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

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

Kaynakça

  • Bannerman, T.L. (2003). Staphylococcus, Micrococcus, and Other Catalase-Positive Cocci That Grow Aerobically. In: Editor Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, and Yolken RH, (Ed.). Manual of Clinical Microbiology, 8th Edition, American Society for Microbiology, Washington DC.
  • Yılmaz, M.A, Aslantaş, Ö, Özer, B. ve Yılmaz, E.Ş. (2015). “Nasal Carriage of Methicillin-Resistant Coagulase Negative Staphylococci (MR-Cons) Among Veterinarians and Veterinary Students”. J. Fac. Vet. Med, 41 (1), 69-78.
  • Appiah, V.A, Pesewu, G.A, Kotey, F, Boakye, A.N, Duodu, S, Tette, E, Nyarko, M.Y, and Donkor, E.S. (2020). “Staphylococcus Aureus Nasal Colonization Among Children With Sickle Cell Disease At The Children's Hospital, Accra: Prevalence, Risk Factors, and Antibiotic Resistance”. Pathogens, 9 (5), 329.
  • Gopal, R.G, Michalczyk, P, Nayeem, N, Walker, G, and Wigmore, L. (2007). “Prevalence and Risk Factors for Methicillin-Resistant Staphylococcus Aureus in Adult Emergency Admissions A Case For Screening All Patients?”. J Hosp Infect, 66 (11), 15-21.
  • Barr, B, Wilcox M.H, Brady, A, Parnell, P, and Darby, B. (2007). “Prevalence of Methicillin-Resistant Staphylococcus Aureus Colonization among Older Residents of Care Homes in The United Kingdom”. Infect Control Hosp Epidemiol, 28 (7), 853-859.
  • Shukla, S.K. (2005). “Community-associated Methicillin-Resistant Staphylococcus Aureus and Its Emerging Virulence”. Clinical Medicine and Research, 3 (2), 57-60.
  • Pineles, L, Morgan, D.J, Lydecker, A, Johnson, J.K, Sorkin, J.D, Langenberg, P, Blanco, N, Lesse, A, Sellick, J, Gupta, K, Leykum, L, Cadena, J, Lepcha, N, and Roghmann, M.C. (2017). “Transmission of Methicillin-Resistant Staphylococcus Aureus To Health Care Worker Gowns and Gloves During Care of Residents in Veterans Affairs Nursing Homes”. American Journal of Infection Control, 45 (9), 947–953.
  • Ma, X.X, Ito, T, Tiensasitorn, C, Jamklang, M, and Chongtrakool, P. (2002). “Novel Type of Staphylococcal Cassette Chromosome Mec Identified in Community-Acquired Methicillin-Resistant Staphylococcus Aureus Strains”. Antimicrob Agents Chemother, 46 (4), 1147-1152.
  • Humphreys, H, Becker, K, Dohmen, P.M, Petrosillo, N, and Spencer, M. (2016). “Staphylococcus Aureus and Surgical Site Infections: Benefits of Screening and Decolonization Before Surgery”. J Hosp Infect, 94 (3), 295-304.
  • Katayama, Y, Ashley R.D, and Mark, C.E. (2005). “Genetic Background Affects Stability of Meca in S. Aureus”. J. Clin. Microbiol, 43 (5), 2380-238.
  • Bhowmik, D, Chetri, S, Das, B.J, Dhar Chanda, D, and Bhattacharjee, A. (2021). “Distribution of Virulence Genes And Sccmec Types among Methicillin-Resistant Staphylococcus Aureus of Clinical And Environmental Origin: A Study From Community of Assam, India”. BMC Research Notes, 14 (1), 58.
  • Melo, P.C, Ferreira, L.M, Filho, A.N, Zafalon, L.F, and Vicente, H.G. (2013). “Comparison of Methods for The Detection of Biofilm Formation By Staphylococcus Aureus İsolated From Bovine Subclinical Mastitis”. Brazilian Journal of Microbiology, 44 (1), 119-124.
  • Oliveira, D.C, and Lencastre, H. (2002). “Multiplex PCR Strategy for Rapid İdentification of Structural Types and Variants of The Mec Element in Methicillin-Resistant Staphylococcus Aureus”. Antimicrob Agents Chemother, 46 (7), 2155-2161.
  • Kluytmans, J.A, and Wertheım, H.F. (2005). “Nasal Carriage of Staphylococcus Aureus and Prevention of Nosocomial Infections”. Infection, 33 (1), 3-8.
  • Kampf, G, Adena, S, Rüden, H, and Weıst, K. (2003). “Inducibility and potential role of mecagene- positive oxacillin-susceptible staphylococcus aureus from colonized healthcare workers as a source for nosocomial ınfections”. Journal of Hospital Infection, 54 (2), 124-129.
