You are here

Sağlık Çalışanlarının Burunlarından İzole Edilen Koagülaz Pozitif ve Negatif Stafilokoklarda Metisilin Direnci ve Slime Pozitifliği

Methicillin Resistanc e and Slime Positivity of Coagulase Negative and Positive Staphylococci Isolated From Nares of Healthcare Workers

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Objectives: It was aimed to detect the prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus and Coagulase negative staphylococci (CoNS) of the healthcare personnel in our hospital and if any relation with slime production and methicillin resistance in these strains. Materials and Methods: Specimens for culture were collected from the anterior nares from healthcare personnel with sterile cotton swabs. The nasal swabs were cultured on 5% sheep blood agar plates and incubated at 37°C for 24-hour. Coagulase tests were performed for the strains identified with colony morphology and Gram staining. The susceptibilities of the isolates to oxacillin were determined by the disk diffusion method according to National Committee for Clinical Laboratory Standards. Slime production was investigated by Congo Red Agar plate method. Results: When thirty-seven (31.4%) of the isolated strains were S. aureus, and 35.1% of these were methicillin-resistant, methicillin resistance was 59.3% for CoNS (p=0.015). Slime positivity was 73% at S. aureus strains, and 65.4% for CoNS (p=0.4). It was detected a risk factor that studying at surgical departments (%23.1 vs. %76.9, r= 0.48, %95 CI: 0.196-0.768, p=0.002). Conclusion: The potential of slime production was observed higher at MR staphylococci. No methicillin resitancy was observed at slime produced species, but it was observed a high prevalence rate of MRSA carriage. Thus, it proposes that it needs to continuing education for hospital infection control and applicable and permanent solution for eradication of MRSA ©2005, Fırat Üniversitesi, Tıp Fakültesi
Abstract (Original Language): 
Amaç: Bu çalışmada, sağlık çalışanlarının burunlarında metisilin dirençli Staphylococcus aureus (MRSA) ve koagülaz negatif stafilokok taşıyıcılık oranı ve bu suşlarda metisilin direnci ile slime oluşumu arasında ilişki olup olmadığının irdelenmesi amaçlandı. Gereç ve Yöntem: Steril eküvyonlu çubuklarla 118 hastane çalışanının her iki burun mukozalarından alınan sürüntü kültürleri %5 koyun kanlı ağara ekilerek 35 °C'de 24 saat inkübe edildi. Koloni morfolojisi ve Gram boyama ile stafilokok olarak tanımlanan suşlar için koagülaz testi yapıldı. Metisilin direnci (oksasilin direnci) NCCLS önerilerine göre disk difüzyon yöntemi ile belirlendi. Slime oluşumu Kongo Red Agar plak yöntemiyle araştırıldı. Bulgular: İzole edilen suşların 37'si (%31,4) S. aureus ve bunların %35.1'i metisiline dirençli iken KNS suşlarında metisilin direnci %59.3 idi (p=0.015). S. aureus suşlarında slime pozitiflik oranı %73, KNS suşlarında %65.4 idi (p=0.4). Cerrahi kliniklerde çalışmanın MRSA taşıyıcılığı için bir risk faktörü olduğu saptandı (%23.1'e karşı %76.9, r= 0.48, %95 güvenilirlik aralığı: 0.196-0.768, p=0.002). Sonuç: Metisiline dirençli stafilokoklarda slime oluşturma potansiyeli oldukça yüksek oranda saptandı. Slime oluşturan suşlarda metisilin direncinde artış gözlenmedi ancak MRSA taşıyıcılık oranının oldukça yüksek düzeyde olduğu göz önüne alınırsa hastane infeksiyonlarının kontrolü için yapılan eğitimlerin sürekliliğine ve MRSA eradikasyonu için uygulanabilir ve kalıcı çözümlere ihtiyaç vardır. ©2005, Fırat Üniversitesi, Tıp Fakültesi
123-126

REFERENCES

References: 

