Çeşitli Klinik Örneklerden İzole Edilen Enterokok Türlerinin Kliniklere Dağılımı

Öz

Amaç: Bu çalmann amac, Ocak 2006 -Temmuz 2007 tarihleri arasnda Türkiye Yüksek htisas Eitim ve Aratrma Hastanesi’nin çeitli bölümlerinde yatan hastalarn kan, idrar, yara, mayi safra, nazobilier dren veya perkütan transhepatik kolanjiogra dren mayileri ve santral venöz kateter gibi klinik örneklerinden izole edilen enterokok türlerinin saptanmas ve hangi türlerin hastanenin hangi bölümlerinde daha sk görüldüünün deerlendirilmesidir. Yöntem: Enterokok sularnn tanmlanmas klasik mikrobiyolojik yöntemlerin yan sra Microscan Walk Away 96 SI Dade Behring Inc, USA otomatize sistemi ile yaplmtr. Kateter ucu kültürleri Maki Yöntemi ile, kan kültürleri otomasyon sistemiyle BACTEC 9120, BD , idrar kültürleri ölçülü öze ile kantitatif olarak, dier kültürler ise klasik mikrobiyolojik yöntemlerle yaplmtr. Bulgular: zole edilen toplam 341 enterokok suunun 188 % 55.13 ’i Enterococcus faecium, 145 % 42.5 ’i Enterococcus faecalis, üçü % 0.87 Enterococcus casseli avus, ikisi % 0.58 Enterococcus avium, ikisi % 0.58 Enterococcus durans ve biri % 0.29 Enterococcus gallinarum olarak tanmlanmtr. Sularn klinik örneklere göre dalm incelendiinde, 109 % 31.96 ’unun idrar, 92 % 26.97 ’sinin yara, 67 % 19.64 ’sinin kan, 61 % 17.88 ’inin mayi ve 12 % 3.5 ’sinin kateter ucundan izole edildii belirlenmitir. Kardiyovasküler Cerrahi Klinii ile bu kliniin Youn Bakm ünitesinde % 63 E.faecalis saptanmtr. Gastroenteroloji Klinii ve Youn Bakm ünitesi % 76 ile Gastroenteroloji Cerrahisi ve Üroloji Cerrahisi klinikleri ortak Youn Bakm ünitesinde % 75 ise E. faecium daha sk olarak görülmütür. Sonuç: Çalmamzda literatürde bildirilenlerden farkl olarak, hastane izolat olan enterokoklar içerisinde E. faecium sular, E. faecalis sularna göre daha yüksek oranda bulunmutur.

Anahtar Kelimeler

• E. faecalis, E. faecium

Distribution to Clinics of Enterococci Species Isolated from Various Clinical Samples

Abstract

Objective: The aim of this study were to determine enterococcus species isolated from clinical samples like blood, urine, wound, bile and uids from nasobiliary drainage or percutaneous transhepatic cholangiography, and central venous catheter taken from the hospitalized patients in the various departments of Türkiye Yüksek htisas ve Training and Reseorch Hospital between January 2006 and July 2007 and to evaluate the isolation frequency of these species according the clinics of the hospital.Method: In addition to conventional microbiological methods, identi cation of enterococci species was performed by an automated system; MicroScan WalkAway 96 SI, Dade Behring Inc, USA . Intravenous catheter tip samples were cultured by Maki Method, blood cultures were performed by an automated system BACTEC 9120, BD , and urine cultures were performed quantitatively by calibrated loop method. Other samples were processed by conventional microbiologic methods.Results: Of the total of 341 enterococcus strains isolated, 188 were E. faecium 55.13 % , 145 were E. faecalis 42.52% , three were E. casseli avus 0.87% , two were E. avium 0.58 % , two were E .durans 0.58 % and one was E. gallinarum 0.29 % . As the distribution of the strains were evaluated according to the clinic samples, it was determined that 109 of the strains 31.96 % were isolated from urine, 92 26.97 % from wound, 67 19.64 % from blood, 61 17.88 % from bile or uids, and 12 3.5% from intravenous catheter tip samples. When the distribution was investigated among the clinics; the isolation frequency of E. faecalis was found to be 63 % 48/76 in Cardiovascular Clinic and its Intensive Care Unit, whereas E. faceium strains were isolated more frequently in Gastroenterology Clinic and in its Intensive Care Unit 76 % and in Gastoenterology and Urology Surgerys joint Intensive Care Unit 75 %, 48/64 .Conclusion: In our study, among all of the hospital isolates of enterococci, E. faecium strains were found more frequently than E. faecalis strains in contrast to the literature

Keywords

• E. faecalis, E. faecium

Kaynakça

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