  • Shopsin, B, Mathema, B, Martinez, J, Ha, E, and Campo, M.L. (2000). “Prevalance of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus Aureus in The Community”. The Journal of Infectious Diseases, 182 (1), 359-362.
  • Naz, H, Çevik, F.Ç. ve Aykın, N. (2006). “Nasal Staphylococcus Aureus Carriage in the Eskişehir Yunus Emre State Hospital Staff”. Ankem Journal, 20 (4), 141-144.
  • Demirdal, T, Demirtürk, N, and Altındiş, M. (2006). “Nasal Staphylococcus Aureus Carriage İn Hospital Staff”. Klimik Dergisi, 19 (1), 25-27.
  • Erdenizmenli, M, Yapar, N, Senger, S.S, Özdemir, S, and Yüce, A. (2004). “Investigation of Colonization with Methicillin-Resistant and Methicillin-Susceptible Staphylococcus Aureus in An Outpatient”. Population in Journal of Infectious Diseases, 59 (3), 195-196.
  • Kıllgore, G, and Tenover, F.C. (2006). “Prevalance of Staphylococcus Aureus Nasal Colonization in The United States, 2001-2002”. Journal of Infectious Diseases, 193 (2), 172-9.
  • Kuehnert, M.J, Kruszon-Moran, D, Hill, H.A, Mcquillan, G, and Mcallister, S.K. (2006). “Prevalance of Staphylococcus Aureus Nasal Colonization in The United States, 2001-2002”. Journal of Infectious Diseases, 193 (2), 172-9.
  • Kenner, J, O’connor, T, Piantanida, N, Fishbain, J, and Eberly, B. (2003). “Rates of Carriage of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus Aureus in An Outpatient Population”. Infection Control and Hospital Epidemiology, 24 (6), 439-444.
  • Oğuzkaya-Artan, M, Gülgün, M, Baykan, Z, and Tok, D. (2008). “Investıgatıon of Nasal Carrıage Rates and Antımicrobial Susceptıbılıty of Staphylococcus Aureus in Hospital Staff”. Turkish Journal of Infection, 22 (2), 87-90.
  • Mert, G, Kılıç, A, Bedir, O. ve Başustaoğlu, A.C. (2011). “Clinical signifi cance and staphylococcal cassette chromosome mec (SCCmec) characterization of coagulase-negative staphylococci isolated from blood cultures”. Turk J Med Sci, 41 (5), 859-865.
  • Çetinkaya, Ş.Y. (2000). “Epidemiology and control of methicillin-resistant Metisilin Direncli Staphlococcus aureus infetions”. Hastane Enfeksiyonları Dergisi, 4 (1), 205-217.
  • Soysal, A, Sahin, H, Yağcı, A, Barlan, I, and Bakir, M. (2006). “The Low Rate of Methicillin-Resistant Staphylococcus Aureus in Turkish Children”. Japanese Japanese Journal of Infectious Diseases, 57 (4), 172-175.
  • Elie-Turenne, M.C, Fernandes, H, Mediavilla, J.R, Rosenthal, M, and Mathema. (2010). “Prevalence and Characteristics of Staphylococcus Aureus Colonization Among Healthcare Professionals in An Urban Teaching Hospital”. Infect Control Hosp Epidemiol, 31 (6), 574-580.
  • Cesur, S, and Cokça, F. (2002). “Determination of Nasal Carriage Rates of Methicillin Resistant Staphylococcus Aureus in Hospital Personnel and in The Community”. Mikrobiyoloji Bülteni, 36 (3-4), 247-252.
  • Oliviera, D.C, Tomasz, A, and Lencastre, H. (2001). “The Evolution of Pandemic Clopnes of Methicillin-Resistant Staphylococcus Aureus: İdentification of Two Ancestral Genetic Backgraunds and The Associated Mec Elements”. Microb Drug Resist, 7 (4), 349-61.
  • Patel, M, Hoesley, C.J, Moser, S.A, Stamm, A.M, and Baddley, J.W. (2008). “Dissemination of Community-Associated Methicillin-Resistant Staphylococcus Aureus in A Tertiary Care Hospital”. Southern Medical Journal, 101 (3), 40-45.
  • Karapsias, S, Piperaki, E.T, Spiliopoulou, I, Katsanis, G, and Tseleni-Kotsovili, A. (2008). “Methicillin-Resistant Staphylococcus Aureus Nasal Carriage among Healthy Employees of The Hellenic Air Force”. Euro Surveillance, 13 (40), print online, ISSN: 1560-7917.
  • Shore, A, Rossey, A.S, Keane, C.T, Enright, M.C, and Coleman, D.C. (2005). “Seven Novel Variants of The Staphylococcal Chromosomal Casette Mec in Methicillin-Resistant Staphylococcus Sureus Isolates from Ireland”. Antimicrob Agents Chemother, 49 (5), 2070-2083.
  • Karahan, Z.C, Tekel, A, Adalet, R, Koyuncu, E, and Dolapcı, I. (2008). “Investigation of Panton-Valentine Leukocidin Genes and Sccmec Types in Clinical Staphylococcus Aureus Isolates from Turkey”. Microbial Drug Resistance, 14 (3), 203-221.

