Gıda çalışanlarından saptanan bağırsak parazitleri, izole edilen potansiyel patojenler ve patojenlerin antibiyotiklere duyarlılıkları

Yıl 2019, Cilt: 76 Sayı: 1, 31 - 40, 01.03.2019

Nebiye Yentur Doni Gülcan Gürses Mehmet Bayraktar Fadile Yildiz Zeyrek Zeynep Simsek

Öz

Amaç: Gıda ve su kaynaklı enfeksiyon hastalıkları, gelişmiş ve gelişmekte olan ülkelerde morbidite ve mortaliteye neden olan önemli bir halk sağlığı sorunudur. Gıda sektöründe görev yapan gıda çalışanları, kişisel hijyen eksikliği durumunda, Staphylococcus aureus, Streptocoocus pyogenes, enteropatojen bakterilerin ve bağırsak parazitlerinin sağlıklı insanlara bulaştırılmasında potansiyel enfeksiyon kaynağı olabilirler. Bu çalışmada, gıda çalışanlarında, bağırsak parazitlerinin saptanması; boğaz, burun, dışkıda bulunan patojen mikroorganizmaların ve bu mikroorganizmaların antibiyotiklere duyarlılıklarının araştırılması amaçlanmıştır.Yöntem: Bu çalışmaya, 2011 yılının Ekim ve Kasım aylarında, Harran Üniversitesi yemekhanesinde tam ve kısmi zamanlı çalışan toplam 62 kişi dahil edilmiştir. Potansiyel S. aureus ve S. pyogenes taşıyıcılığını araştırmak amacıyla burun ve boğaz sürüntü örnekleri alınmış ve incelenmiştir. Bakteri suşları, geleneksel biyokimyasal tekniklerle tanımlanmıştır. S. aureus olarak tanımlanan bakteri, Mueller-Hinton Agar besiyerine ekilmiş ve 37oC’de 24 saat inkübe edilmiştir. Staphylococcus aureus antimikrobiyal duyarlılık testi, Klinik ve Laboratuvar Standartları Enstitüsü’nün

Anahtar Kelimeler

Gıda çalışanı, bağırsak parazitleri, Staphylococcus aureus, MRSA, Streptococcus pyogenes, antibiyotik duyarlılık testi

Detection of intestinal parasites and isolation of potential pathogens and their susceptibility to antibiotics from food handlers

Öz

Objective: Foodborne and waterborne infection diseases are an important public health problem that leads morbidity and mortality in developed and developing countries. Food handlers with poor personal hygiene, working in food industries could be potential carrier sources of infec tions of Staphylococcus aureus, Streptococcus pyogenes, enteropathogenic bacteria and intestinal parasites regarding the transmission to healthy individuals. In this study it was aimed to determine the intestinal parasites, and to investigate pathogenic microoorganisms in nose, throat, stool and their susceptibility to antibiotics among foodhandlers.Methods: Foodborne and waterborne infection diseases are leading causes of mortality and morbidity is a major health problem in both developed and developing countries. Food handlers with poor personal hygiene, working in food industries could be potential carrier sources of infec tions of Staphylococcus aureus, Streptococcus pyogenes, enteropathogenic bacteria and intestinal parasites regarding the transmission to healthy individuals. This study was undertaken to determine the intestinal parasites; pathogen microoorganisms in nose, throat, stool and their susceptibility to antibiotics among foodhandlers.Results: The mean age of the participants was 28.0±1.3 range = 19-51 years , 25.8% female and 74.2% were male. Among 62 throat swab samples, 35.5% yielded Streptococcus pyogenes. of the 62 nasal swabs, 32.3% 20 were identified as Staphylococcus spp. Of the Staphylococcus spp. isolates, 8.1%, 4.8% and 19.4% of them were identifified as methicillinresistant S. aureus MRSA , methicillin-susceptible S. aureus and methicillin-sensitive coagulase-negative staphylococci, respectively. All of the 15 methicillinsusceptible staphylococci were susceptible to vancomycin, ampicillin/sulbactam, cefazolin, cefoxitin and cefotaxime; of the 15 methicillin-sensitive Staphylococcus spp. 40.0% of them were resistant to penicillin, 13.3% were resistant to erythromycin, 6.7% were resistant to clindamycin. Out of 62 stool specimens 95.1% were negative in terms of intestinal parasites, 3.2% were determined to have G. intestinalis. In one specimen 1.6% Entamoeba cyst was determined and confirmed as E. histolytica by using antigen test. None of the specimens were positive for Salmonella and Shigella spp.Conclusion: Regular periodic health examinations and controls should be performed to determine nasal carriage of S. aureus and throat carriage of S. pyogenes. Foodhandlers infected with S. aureus and S. pyogenes threatening food safety and public health, should be compulsorily allocated or excluded from the work and be treated immediately. They should be allowed to return to work only after having negative clinical laboratory examination and symptoms of the food borne disease have entirely resolved. Foodhandlers should be educated and trained about the personal hygiene, food hygiene and safety by the manager of food establishment

