Bir veteriner fakültesinin kliniklerinde metisiline dirençli Staphylococcus aureus (MRSA) kolonizasyonu

Yıl 2015, Cilt: 31 Sayı: 1, 27 - 32, 01.03.2015

Dilek Öztürk Hülya Türütoğlu Özlem Şahan

Öz

Amaç: Metisiline dirençli S. aureus (MRSA), birçok antibiyotiğe direnci nedeniyle, insan ve veteriner hekimliğinde enfeksiyonların tedavisinde güçlüklere neden olan önemli bir zoonotik ajandır. Bu çalışmada, bir veteriner fakültesinin kliniklerinde çalışan veteriner hekimler, personel ve öğrencilerin el ve burun mukozaları ile klinik ortamından alınan sıvap örneklerinde MRSA kolonizasyonu araştırıldı. Gereç ve Yöntem: Bu amaçla, 16 veteriner hekim, 2 klinik personeli ve 17 öğrencinin herbirinden alınan dört (iki el ve burun mukozası) ve klinikte el ile temasının sık olduğu düşünülen 41 farklı çevresel yüzeyden sıvap örnekleri toplandı. Bulgular: Yüz on sekiz S. aureus izolatının 75’i (%63.6; 34 veteriner hekim, 8 personel, 24 öğrenci, 9 çevresel yüzey) disk difüzyon testi ile metisiline fenotipik olarak dirençli bulundu. On dört veteriner hekim ve 7 öğrenciden alınan örneklerin en az birinde metisiline fenotipik dirençli S. aureus taşıyıcılığı belirlenirken, iki personelden alınan örneklerin tümünde metisiline fenotipik dirençli S. aureus tespit edildi. Veteriner hekimler (13 izolat), personel (1 izolat) ve öğrencilerden (10 izolat) izole edilen 24 (%20.3) S. aureus izolatında, metisiline direnci kodlayan mecA geni pozitif bulunurken, çevresel yüzeylerden izole edilemedi. Öneri: MRSA kolonizasyonunun klinikte çalışan insanlar ve öğrencilerde yüksek olduğu, insanlar ve hayvanlar arasındaki geçiş riski nedeniyle sanitasyon önlemlerinin, özellikle de personel hijyeninin gerekli olduğu kanısına varıldı.

Anahtar Kelimeler

Kolonizasyon, MRSA, Staphylococcus aureus, veteriner klinikleri

Methicillin resistant Staphylococcus aureus (MRSA) colonization at clinics of a Faculty of Veterinary Medicine

Öz

Aim: Methicillin resistant Staphylococcus aureus (MRSA) is an important zoonotic agent causing difficulties in treatment of the infections in human and veterinary medicine, due to multiple antibiotic resistances. In this study, the colonization of MRSA was investigated by the swabbing samples from the skin and nasal mucosa of veterinarians, personnel and students and from the environment at clinics of a Faculty of Veterinary Medicine. Materials and Methods: For this purpose, samples were obtained from 16 veterinarians, 2 clinic personnel and 17 students that each was sampled 4 times and from 41 different environmental surfaces thought to be common sites of hand contact. Results: Out of 118 S. aureus isolates, 75 (63.6%; 34 veterinarians, 8 personnel, 24 students and 9 environmental surfaces) were found phenotypically resistant to methicillin by a disk diffusion test. All samples taking from two personnel were colonized with phenotypic resistant S. aureus, while the 14 veterinarians and 7 students sampled were carried the phenotypic resistant S. aureus at least to one of samples. Although 24 (20.3%) S. aureus isolated from veterinarians (13 isolates), personnel (1 isolate) and students (10 isolates) were determined to be positive for mecA gene encoded resistance to methicillin, mecA-positive isolates can not be isolated from environmental surfaces at clinics. Conclusions: It has been determined that MRSA colonization has high in working people and students at the clinic, thus standard sanitation measures, particularly personnel hygiene, are required because of the risk of transmission between humans and animals.

