YAŞAR NAKİPOĞLU, Handan KATRANCI, Atahan ÇAĞATAY, Şengül DERBENTLİ

İstanbul Tıp Fakültesi'nde çeşitli örneklerden izole edilen Stafilokok suşlarında glikopeptit direncinin araştırılması

Stafilokoklarda vankomisine direnç sınırı MİK $geq$ 32 mg/L'dir. Vankomisinin MİK'u 8-16 mg/L olan suşlar, vankomisine azalmış duyarlı veya vankomisine prta duyarlı Staphylococcus aureus (VISA) olarak tanımlanır. Bu özelliği gösteren suşların sayısı bugün için oldukça azdır. Ancak klinik önem taşıdıkları, örneğin vankomisin tedavisinden sonra nüksler gelişebildiği ve bakteremi olgularının ölümle sonlandığı bildirilmektedir.Bu çalışmada çeşitli klinik örneklerden izole edilen 135 stafllokok (81 Staphylococcus aureus ve 54 koagülaz negatif stafllokok) susunda glikopeptit direnci araştırılmıştır. Bu amaçla ağar tarama yöntemi uygulanmıştır. Bazı hücreleri vankomisinli besiyerlerinde ttreyen orijinal suşlar populasyon analizi yöntemi ile incelenerek, glikopeptitlere heterodirenç sıklığı hesaplanmıştır. Sonuç olarak; çalışmamızda VISA ve hVISA suşlarına rastlanmamış, bir (% 1.2) S/mreus suşunda'teikoplanin direnci (MİK32 mg/L) ve yedi (% 13) koagülaz negatif stafilokok susunda vankomisin (MİK 5-8 mg/L) ve teikoplanine (MİK 32-64 mg/L) heterojen direnç belirlenmiş ve bu suşlardaki heterodirenç sıklığının 10^-6 -10^-7 olduğu saptanmıştır.

Anahtar Kelimeler:

Glikopeptidler, Staphylococcus, Vankomisin, Teikoplanin

An investigation of glycopeptide resistance in the Staphylococcus strains isolated from various specimens in İstanbul Faculty of Medicine

The vancomycin resistance criteria for staphylococd is MIC $geq$32 mg/L. Strains with 8-16 mg/L vancomycin MIC are defined as strains with reduced susceptibility to vancomycin or vancomycin intermediate Staphylococcus aureus (VISA). Today, the number of strains that display this feature are very few. However, some cases have been reported to show their clinical significance such as relapses that followed vancomycin treatment and bacteremia which ended with death. In this study, glycopeptide resistance were investigated in 135 strains (81 Staphylococcus aureus and 54 coagulase negative staphylococd) which were isolated from various clinical specimens. For this aim agar screeen method has been applied. The results showed no VISA or hVISA presence, but one (1.2 %) S.aureus was found to be resistant to teicoplanin (MIC 32 mg/L) and seven (13 %) coagulase negative staphylococd were determined to be heteroresistant to vancomycin (MIC 5-8 mg/L) and teicoplanin (MIC 32-64 mg/L) with the frequency of 10^-6-10^-7.

Keywords:

Glycopeptides, Staphylococcus, Vancomycin, Teicoplanin,

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