Anahtar Kelimeler

Food handler, intestinal parasites, Staphylococcus aureus, MRSA, Streptococcus pyogenes, antimicrobial susceptibility test

Kaynakça

• 1. WHO. Five keys to safer food manual. World Health Organization, Geneva/ Switzerland. 2006. http://apps.who.int/iris/ bitstream/10665/43546/1/9789241594639_eng. pdf.
• 2. CDC. Foodborne Illnesses and Germs. Atlanta/ USA. 2017. https://www.cdc.gov/foodsafety/ foodborne-germs.html.
• 3. Sezer Ç, Özgür Ç, Aksem A, Leyla V. Food handlers: a bridge in the journey of enterotoxigenic MRSA in food. Journal für Verbraucherschutz und Lebensmittelsicherheit. 2015; 10(2):123-9. doi:10.1007/s00003-015-0939-7.
• 4. Hacıbektaşoğlu A, Eyigün CP, Özsoy MF. Gıda elleyicilerinde burun ve boğaz portörlüğü. Mikrobiyol Bul. 1993; 27:62-70.
• 5. Castro A, Santos C, Meireles H, Silva J, Teixeira P. Food handlers as potential sources of dissemination of virulent strains of Staphylococcus aureus in the community. J Infect Public Health. 2016; 9(2):153- 60. doi:10.1016/j.jiph.2015.08.001.
• 6. Çepoğlu H, Vatansever L, Bilge Oral N. Gıda çalışanlarından İzole edilen stafilokokların enterotoksijenitelerinin ve bazı antibiyotiklere duyarlılıklarının araştırılması. Kafkas Univ Vet Fak Derg. 2009; 16 (Suppl-A): S1-S5. doi:10.9775/ kvfd.2009.744.
• 7. Bannerman TL, Peacock SJ. Staphylococcus, Micrococcus, and other catalase-positive cocci. In: Murray PR, Baron EJ, Jorgensen JH, et al., eds. Manual of Clinical Microbiology. Washington: ASM Press; 2007. p. 390-411.
• 8. Shimizu A, Fujita M, Igarashi H, Takagi M, Nagase N, Sasaki A, Kawano J. Characterization of Staphylococcus, Micrococcus coagulase type VII isolates from staphylococcal food poisoning outbreaks (1980-1995) in Tokyo, Japan, by pulsedfield gel electrophoresis. J Clin Microbiol. 2000; 38(10):3746-9.
• 9. Bennett SD, Walsh KA, Gould LH. Foodborne disease outbreaks caused by Bacillus cereus, Clostridium perfringens, and Staphylococcus aureus in United States, 1998-2008. Clin Infect Dis. 2013; 57(3):425-33. doi:10.1093/cid/cit244.
• 10. Wei HL, Chiou CS. Molecular subtyping of Staphylococcus aureus from an outbreak associated with a food handler. Epidemiol Infect. 2002; 128(1):15-20. doi:10.1017}S0950268801006355.
• 11. Ho J, O’Donoghue MM, Boost MV. Occupational exposure to raw meat: A newly-recognized risk factor for Staphylococcus aureus nasal colonization amongst food handlers. Int J Hyg Environ Health. 2014; 217(2-3):347-53. doi:10.1016/j.ijheh.2013.07.009.
• 12. El-Shenawy M, El-Hosseiny L, Tawfeek M, ElShenawy M, Baghdadi H, Saleh O, Manes J, Soriano JM. Nasal carriage of enterotoxigenic Staphylococcus aureus and risk factors among food handlers - Egypt. Food Public Health. 2013; 3:284-8.
• 13. Andargie G, Kassu A, Moges F, Tiruneh M, Huruy K. Prevalence of Bacteria and Intestinal Parasites among Food-handlers in Gondar Town, Northwest Ethiopia. J Health Popul Nutr. 2008; 26(4):451-5.
• 14. Assefa T, Tasew H, Wondafrash B, Beker J. Contamination of Bacteria and Associated Factors among Food Handlers Working in the Student Cafeterias of Jimma University Main Campus, Jimma, South West Ethiopia. Altern Integr Med. 2015; 4(185). doi:10.4172/2327-5162.1000185.
• 15. TSHGM. Portör Muayenelerine Esas Laboratuvar Tetkikleri Sayı:1059. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü, Ankara. 2005. http://www.isguvenligi.net/wp-content/ uploads/mevzuat/portor_muayenelerine_esas_ laboratuar_tetkikleri.pdf.
• 16. Resmi Gazete, 17 Aralık 2011, Sayı: 28145. http://www.resmigazete.gov.tr/ eskiler/2011/12/20111217-5.htm.
