a Turkish university hospital. J Antimicrob Chemother. 2005; 56(3): 519-23.
35. 35. Mirza HC, Sancak B, Gur D. The prevalence of vancomycin-intermediate Staphylococcus aureus and Heterogeneous VISA among methicillin-resistant strains isolated from pediatric population in a Turkish university hospital. Microbial Drug Resistance. 2015; 21(5): 537-44.
36. 36. Korkut Tunç E, Kuzucu Ç, Otlu B. Metisiline dirençli Staphylococcus aureus suşlarında vankomisine karşı azalmış duyarlılığın araştırılması. Türk Mikrobiyol Cem Derg. 2017; 47(1): 39-46.
37. 37. Souli M, Karaiskos I, Galani L, Maraki S, Perivolioti E, Argyropoulou A, et al. Nationwide surveillance of resistance rates of Staphylococcus aureus clinical isolates from Greek hospitals, 2012-2013. Infectious Diseases. 2016; 48(4): 287-92
38. 38. Khatib R, Jose J, Musta A, Sharma M, Fakih MG, Johnson LB, et al. Relevance of vancomycinintermediate susceptibility and heteroresistance in methicillin-resistant Staphylococcus aureus bacteraemia. Journal of Antimicrobial Chemotherapy. 2011; 66(7): 1594-9.
39. 39. Pitz AM, Yu F, Hermsen ED, Rupp ME, Fey PD, Olsen KM. Vancomycin susceptibility trends and prevalence of heterogeneous vancomycinintermediate Staphylococcus aureus in clinical methicillin-resistant S. aureus isolates. Journal of Clinical Microbiology. 2011; 49(1): 269-74.
40. 40. KORKUT TUNÇ E, KUZUCU Ç, OTLU B. Metisiline Dirençli Staphylococcus aureus Suşlarında Vankomisine Karşı Azalmış Duyarlılığın Araştırılması, Türk Mikrobiyol Cem Derg. 2017; 47(1):39-46.
41. 41. Arabacı Ç, Uzun B. Staphylococcus aureus İzolatlarının Çeşitli Antibiyotiklere Duyarlılıklarının Değerlendirilmesi . Klimik Dergisi 2021; 34(1): 69-74
42. 42. Shepard BD, Gilmore MS: Antibiotic resistant enterococci: The mechanisms and dynamics of drug introduction and resistance, Microbes Infect 2002;4(2):215-24.
43. 43. Moellering RC:Enterococcus species, Streptococcus bovis and Leuconostoc species, “Mandell GL, Bennet JE, Dolin R (eds): Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 5.baskı” kitabında s.2147-56, Churchill Livingstone, Philadelphia (2000)
44. 44. Arda B, Yamazhan T, Aydemir fi, Tünger A, Özinel MA, Ulusoy S. Vankomisine Dirençli Enterokok Epidemisi Ege Üniversitesi T›p Fakültesi Deneyimi. Hastane ‹nfeksiyonlar› Dergisi 2002; 6: 202-206.
45. 45. Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. Am J Med 1991; 91(3B): 72S-5S Çetinkaya Şardan Y. Vankomisine dirençli enterokoklara bağlı hastane infeksiyonlarının epidemiyolojisi ve kontrolü. In: Ulusoy S, Usluer G, Ünal S, eds. Önemli ve Sorunlu Gram-Pozitif Bakteri İnfeksiyonları. Ankara: Bilimsel Tıp Yayınları, 2004: 171-85.
46. 46. Guclu, A. U., Kocak, A. A., Ok, M. A., Tutluoglu, B., Basustaoglu, A. C., & Respiratory Study Group. (2021). Antibacterial Resistance in Lower Respiratory Tract Bacterial Pathogens: A Multicenter Analysis from Turkey. The Journal of Infection in Developing Countries, 15(02), 254-262.
47. 47. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004; 39(3): 309- 17.
48. 48. Alkan S, Kuloglu F, Akata F. Enterokok bakteriyemilerinde risk faktörlerinin degerlendirilmesi. Klimik Derg. 2016; 29(2): 66-71.
49. 49. Biedenbach DJ, Moet GJ, Jones RN. Occurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997- 2002). Diagn Microbiol Infect Dis. 2004; 50(1): 59-6
50. 50. Araç E, Kaya Ş, Almacıoğlu S, Günay E, Yüksel E, Yıldırım MS, et al. What Situation Do We Have In Health Care-Related Infections?: Evaluation of an Intensive Care Unit. Van Med J. 2019; 26(2): 226-231.
51. 51. Alkan-Çeviker S, Günal Ö, Köksal E, Aygün C, Kılıç SS. [Comparison of health care-associated Enterococcus faecium and Enterococcus faecalis bloodstream infections]. Klimik Derg. 2020; 33(1): 87-90.
52. 52. Hayden MK, Trenholme GM, Schultz JE, Sahm DF. In vivo development of teicoplanin resistance in a VanB Enterococcus faecium isolate. J Infect Dis. 1993;167:1224-7.