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

Yıl 2021, Cilt 10, Sayı 3, 435 - 443, 23.09.2021
https://doi.org/10.37989/gumussagbil.906615

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.

Kaynakça

  • Bannerman, T.L. (2003). Staphylococcus, Micrococcus, and Other Catalase-Positive Cocci That Grow Aerobically. In: Editor Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, and Yolken RH, (Ed.). Manual of Clinical Microbiology, 8th Edition, American Society for Microbiology, Washington DC.
  • Yılmaz, M.A, Aslantaş, Ö, Özer, B. ve Yılmaz, E.Ş. (2015). “Nasal Carriage of Methicillin-Resistant Coagulase Negative Staphylococci (MR-Cons) Among Veterinarians and Veterinary Students”. J. Fac. Vet. Med, 41 (1), 69-78.
  • Appiah, V.A, Pesewu, G.A, Kotey, F, Boakye, A.N, Duodu, S, Tette, E, Nyarko, M.Y, and Donkor, E.S. (2020). “Staphylococcus Aureus Nasal Colonization Among Children With Sickle Cell Disease At The Children's Hospital, Accra: Prevalence, Risk Factors, and Antibiotic Resistance”. Pathogens, 9 (5), 329.
  • Gopal, R.G, Michalczyk, P, Nayeem, N, Walker, G, and Wigmore, L. (2007). “Prevalence and Risk Factors for Methicillin-Resistant Staphylococcus Aureus in Adult Emergency Admissions A Case For Screening All Patients?”. J Hosp Infect, 66 (11), 15-21.
  • Barr, B, Wilcox M.H, Brady, A, Parnell, P, and Darby, B. (2007). “Prevalence of Methicillin-Resistant Staphylococcus Aureus Colonization among Older Residents of Care Homes in The United Kingdom”. Infect Control Hosp Epidemiol, 28 (7), 853-859.
  • Shukla, S.K. (2005). “Community-associated Methicillin-Resistant Staphylococcus Aureus and Its Emerging Virulence”. Clinical Medicine and Research, 3 (2), 57-60.
  • Pineles, L, Morgan, D.J, Lydecker, A, Johnson, J.K, Sorkin, J.D, Langenberg, P, Blanco, N, Lesse, A, Sellick, J, Gupta, K, Leykum, L, Cadena, J, Lepcha, N, and Roghmann, M.C. (2017). “Transmission of Methicillin-Resistant Staphylococcus Aureus To Health Care Worker Gowns and Gloves During Care of Residents in Veterans Affairs Nursing Homes”. American Journal of Infection Control, 45 (9), 947–953.
  • Ma, X.X, Ito, T, Tiensasitorn, C, Jamklang, M, and Chongtrakool, P. (2002). “Novel Type of Staphylococcal Cassette Chromosome Mec Identified in Community-Acquired Methicillin-Resistant Staphylococcus Aureus Strains”. Antimicrob Agents Chemother, 46 (4), 1147-1152.
  • Humphreys, H, Becker, K, Dohmen, P.M, Petrosillo, N, and Spencer, M. (2016). “Staphylococcus Aureus and Surgical Site Infections: Benefits of Screening and Decolonization Before Surgery”. J Hosp Infect, 94 (3), 295-304.
  • Katayama, Y, Ashley R.D, and Mark, C.E. (2005). “Genetic Background Affects Stability of Meca in S. Aureus”. J. Clin. Microbiol, 43 (5), 2380-238.
  • Bhowmik, D, Chetri, S, Das, B.J, Dhar Chanda, D, and Bhattacharjee, A. (2021). “Distribution of Virulence Genes And Sccmec Types among Methicillin-Resistant Staphylococcus Aureus of Clinical And Environmental Origin: A Study From Community of Assam, India”. BMC Research Notes, 14 (1), 58.
  • Melo, P.C, Ferreira, L.M, Filho, A.N, Zafalon, L.F, and Vicente, H.G. (2013). “Comparison of Methods for The Detection of Biofilm Formation By Staphylococcus Aureus İsolated From Bovine Subclinical Mastitis”. Brazilian Journal of Microbiology, 44 (1), 119-124.
  • Oliveira, D.C, and Lencastre, H. (2002). “Multiplex PCR Strategy for Rapid İdentification of Structural Types and Variants of The Mec Element in Methicillin-Resistant Staphylococcus Aureus”. Antimicrob Agents Chemother, 46 (7), 2155-2161.
  • Kluytmans, J.A, and Wertheım, H.F. (2005). “Nasal Carriage of Staphylococcus Aureus and Prevention of Nosocomial Infections”. Infection, 33 (1), 3-8.
  • Kampf, G, Adena, S, Rüden, H, and Weıst, K. (2003). “Inducibility and potential role of mecagene- positive oxacillin-susceptible staphylococcus aureus from colonized healthcare workers as a source for nosocomial ınfections”. Journal of Hospital Infection, 54 (2), 124-129.
