Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması

Yıl 2021, Cilt: 10 Sayı: 3, 435 - 443, 23.09.2021

Ceyda Uzun Şahin , Kurtulus Buruk

https://doi.org/10.37989/gumussagbil.906615

Öz

Bu çalışma, sağlık çalışanlarında nazal metisiline dirençli staphylococcus aureus (MRSA) taşıyıcılığının araştırılması amacıyla gerçekleştirilmiştir. Araştırmada, bir eğitim araştırma hastanesinin farklı kliniklerinde çalışan sağlık çalışanlarından nazal sürüntü örnekleri alınmıştır (n=414). Sağlık çalışanlarından alınan örnekler %5 koyun kanlı agara azaltma yöntemi ile ekilmiş, kuşkulanılan kolonilerden gram boyama yapılmıştır. S. aureus suşlarını belirlemek için plazma koagülaz testi yapılmış, metisilin direnci agar tarama yöntemiyle belirlenmiştir. Metisilin direnci olan suşlarda kromozomal kaset tipleri (SCCmec gen kompleksi) polimeraz zincir reaksiyonu (PCR) yöntemleriyle araştırılmıştır. Ayrıca, doğrulamak amacıyla bu izolatlarda PCR yöntemiyle mecA geni bakılmıştır. Sürekli değişkenler ortalama±standart sapma ve kategorik değişkenler sayı ve yüzde olarak ifade edilmiştir. Kategorik değişkenler arasındaki farklılıkların incelenmesinde ise Ki kare analizi kullanılmıştır. Tüm analizlerde p<0,05 istatistiksel olarak anlamlı kabul edilmiştir. Çalışmada 414 sağlık çalışanının nazal sürüntü örneklerinden 34’ünde (%8.2) S. Aureus ve bunların 11’inde (%32.3) MRSA izole edildi. MRSA suşunun 7’si (%63.7) tip IV ve 1’i (%9.1) tip I olarak saptandı. Diğer 3’ünde (%27.2) MRSA suşu mecA geni pozitif olmasına karşın mevcut SCCmec tipleri arasında sınıflandırılamadı. Çalışma sonucunda, sağlık çalışanlarında MRSA taşıyıcılığı oranları Türkiye verilerine benzerdir. İzolatlarda baskın olarak SCCmec tip IV saptanmasından dolayı hastanemizde MRSA taşıyıcılığının daha çok toplum kökenli olduğu kanaati oluşsa da bir katılımcı SCCmec tip I saptanması, hastane kökenli suşların da bulunduğunu ve yayılabileceğini göstermektedir. Bu veriler doğrultusunda, taşıyıcı sağlık çalışanlarının saptanması, eğitimi, kontrolü ve bunların daha az hasta temasını gerektiren yerlerde istihdam edilmesi göz önünde bulundurulması gereken önemli yaklaşımlardır.

Anahtar Kelimeler

Sağlık çalışanı,, MRSA taşıyıcılığı,, stafilokokal kaset mec (SCCmec) tiplendirme

Destekleyen Kurum

yok

Proje Numarası

yok

Investigation of Nasal Methicillin-Resistant Staphylococcus Aureus (MRSA) Carriage in Healthcare Workers

Öz

This study aims to investigate nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage in healthcare workers. For the study, nasal swab samples were taken from healthcare workers working in various clinics of a training and research hospital (n=414). Samples from healthcare workers were inoculated on 5% sheep blood agar with a reduction method, and gram staining was performed on suspected colonies. A plasma coagulase test was performed to determine S. aureus strains, and methicillin resistance was determined by the agar screening method. Chromosomal cassette types (SCCmec gene complex) in methicillin-resistant strains were explored with polymerase chain reaction (PCR) methods. Besides, the mecA gene was analyzed by PCR method in these isolates for verification. Continuous variables were presented as mean±standard deviation and categorical variables as numbers and percentages. Chi-square analysis was used to examine the differences between categorical variables. In all analyzes, p<0.05 was considered statistically significant. S. Aureus was isolated in 34 (8.2%) of the nasal swab samples of 414 healthcare workers, and MRSA was isolated in 11 (32.3%) of them. 7 (63.7%) of the MRSA strain were the type IV, and 1 (9.1%) was the type I. Although the other 3 (27.2%) had the mecA gene-positive, the MRSA strain could not be classified among the existing SCCmec types. The study revealed that the carriage ratio of MRSA in our hospital health workers is similar to general data in Turkey. Since SCCmec type IV is predominantly detected in the isolates, it has been concluded that MRSA carriage is mostly community-acquired in our hospital, but the detection of SCCmec type I in one employee also indicates the possibility of the presence of hospital-acquired strains, and their spread. In the light of these data, the identification, training and control of carrier personnel and their employment in units requiring less patient contact will be beneficial approaches to consider.

Anahtar Kelimeler

Healthcare workers,, MRSA carriage,, Staphylococcal cassette mec (SCCmec) classification

Proje Numarası

yok

Kaynakça

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