• 17. Resmi Gazete, Hiyen Eğitimi Yönetmeliği, 5 Temmuz 2013, Say: 28698. http://www. resmigazete.gov.tr/eskiler/2013/07/20130705-3. htm.
• 18. Özkan S, Aycan S, ultan N, Maral I. Gölbaşı’nda gıda sektöründe çalışanların periyodik esnaf muayenelerinin ve burun-boğaz taşıyıcılılarının değerlendirilmesi. Turk Hij Den Biyol Derg. 1999; 56(1):13-7.
• 19. Ören MM, Evciman A, Duman A, Önal AE, Özyıldırım, Öngen B, Boral Ö. Bir tıp fakültesİ hastanesinde gıda çalışanlarının periyodik sağlık taramalarının değerlendirilmesi. İstanbul Tıp Fakültesi Dergisi. 2014; 77 (4):51-4.
• 20. WHO. Health surveillance and management procedures for food-handling personnel : report of a WHO consultation World Health Organization, Geneva/Switzerland. 1989. http://apps.who.int/ iris/bitstream/10665/39610/1/WHO_TRS_785. pdf.
• 21. Hatakka M, Bjorkroth KJ, Asplund K, Maki-Petays N, Korkeala HJ. Genotypes and enterotoxicity of Staphylococcus aureus isolated from the hands and nasal cavities of flight-catering employees. J Food Prot. 2000; 63(11):1487-91.
• 22. Jorda GB, Marucci RS, Guida AM, Pires PS, Manfredi EA. [Carriage and characterization of Staphylococcus aureus in food handlers]. Rev Argent Microbiol. 2012; 44(2):101-4.
• 23. Al Bustan MA, Udo EE, Chugh TD. Nasal carriage of enterotoxin-producing Staphylococcus aureus among restaurant workers in Kuwait City. Epidemiol Infect. 1996; 116(3):319-22.
• 24. Acco M, Ferreira FS, Henriques JAP, Tondo EC. Identification of multiple strains of SStaphylococcus aureus colonizing nasal mucosa of food handlers. Food Microbiol. 2003; 20:489-93.
• 25. Noor-Azira AM, Mohammad-Faid AR, Shuhaimi M, Syafinaz AN, Hamat RA, Malina. Staphylococcus aureus in food and nares of food handlers in Kuala Pilah, Malaysia. Pertanika J Trop Agric Sci. 2012; 35(4):853-62.
• 26. Erdogan H, Arslan H. Nasal and Pharyngeal Carriage of Staphylococcus aureus among Hotel Staff and Risk Assessment. Klimik Dergisi/Klimik Journal. 2011; 24(2):90-3. doi:10.5152/kd.2011.21.
• 27. Gunduz T, Limoncu ME, Cumen S, Ari A, Etiz S, Tay Z. The prevalence of intestinal parasites and nasal Staphylococcus aureus carriage among food handlers. J Environ Health. 2008; 70(10):64-5.
• 28. Simsek Z, Koruk I, Copur AC, Gurses G. Prevalence of Staphylococcus aureus and intestinal parasites among food handlers in Sanliurfa, Southeastern Anatolia. J Public Health Manag Pract. 2009; 15(6):518-23.
• 29. Pala K, Özakın C, Akış N, Sınırtaş M, Gedikoğlu S, Aytekİn H. Asymptomatic carriage of bacteria in food workers in Nilüfer district, Bursa, Turkey. Turk J Med Sci. 2010; 40(1):133-9. doi:10.3906/ sag-0811-12.
• 30. Sepin Ozen N, Tuglu Ataman S, Seyman D, Aldag H, Emek M. Investigation of nasal Staphylococcus aureus carriage and methicilin resistantance rates with three different methods in food handlers working at Antalya. Turk Hij Den Biyol Derg. 2013; 70(2):51-8. doi:10.5505/TurkHijyen.2013.83702.
• 31. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement.CLSI document M100-S24. Clinical and Laboratory Standards Institute, Wayne, PA. 2014. http://www.gxccl.com/download/upload/CLSIM1 00S24%E8%8B%B1%E6%96%87%E7%89%88.pdf.
• 32. Daldal N, Aycan Ö, Atambay M, Pala M, Miman Ö. İnönü Üniversitesi Tıp Fakültesi mutfak personelinde bağırsak parazitlerinin görülme sıklığı. İnönü Üniversitesi Tıp Fakültesi Dergisi. 2004; 11(2).
• 33. Kurtoğlu MG, Körkoca H, Çiçek M, Taş Cengiz Z. Van yöresinde gıda sektörü çalışanlarında bağırsak parazitlerinin yaygınlığı. Turkiye Parazitol Derg. 2007; 31(4).
• 34. Yazıcı V, Sırıken F, Ertuğ S. Aydın il merkezindeki hastanelerde çalışan mutfak personelinde bağırsak parazitlerinin araştırılması. Turkiye Parazitol Derg. 2007; 31(2):136-8.