Ortopetik Cerrahi Yaralardaki Staphylococcus aureus İzolatlarında Slime Üretiminin Genotipik ve Fenotipik Olarak Araştırılması

Bu çalışmada, Mardin Devlet Hastanesi Ortopedi Servisinde yatan ve implant takılı toplam 180 hastanın yara yerlerinden alınan örneklerin 125’inde Staphylococus aureus suşu izole edilirken, 62’sinde ise Staphylococus epidermitis suşu izole edilmiştir. Bu izolatlarda Multiplex PCR ile slime üretiminden sorumlu icA ve icD genlerinin varlığı, Kongo red agar (CRA), standart test tüp (ST) ve mikropleyt (MP) gibi fenotipik yöntemlerle slime üretimleri, disk difüzyon agar ile suşların antibiyotik dirençlerine bakılarak slime (biyofilm) tabakasının direnç mekanizmasındaki rolünün saptanması amaçlanmıştır. İncelenen stafilokok suşlarının CRA, MP ve ST testleri ile slime üretimi sırasıyla %62.4, %57,7 ve %52.9 oranında pozitif bulunurken icA ve icD gen pozitifliği ise %65,6 (82/125) bulunmuştur. İncelenen tüm stafilokoklar ise teikoplanine ile vankomisin antibiyotiklerine karşı duyarlı oldukları belirlendi. Antibiyotiklere karşı direnç oranlarının slime pozitif suşlarında slime negatif suşlara göre daha yüksek olduğu görülürken, sadece penisilin, ampisilin ve eritromisine dirençlilik oranları istatistiksel olarak anlamlı bulundu. Sonuç olarak, icA ve icD genleri bakımından pozitif olan suşlarda antibiyotiklere dirençlilik oranları anlamlı bulundu.

Anahtar Kelimeler:

Staphylococcus, slime, PCR, kongo red, enfeksiyon

Genotypic and Phenotypic Investigation of Slime Production in Staphylococcus aureus Isolates in Orthopedic Surgical Wounds

In this study, Staphylococus aureus strain was isolated in 125 of the samples of 180 patients’wounds who were hospitalized in Mardin State Hospital Orthopedic Service and implanted, while Staphylococus epidermitis strain was isolated in 62 of them. In these isolates, it was aimed to determine the presence of ica A and ica D genes responsible for slime production by Multiplex PCR, to determine slime production by phenotypic methods such as Congo red agar (CRA), standard test tube (ST) and microplate (MP) and to determine the role of the slime (biofilm) layer in the resistance mechanism by looking at the antibiotic resistance of the strains with disc diffusion agar. While the CRA, MP and ST tests of the staphylococcus strains examined were found to be respectively 62.4%, 57.7% and 52.9% positive, the ica A and ica D gene positivity was 65.6% (82/125). It was determined that all staphylococci examined were sensitive to teicoplanin and vancomycin antibiotics. While antibiotic resistance rates were higher in slime positive strains than slime negative strains, only penicillin, ampicillin and erythromycin resistance rates were found statistically significant. As a result, resistance to antibiotics was found to be significant in strains positive with regard to ica A and ica D genes.

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