Anahtar Kelimeler

Colonization, MRSA, Staphylococcus aureus, veterinary clinics

Kaynakça

• Anderson MEC, Lefebvre SL, Weese JS, 2008. Evaluation of prevalence and risk factors for methicillin resistant Staphylococcus aureus colonization in veterinary personnel attending an international equine veterinary conference. Vet Microbiol, 129, 410-417.
• Baptiste KE, Williams K, Williams NJ, Wattret A, Clegg PD, Dawson S, Corkill JE, O’Neill T, Hart CA, 2005. Methicillinresistant staphylococci in companion animals. Emerg Infect Dis, 11, 1942-1943.
• Boyce JM, Potter-Bynoe G, Chenevert C, King T, 1997. Environmental contamination due to methicillin resistant Staphylococcus aureus: Possible infection control implications. Infect Contr Hosp Epidemiol, 18, 622-627.
• Burstiner LC, Faires M, Weese JS, 2010. Methicillin resistant Staphylococcus aureus colonisation in personnel attending a veterinary surgery conference. Vet Surgery, 39, 150-157.
• Choi SM, Kim SH, Kim HJ, Lee DG, Choi JH, Yoo JH, Kang JH, Shin WS, Kang MW, 2003. Multiplex PCR for the detection of genes encoding aminoglycoside modifying enzymes and methicillin resistance among Staphylococcus species. J Korean Med Sci, 18, 631-6.
• Duquette RA, Nuttall TJ, 2004. Methicillin-resistant Staphylococcus aureus in dog and cats: An emerging problem. J Small Anim Pract, 45, 591-597.
• Duijkeren E, Box ATA, Heck MEOC, Wannet WJB, Fluit AC, 2004. Methicillin-resistant staphylococci isolated from animals. Vet Microbiol, 103, 91-97.
• Eiff C, Becker K, Machka K, Stammer H, Peters G, 2001. Nasal carriage as a source of Staphylococcus aureus bacteremia. N Engl J Med, 344, 11-15.
• Hanselman BA, Kruth SA, Rousseau J, Low DE, Willey BM, McGeer A, Weese JS, 2007. Methicillin-resistant Staphylococcus aureus colonization in veterinary personnel. Emerg Infect Dis, 12, 1933-1938.
• Kaszanyitzky EJ, Janosi SZ, Egyed Z, Agost G, Semjen G, 2003. Antibiotic resistance of staphylococci from humans, food and different animal species according to data of the Hungarian resistance monitoring system in 2001. Acta Vet Hung, 51, 451-464.
• Kaszanyitzky EJ, Janosi S, Somogyi P, Dan A, Graaf van Bloois L, Duijkeren E, Wagenaart JA, 2007. MRSA transmission between cows and humans. Emerg Infect Dis, 13, 630-632.
• Kilic IH, Ozaslan M, Karagoz ID, Zer Y, Savas E, Davutoglu V, 2011. The role of stethoscopes in the transmission of hospital infections. Afr J Biotechnol, 10, 5769-5772.
• Loeffler A, Boag, AK, Sung J, Lindsay JA, Guardabassi L, Dalsgaard A, Smith H, Stevens KB, Lloyd DH, 2005. Prevalence of methicillin-resistant Staphylococcus aureus among staff and pets in a small animal referral hospital in the UK. J Antimicrobial Chemother, 56, 692-697.
• Loeffler A, Pfeiffer DU, Lloyd DH, Smith H, Soares-Magalhaes R, Lindsay JA, 2010. Methicillin resistant Staphylococcus aureus carriage in UK veterinary staff and owners of infected pets: new risk groups. J Hosp Infect, 74, 282-288.
• Manian FA, 2003. Asymptomatic nasal carriage of mupirocinresistant, methicillin-resistant Staphylococcus aureus (MRSA) in a pet dog associated with MRSA infection in household contacts. Clin Infect Dis, 36, 26-28.
• Martino L, Lucido M, Mallardo K, Facello B, Mallardo M, Iovane G, Pagnini U, Tufano MA, Catalanotti P, 2010. Methicillin resistant staphylococci isolated from healthy horses and horse personnel in Italy. J Vet Diagn Invest, 22, 77-82.
• Moodley A, Stegger M, Bagcigil AF, Baptiste KE, Loeffler A, Lloyd DH, Williams NJ, Leonard N, Abbott Y, Skov R, Guardabassi L, 2006. Spa typing of methicillin-resistant Staphylococcus aureus isolated from domestic animals and veterinary staff in the UK and Ireland. J Antimicrobiol Chemother, 58, 1118-1123.
• NCCLS (2003) National committe for clinical laboratory standarts: Performance standarts for antimicrobial susceptibility testing. Eighth Edition, NCCLS document M2-A8 volume 23, no 1.
• O’Mahony R, Abbott Y, Leonard FC, Markey BK, Quinn PJ, Pollock PJ, Fanning S, Rossney AS, 2005. Methicillin-resistant Staphylococcus aureus (MRSA) isolated from animals and veterinary personnel in Ireland. Vet Microbiol, 109, 285- 296.
• Oie S, Suenaga S, Sawa A, Kamiya A, 2007. Association between isolation sites of methicillin resistant Staphylococcus aureus (MRSA) in patients with MRSA-positive body sites and MRSA contamination in their surrounding environmental surfaces. Jpn J Infect Dis, 60, 367-369.
• Ozturk D, Avki S, Turutoglu H, Yigitarslan K, Sagnak S, 2010. Methicillin resistance among coagulase-positive staphylococci isolated from dogs with otitis externa, skin wounds and pyoderma. Kafkas Univ Vet Fak Derg, 16, 651-656.
• Seguin JC, Walker RD, Caron JP, Kloos WE, George CG, Hollis RJ, Jones RN, Pfaller MA, 1999. Methicillin-resistant Staphylococcus aureus outbreak in a veterinary teaching hospital: Potential human-to-animal transmission. J Clin Microbiol, 37, 1459-1463.
• Unal S,1996. Stafilokoklarda metisilin direnç mekanizmaları ve metisilin direnç tespit yöntemleri. Flora, 1, 14–17. Weigelt JA, 2008. MRSA, first edition, Informa Healthcare USA, Inc., New York.
• Weese JS, Dick H, Willey BM, McGeer A, Kreiswirth BN, Innis B, Low DE, 2006. Suspected transmission of methicillin-resistant Staphylococcus aureus between domestic pets and humans in veterinary clinics and in the household. Vet Microbiol, 115, 148-155.
• Weese JS, DaCosta T, Button L, Kathryn G, Ethier M and Boehnke K, 2004. Isolation of methicillin resistant Staphylococcus aureus from the environment in a veterinary teaching hospital. J Vet Intern Med, 18, 468-470.
• Winn WJ, Allen S, JandaW, Koneman E, Procop G, Schreckenberger P, Woods G, 2006. Koneman’s Color Atlas and Textbook of Diagnostic Microbiology, Lippincott Williams and Wilkins, Philadelphia, 624-648.
• Wulf MWH, Sorum M, Nes A, Skov R, Melchers WJG, Klaassen CHW, Voss A, 2008. Prevalence of methicillin resistant Staphylococcus aureus among veterinarians: An international study. Clin Microbiol Infect, 14, 29-3