  • Shopsin, B, Mathema, B, Martinez, J, Ha, E, and Campo, M.L. (2000). “Prevalance of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus Aureus in The Community”. The Journal of Infectious Diseases, 182 (1), 359-362.
  • Naz, H, Çevik, F.Ç. ve Aykın, N. (2006). “Nasal Staphylococcus Aureus Carriage in the Eskişehir Yunus Emre State Hospital Staff”. Ankem Journal, 20 (4), 141-144.
  • Demirdal, T, Demirtürk, N, and Altındiş, M. (2006). “Nasal Staphylococcus Aureus Carriage İn Hospital Staff”. Klimik Dergisi, 19 (1), 25-27.
  • Erdenizmenli, M, Yapar, N, Senger, S.S, Özdemir, S, and Yüce, A. (2004). “Investigation of Colonization with Methicillin-Resistant and Methicillin-Susceptible Staphylococcus Aureus in An Outpatient”. Population in Journal of Infectious Diseases, 59 (3), 195-196.
  • Kıllgore, G, and Tenover, F.C. (2006). “Prevalance of Staphylococcus Aureus Nasal Colonization in The United States, 2001-2002”. Journal of Infectious Diseases, 193 (2), 172-9.
  • Kuehnert, M.J, Kruszon-Moran, D, Hill, H.A, Mcquillan, G, and Mcallister, S.K. (2006). “Prevalance of Staphylococcus Aureus Nasal Colonization in The United States, 2001-2002”. Journal of Infectious Diseases, 193 (2), 172-9.
  • Kenner, J, O’connor, T, Piantanida, N, Fishbain, J, and Eberly, B. (2003). “Rates of Carriage of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus Aureus in An Outpatient Population”. Infection Control and Hospital Epidemiology, 24 (6), 439-444.
  • Oğuzkaya-Artan, M, Gülgün, M, Baykan, Z, and Tok, D. (2008). “Investıgatıon of Nasal Carrıage Rates and Antımicrobial Susceptıbılıty of Staphylococcus Aureus in Hospital Staff”. Turkish Journal of Infection, 22 (2), 87-90.
  • Mert, G, Kılıç, A, Bedir, O. ve Başustaoğlu, A.C. (2011). “Clinical signifi cance and staphylococcal cassette chromosome mec (SCCmec) characterization of coagulase-negative staphylococci isolated from blood cultures”. Turk J Med Sci, 41 (5), 859-865.
  • Çetinkaya, Ş.Y. (2000). “Epidemiology and control of methicillin-resistant Metisilin Direncli Staphlococcus aureus infetions”. Hastane Enfeksiyonları Dergisi, 4 (1), 205-217.
  • Soysal, A, Sahin, H, Yağcı, A, Barlan, I, and Bakir, M. (2006). “The Low Rate of Methicillin-Resistant Staphylococcus Aureus in Turkish Children”. Japanese Japanese Journal of Infectious Diseases, 57 (4), 172-175.
  • Elie-Turenne, M.C, Fernandes, H, Mediavilla, J.R, Rosenthal, M, and Mathema. (2010). “Prevalence and Characteristics of Staphylococcus Aureus Colonization Among Healthcare Professionals in An Urban Teaching Hospital”. Infect Control Hosp Epidemiol, 31 (6), 574-580.
  • Cesur, S, and Cokça, F. (2002). “Determination of Nasal Carriage Rates of Methicillin Resistant Staphylococcus Aureus in Hospital Personnel and in The Community”. Mikrobiyoloji Bülteni, 36 (3-4), 247-252.
  • Oliviera, D.C, Tomasz, A, and Lencastre, H. (2001). “The Evolution of Pandemic Clopnes of Methicillin-Resistant Staphylococcus Aureus: İdentification of Two Ancestral Genetic Backgraunds and The Associated Mec Elements”. Microb Drug Resist, 7 (4), 349-61.
  • Patel, M, Hoesley, C.J, Moser, S.A, Stamm, A.M, and Baddley, J.W. (2008). “Dissemination of Community-Associated Methicillin-Resistant Staphylococcus Aureus in A Tertiary Care Hospital”. Southern Medical Journal, 101 (3), 40-45.
  • Karapsias, S, Piperaki, E.T, Spiliopoulou, I, Katsanis, G, and Tseleni-Kotsovili, A. (2008). “Methicillin-Resistant Staphylococcus Aureus Nasal Carriage among Healthy Employees of The Hellenic Air Force”. Euro Surveillance, 13 (40), print online, ISSN: 1560-7917.
  • Shore, A, Rossey, A.S, Keane, C.T, Enright, M.C, and Coleman, D.C. (2005). “Seven Novel Variants of The Staphylococcal Chromosomal Casette Mec in Methicillin-Resistant Staphylococcus Sureus Isolates from Ireland”. Antimicrob Agents Chemother, 49 (5), 2070-2083.
  • Karahan, Z.C, Tekel, A, Adalet, R, Koyuncu, E, and Dolapcı, I. (2008). “Investigation of Panton-Valentine Leukocidin Genes and Sccmec Types in Clinical Staphylococcus Aureus Isolates from Turkey”. Microbial Drug Resistance, 14 (3), 203-221.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Araştırma Makaleleri
Yazarlar