53. 53. Kawalec M, Gniadkowski M, Kedzierska J, Skotnicki A, Fiett J, Hryniewicz W. Selection of a teicoplaninresistant Enterococcus faecium mutant during an outbreak caused by vancomycin-resistant enterococci with the vanB phenotype. J Clin Microbiol. 2001;39(12):4274-82.
54. 54. Depardieu F, Perichon B, Courvalin P. Detection of the van alphabet and identification of enterococci and staphylococci at the species level by multiplex PCR. J Clin Microbiol. 2004;42(12):5857-60.
55. 55. Boyd DA, Willey BM, Fawcett D, Gillani N, Mulvey MR. Molecular characterization of Enterococcus faecalis N06-0364 with low-level vancomycin resistance harboring a novel D-Ala-D-Ser gene cluster, vanL. Antimicrob Agents Chemother. 2008;52(7):2667-72.
56. 56. Xu X, Lin D, Yan G, Ye X, Wu S, Guo Y, et al. vanM, a new glycopeptide resistance gene cluster found in Enterococcus faecium. Antimicrob Agents Chemother. 2010;54(11):4643-7.
57. 57. Lebreton F, Depardieu F, Bourdon N, Fines-Guyon M, Berger P, Camiade S, et al. D-Ala-d-Ser VanN-type transferable vancomycin resistance in Enterococcus faecium. Antimicrob Agents Chemother. 2011;55(10):4606-12.
58. 58. Ramotar K, Woods W, Larocque L, Toye B. Comparison of phenotypic methods to identify enterococci intrinsically resistant to vancomycin (VanC VRE). Diagn Microbiol Infect Dis. 2000;36(2):119-24.
59. 59. Şen M, Elaldı N, Gözel MG, Çelik C, Engin A, Bakır M, et al.Bir Üniversite Hastanesinde Vankomisine Dirençli Enterokok Epidemisi: Risk Faktörlerinin Araştırılması.FLORA 2015;20(3):140-149.
60. 60. Shorman M, Al-Tawfi q J. Risk factors associated with vancomycin-resistant enterococcus in intensive care unit settings in Saudi Arabia. Interdiscip Perspect Infect Dis 2013;2013:369674
61. 61. Carmeli Y, Eliopoulos GM, Samore MH. Antecedent treatment with different antibiotic agents as a risk factor for vancomycin-resistant enterococcus. Emerg Infect Dis 2002;8:802-7.
62. 62. Batistão DWF, Gontijo-Filho PP, Conceição N, Oliveira AG, Ribas RM. Risk factors for vancomycin-resistant enterococci colonisation in critically ill patients. Mem Inst Oswaldo Cruz 2012;107:57-63.
63. 63. Cheng VC, Tai JW, Ng ML, Chan JF, Wong SC, Li IW, et al. Extensive contact tracing and screening to control the spread of vancomycin-resistant Enterococcus faecium ST414 in Hong Kong. Chin Med J 2012;125:3450-7.
64. 64. Zirakzadeh A, Patel R. Vancomycin-resistant enterococci: colonization, infection, detection, and treatment. Mayo Clin Proc 2006; 81(4): 529-36.
65. 65. Patel R, Allen SL, Manahan JM, et al. Natural history of vancomycin-resistant enterococcal colonization in liver and kidney transplant recipients. Liver Transplantation 2001; 7(1): 27-31.
66. 66. Roghmann MC, McCarter RJ, Brewrink J, Cross AS, Morris JG. Clostridium diffi cile infection is a risk factor for bacteremia due to vancomycin-resistant enterococci (VRE) in VREcolonized patients with acute leukemia. Clin Infect Dis 1997;25:1056-9.
67. 67. Kamboj M, Chung D, Seo SK, Pamer EG, Sepkowitz KA, Jakubowski AA. The changing epidemiology of vancomycinresistant enterococcus (VRE) bacteremia in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Biol Blood Marrow Transplant 2010;16:1576-81.
68. 68. Josko D. Molecular bacteriology in the clinical laboratory. Clin Lab Sci 2010; 23(4): 237-41.
69. 69. Marner ES, Wolk DM, Carr J, et al. Diagnostic accuracy of the Cepheid GeneXpert vanA/vanB assay ver. 1.0 to detect the vanA and vanB vancomycin resistance genes in Enterococcus from perianal specimens. Diagn Microbiol Infect Dis 2011; 69(4): 382-9.
70. 70. Jayaratne P, Rutherford C. Detection of clinically relevant genotypes of vancomycin-resistant enterococci in nosocomial surveillance specimens by PCR. J Clin Microbiol 1999; 37(6): 2090-2
71. 71. Atalay S, Ece G, Şamlıoğlu P, Maraş G, Köse I, Köse Ş. İzmir’de üçüncü basamak bir hastanede görülen vankomisine dirençli enterokok olgularının değerlendirilmesi. Mikrobiyol Bul 2012;46:553-9.
72. 72. Millan, G., & Wehrhahn, M. C. (2022). Eucast rapid antibiotic susceptibility testing method for blood cultures–Implementation in a private laboratory setting. Pathology, 54, S86-S87.