Huzurevi Sakinlerinde Nazal Staphylococcus Kolonizasyonu ve Antibiyotik Direnç Profilleri

Cansu ÖNLEN GÜNERİ; Pınar DÖNER GÜNER; Özkan ASLANTAŞ

doi:10.4274/mjima.galenos.2022.2022.44

Huzurevi Sakinlerinde Nazal Staphylococcus Kolonizasyonu ve Antibiyotik Direnç Profilleri

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Huzurevi Sakinlerinde Nazal Staphylococcus Kolonizasyonu ve Antibiyotik Direnç Profilleri

Mediterr J Infect Microb Antimicrob 2022;11:44-44 DOI: 10.4274/mjima.galenos.2022.2022.44

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Giriş: Stafilokoklar, birçok antibiyotiğe dirençli mikroorganizmalardır. Staphylococcus epidermidis, son zamanlarda nozokomiyal bir patojen olarak ortaya çıkan ve dünya çapında sorun haline gelen bir normal flora bakterisidir. Bu çalışmanın amacı, huzurevi sakinlerinde koagülaz negatif stafilokoklar ve Staphylococcus aureus’un nazal taşıyıcılık prevalansını ve bu bakterilerin antibiyotik direncini belirlemekti.

Gereç ve Yöntem: Bu çalışma Temmuz 2017’de yapıldı. Katılımcıların burun mukozasından alınan 46 örneğin kültürü yapıldı. Tür tanımlaması MALDI-TOF-MS ile yapıldı. İzolatların antibiyotik duyarlılığını belirlemek için disk difüzyon testi uygulandı ve bilinen antimikrobiyal direnç genlerini belirlemek için polimeraz zincir reaksiyon yöntemi kullanıldı.

Bulgular: Kırkaltı katılımcının 28’inden (%61) stafilokok izole edildi. İzolatlar (n=29) S. epidermidis (n=22), Staphylococcus succinus (n=4) ve S. aureus (n=3) idi. Bir katılımcıdan iki farklı S. epidermidis suşu izole edildi. İzolatlarda, metisiline dirençli S. aureus izole edilmezken; %43’ünde (n=12) metisiline dirençli S. epidermidis (MRSE) bulundu. S. epidermidis suşlarının %68’i çok ilaca (β-laktamlar dışındaki üç veya daha fazla antimikrobiyal gruptaki en az bir ajana) dirençliydi. Tüm MRSE izolatları mecA pozitifti. MRSE izolatları (n=12) arasında blaZ (n=5), lnuA (n=1), tetK (n=1), ermA (n=1), aac(6’)/aph(2’’) (n=1) ve ant(4’ )-la (n=1) direnç genleri bulundu.

Sonuç: Bildiğimiz kadarıyla, bu araştırmayla Türkiye’de ilk kez huzurevinde yaşayanlarda çok ilaca dirençli MRSE tespit edilmiştir. Sonuçlarımız, S.epidermidis’in nazal mukozada kalıcı kolonizasyon yoluyla bir ilaç direnci rezervuarı görevi görebileceğini düşündürmektedir. Bu dirençli hastane patojeninin yayılması moleküler sürveyans yoluyla gözlemlenmeli ve sınırlandırılmalıdır.

Anahtar Kelimeler: Huzurevi, PCR, Staphylococcus epidermidis, nazal flora

Kaynakça

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