Ceyda UZUN ŞAHİN (Sorumlu Yazar)
RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ
0000-0002-1392-7409
Türkiye


Kurtulus BURUK
KARADENİZ TEKNİK ÜNİVERSİTESİ
0000-0001-8497-5419
Türkiye

Destekleyen Kurum yok
Proje Numarası yok
Yayımlanma Tarihi 23 Eylül 2021
Yayınlandığı Sayı Yıl 2021, Cilt 10, Sayı 3

Kaynak Göster

Bibtex @araştırma makalesi { gumussagbil906615, journal = {Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi}, issn = {}, eissn = {2146-9954}, address = {}, publisher = {Gümüşhane Üniversitesi}, year = {2021}, volume = {10}, pages = {435 - 443}, doi = {10.37989/gumussagbil.906615}, title = {Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması}, key = {cite}, author = {Uzun Şahin, Ceyda and Buruk, Kurtulus} }
APA Uzun Şahin, C. & Buruk, K. (2021). Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması . Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi , 10 (3) , 435-443 . DOI: 10.37989/gumussagbil.906615
MLA Uzun Şahin, C. , Buruk, K. "Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması" . Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 10 (2021 ): 435-443 <https://dergipark.org.tr/tr/pub/gumussagbil/issue/65005/906615>
Chicago Uzun Şahin, C. , Buruk, K. "Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması". Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 10 (2021 ): 435-443
RIS TY - JOUR T1 - Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması AU - Ceyda Uzun Şahin , Kurtulus Buruk Y1 - 2021 PY - 2021 N1 - doi: 10.37989/gumussagbil.906615 DO - 10.37989/gumussagbil.906615 T2 - Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 435 EP - 443 VL - 10 IS - 3 SN - -2146-9954 M3 - doi: 10.37989/gumussagbil.906615 UR - https://doi.org/10.37989/gumussagbil.906615 Y2 - 2021 ER -
EndNote %0 Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması %A Ceyda Uzun Şahin , Kurtulus Buruk %T Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması %D 2021 %J Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi %P -2146-9954 %V 10 %N 3 %R doi: 10.37989/gumussagbil.906615 %U 10.37989/gumussagbil.906615
ISNAD Uzun Şahin, Ceyda , Buruk, Kurtulus . "Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması". Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 10 / 3 (Eylül 2021): 435-443 . https://doi.org/10.37989/gumussagbil.906615
AMA Uzun Şahin C. , Buruk K. Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2021; 10(3): 435-443.
Vancouver Uzun Şahin C. , Buruk K. Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2021; 10(3): 435-443.
IEEE C. Uzun Şahin ve K. Buruk , "Sağlık Çalışanlarında Nazal Metisiline Dirençli Staphylococcus Aureus (MRSA) Taşıyıcılığının Araştırılması", Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 10, sayı. 3, ss. 435-443, Eyl. 2021, doi:10.37989/gumussagbil.906615