Gram Pozitif Bakteriyel Sepsis Etkenlerinin Hızlı Genotip Test ile Tanımlanması

Abstract

Amaç: Sistemik bir enfeksiyon sepsise neden olduğunda geri dönüşü olmayan bir süreç başlamaktadır. Bu nedenle sepsisteki etken bakterinin ve antibiyotik direncinin hızlı bir şekilde tanımlanması çok önemlidir. Bu çalışmada, sepsis etkeni Gram pozitif bakterileri ve önemli antibiyotik dirençlerini saptamada hızlı genotip testinin etkinliğinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Laboratuvara 2018-2019 yılları arasında gönderilen 2132 kan kültürü örneği otomatik kan kültürü sistemi (BACTEC, BD, ABD) ile incelenmiştir. Üreyen bakteriler VİTEK (bioMérieux,Fransa) otomatize bakteri identifikasyon/antibiyotik duyarlılık sistemi ile tanımlanmıştır. Ayrıca Gram pozitif bakteri üremesi olan kan kültürlerindeki bakteri türleri ve mecA, vanA, vanB, vanC1, vanC2 / C3 genleri “Genotype® BC Gram-pozitif (Hain Lifesience, Almanya)” testi ile de belirlenmiştir. Bulgular: İki veya daha fazla kan kültürü şişesinde Gram pozitif bakteri üremesi saptanan 72 hasta çalışmaya dahil edildi. Örneklerin 44'ünde (% 61) konvansiyonel yöntemle (bakteri kültürü) ve BC Gram pozitif testi ile aynı bakteri türü tespit edildi. Örneklerin 28'inde (% 39) bakteri tür adı veya vankomisin / metisilin direnç oranı ile ilgili yöntemlerin sonuçları arasında farklılıklar tespit edildi. Tüm örneklerde kültür yöntemi ile tek etken izole edilmesine rağmen hızlı genotip testi ile sekiz örnekte birden fazla etken tespit edildi. Ayrıca mecA pozitif örneklerde siprofloksasin direncinin mecA negatiflere göre daha yüksek olduğu bulundu. Sonuç: Çalışmada BC Gram pozitif testinin, sepsis etkeni bakterileri ve direnç genlerini 4-5 saat içinde doğru bir şekilde belirleyebildiği görülmüştür.

Keywords

• İlaç direnci
• PCR
• Hızlı test
• Sepsis
• Stafilokok

Identification of the Gram Positive Bacterial Sepsis Agent with Rapid Genotype Test

Abstract

Objective: An irreversible process begins when a systemic infection causes sepsis. Therefore, rapid identification of the agent bacteria in sepsis and its antibiotic resistance is crucially important. In this study, it was aimed to investigate the efficiency of rapid genotype test. Methods: Blood culture bottles sent to the laboratory were examined with an automatic blood culture system (BACTEC, BD, USA). Growing bacteria was identificated by VİTEK (bioMérieux, France) automated bacteria identification / antibiotic susceptibility system. In addition, bacterial species and mecA, vanA, vanB, vanC1, vanC2 / C3 genes in blood cultures with Gram positive bacterial growth were also determined by the "Genotype® BC Gram-positive (Hain Lifesience, Germany)" test. Results: 72 patients with gram-positive bacteria growth in two or more blood culture bottles were included in the study. In 44 of the samples (61%) the same bacterial species were detected with conventional method (bacteria culture) and BC Gram positive test. In 28 of the samples (39%) differences were detected between results of methods regarding bacterial species name or vancomycin/methicillin resistance rate. Although single agent was isolated with culture method in all of the samples, multiple agents were detected in eight samples with rapid genotype test. Also, it was found that in mecA positive samples, ciprofloxacin resistance was higher than mecA negative ones. Conclusion: In the study, it was observed that BC Gram positive test could correctly identify sepsis agent bacteria and their resistance genes within 4-5 hours.

Keywords

• Drug resistance
• PCR
• Rapid test
• Sepsis
• Staphylococci

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