1. Fluit AC, Schmitz FJ, European SENTRY Participant Group and J. Verhoef. Frequency of isolation of pathogens from bloodstream, nosocomial pneumonia, skin and soft tissue, and urinary tract infections occurring in European patients. Eur J Clin Microbio Infec Dis 200;20:188-191.
2. von Eiff C, Becker C, Machka K, Stammer H, Peters G. Nasal carriage as a source of Staphylococcus aureus bacteremia. N Engl J Med 2001;344:11-16.
3. Domenico P, Baldassari L, SchochPE, et al. Activities of bismuth thiols against Staphlococci and Staphlococcal biofihns. Antimicrob Agents Chemother 2001;45:1417-1421.
4. Archer GL, Climo MW. Antimicrobial susceptibility of coagulase-negative staphylococci. Antimicrob Agents Chemother 199438:2231-2237.
5. Kluytmans J, Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10: 505-520.
6. Shuter J, Hatcher VB, Lowy FD. 1996. Staphylococcus aureus binding to human nasal mucin. Infect Immun 64:310-318.
7. Arciola CR, Campoccia D, Gamberini S, Donati ME, Montanaro L. Presence of fibrinogen-binding adhesin gene in Staphylococcus epidermidis isolates from central venous catheters-associated and orthopaedic implant-associated infections. Biomaterials 2004;25:4825-9.
8. Costerton JW, Stewart PS. Greenberg, E.P. Bacterial biofilms: a common cause of persistent infections. Science 1999; 284: 1318¬22.
9. Boussard P, Pithsy A, Devleeschuwer MY. Relationship between slime production, antibiotic sensitivity and the phagetype of coagulase
-negative staphylococci. J Clin Pharm Ther 1993: 18:271.
10. Domingue G, Ellis B, Dasgupta M, Costerton JW. Testing antimicrobial susceptibilities of adherent bacteria by a method that incorporates guidelines of the National Committee for Clinical Laboratory Standards. J Clin Microbiol 1994;32, 2564-8
11. Brandt CM, Rouse MS, Tallan BM, Laue NW, Wilson WR, Steckelberg JM. Effective treatment or cephalosporin- rifampicin combinations against cryptic methicillin-resistant fi-lactamase-producing coagulase-negative staphylococcal experimental endocarditis. Antimicrob Agents Chemother 1995; 39, 1815-19.
12. Dunne WM, Mason EO, Kaplan SL. Diffusion of rifampicin and vancomycin through a Staphylococcus epidermidis biofilm. Antimicrob Agents Chemother 1993; 37, 2522-6.
13. Diaz-Mitoma F, Harding GKM, Hoban DJ, Roberts RS, Low DE. Clinical significance of a test for slime production in ventriculoperitoneal shunt infections caused by coagulase-negative staphylococci. J Infect Dis 1987;156:555-560.
14. Freeman DJ, Falkiner FR. Coagulase-negative staphylococci and continuous peritoneal ambulatory dialysis. Rev Med Microbiol 1991:2:98-104.
15. Kristinsson KG, Spencer RC, Brown CB. Clinical importance of production of slime by coagulase-negative staphylococci in chronic ambulatory peritoneal dialysis. J Clin Pathol 1986;39:117.
16. Nourizadeh E, Sultan N.
Koagülaz-negati
f stafilokoklarda slaym (slime) faktör yapımının çeşitli yöntemlerle gösterilmesi. İnfeksiyon Derg 1993;7:31.
17.
Ba
l Ç, Aydın MD, Ang Ö. Tıp personelinde stafilokok kolonizasyonu. İnfeksiyon Derg 1997;11:237.
18. Baussard P, Pithsy A, Devleeschovwer M J. Relationship between slime production, antibiotic sensitivity and the phagotype of coagulase-negative staphylococci. J Clin Pharm Ther 1993;18:271.
19. Chisena S, Marconato R, Cantoni G, Zappa M, Inzaghi A, Pasargiklian I, Mas Ranzi ML, Longo T. Importance of Staphylococcus epidermidis in the bacterial colonization of abdominal drains in surgical patients. Minerva Chir 1991;46:269.
20.
Elç
i S, Gül K, Öğel F, Suay A, Mete Ö. Koagülaz negatif stafilokoklarda slime oluşumunun ve antibiyotik direncinin saptanması. İnfeksiyon Derg 1996;10:203.
21. Amorena B, Gracia E, Monzon M, Leiva J, Oteiza C, Perez M, Alabart JL, Hernandez-Ya go J. Antibiotic susceptibility assay for Staphylococcus aureus in biofilms developed in vitro. J Antimicrob Chemother 1999;44:43-55.
22. Ammendolia MG, ROSA rd, Montanaro L. Arciola CR, Baldassari L. Slime production and expression of the slime-associated antigen by staphylococcal antigens. J Clin Microbiol 1999;37:3235-3238.
23. Eveillard M, Martin Y, Hidri N, Boussougant Y, Joly-Guillou ML. Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol 2004; 25: 114-20.
24. Cespedes C, Miller M, Quagliarello B, Vavagiakis P, Klein RS, Lowy FD. Differences between Staphylococcus aureus isolates from medical and nonmedical hospital personnel. J Clin Microbiol 2002;40: 2594-7.
25. Scudeller L, Leoncini O, Boni S, Navarra A, Rezzani A, Verdirosi S, Maserati R. MRSA carriage: the relationship between community and healthcare setting. A study in an Italian hospital. J Hosp Infect 2000; 46: 222-9.
26. Cesur S, Cokca F. Nasal carriage of methicillin-resistant Staphylococcus aureus among hospital staff and outpatients. Infect Control Hosp Epidemiol 2004; 25:169-71.

Thank you for copying data from http://www.arastirmax.com