Staphylococcus aureus’larda metisilin direnci ve enfeksiyonlar

Staphylocococus aureus, normal insan ve hayvan florasının bir bölümünü oluşturan gram pozitif bir bakteridir. Staphylococcus aureus izolatlarının en önemli habitatı insanlarda burun mukozası ve hayvanlarda deridir. S.aureus hayvanlarda mastitis, artritis, otitis, epidermitis ve üriner sistem enfeksiyonları gibi enfeksiyonlara neden olurken insanlarda hastane enfeksiyonları, gıda zehirlenmeleri, osteomyelitis, poliartritis, endokarditis, toksik şok sendromu, folikülitis, konjunktivitis, idrar yolları enfeksiyonları, pnömoni, haşlanmış deri sendromu (Scalded Skin Syndrome- SSS) gibi çok sayıda enfeksiyona neden olmaktadırlar. Hemen herkes hayatları süresince S.aureus enfeksiyonlarının bazı tiplerine sahip olmaktadırlar. Stafilokok enfeksiyonlarının tedavisinde stafilokok türleri arasındaki antibiyotiklere direnç yaygınlığı önemli bir sorundur. Yeni antibiyotiklerin klinik kullanıma girmesinden kısa bir süre sonra mikroorganizmanın direnç kazandığı, bununla birlikte penisilinin çok yaygın kullanılmasının sonucunda penisilini parçalayan stafilokok suşlarının ortaya çıktığı da bilinmektedir. Metisilin-dirençli Staphylococcus aureus (MRSA) tüm dünyada hastane enfeksiyonlarından en sık izole edilen “Çoğul antibiyotik Dirençli” mikroorganizmadır. MRSA izolatlarında çoklu direnç gün geçtikçe artmaktadır. Otuz yıldan daha uzun süre MRSA tedavisinde kullanılan vankomisine de bu günlerde direnç gelişmiştir. Derlememizde türlere göre MRSA epidemiyolojileri, MRSA virulens mekanizmaları, metisilin direnç mekanizmaları ve MRSA suşlarının tiplendirilmeleri hakkında bilgiler verilecektir.

Methicillin resistance in Staphylococcus aureus and infections

Staphylococcus aureus is a kind of gram positive bacteria, which builds a part of normal human and animal flora. The most important life space of S.aureus is human nasal mucosa and animal skin. S.aureus causes some infections like mastitis, arthritis, otitis, epidermitis and urinary system infections on animals. On the other hand, it causes many infections such as hospital infections, food poisoning, osteomyelitis, polyarthritis, endocarditis, Toxic Shock Syndrome (TSS), folliculitis, conjunctivitis, urinary infections, pneumonia, Scalded Skin Syndrome (SSS). Nearly everyone hosts some types of S.aureus infections throughout their lifespan. In the cure of Staphylococcus infections, resistance of antibiotics extence among Staphylococcus strains is an important problem. After a short period of starting to clinical use of new antibiotics, this microorganism gained resistance and because of the fact that peniciline is used widely too much, it is known that Staphylococcus strains, which can break peniciline, occured. Methicillin Resisted Staphylococcus aureus (MRSA) is mostly isolated from hospital infections “Multiple Resistant Antibiotic” microorganism in the whole world. Multiple resistence of MRSA isolates increases day by day. Even vancomycin which has been used in the cure of MRSA for more than 30 years gained resistance currently, too. In our composition, MRSA epidemiology, Sequencing of MRSA virulence mechanisms, methicillin resistant mechanisms and MRSA strains are going to be informed according to their species.

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  • Aanensen DM, Spratt BG, (2005). The multilocus sequence typing network: mlst.net. Nucleic Acids. Res. 33: 728-733.
  • Arbeit RD, (1999). Laboratory procedures for the epidemiologic analysis of microorganisms. In: Murray PM, Baron EJ, Pfaller MA, Tenover FC, Yolken RH. eds. Manual of clinical microbiology. Washington. ASM Press.
  • Ayliffe GA, (1997). The progressive intercontinental spread of methicillin resistant Staphylococcus aureus. Clin Infect Dis. 24, 74-79.
  • Birren Bruce, Lai Eric, (1993). Pulsed Field Gel Electrophoresis: A practical guide. San Diego, California: Academic Press Inc.
  • Birren BW, Lai E, (1993). Pulsed field gel electrophoresis: a practical guide. San Diego. Academic Press.
  • Boyle Vavra S, Ereshefsky B, Wang CC, (2005). Successful multiresistant community associated methicillin-resistant Staphylococcus aureus lineage from Taipei, Taiwan, that carries either the novel staphylococcal chromosome cassette mec (SCCmec) type V-T or SCCmec type IV. J Clin Microbiol. 43, 4719-4730.
  • Brigido MDM, Barardi CR, Bonjardin CA, (1991). Nucleotide sequence of a variant Protein A of Staphylococcus aureus suggests molecular heterogeneity among strains. J Basic Microbiol. 31, 337-345.
  • Chambers HF, (1997). Methicillin resistance in staphylococci: molecular and bio chemical basis and clinical implications. Clin Microbiol Rev. 10,781-91.
  • Cox HU, Newman SS, Roy AF, (1984). Species of Staphylococcus isolated from animals infections. Cornell Veterinarian. 74, 124-135.
  • Deurenberg RH, Vink C, Kalenic S, Friedrich AW, Bruggeman CA, Stobberingh EE, (2007). The molecular evolution of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect. 13, 222-235.
  • Enright MC, Day NP, Davies CE, Peacock SC, Spratt BG, (2000). Multilocus sequence typing for characterization of methicillinresistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol. 38, 1008-1015.
  • François P, Renzi G, Pittet D, (2004). A novel multiplex real-time PCR assay for rapid typing of major staphylococcal cassette chromosome mec elements. J Clin Microbiol. 42, 3309-3312.
  • Gortel K, Campbell KL, Kakoma I, (1999). Methicillin resistance among staphylococci isolated from dogs. Am J Vet Res. 60, 1526-1530.
  • Gür D, Topçu AW, Söyletir G, (2008). Bakterilerde antibiyotiklere karşı direnç infeksiyon hastalıkları ve mikrobiyolojisi. İstanbul Nobel Tıp Kitapevleri, s. 243-257.
  • Hanssen AM, Ericson Sollid JU, (2006). SCCmec in staphylococci: genes on the move. FEMS Immunol Med Microbiol. 46, 8-20.
  • Harmsen D, Claus H, Witte W, (2003). Typing of methicillin- resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management. J Clin Microbiol. 41, 5442- 5448.
  • Hiramatsu K, K Okuma, X X Ma, (2002). New trends in Staphylococcus aureus infections: glycopeptide resistance in hospital and methicillin resistance in the community. Curr Opin Infect Dis. 15, 407-413.
  • Hussain FM, Boyle-Vavra S, Daum RS, (2001). Communitiy-acquired methicillin-resistant Staphylococcus aureus colonization in healty children attending an outpatient pediatric clinic. Pediatr Infect Dis J. 20,763-767.
  • Ito T, Katayama Y, Asada K, (2001). Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 45, 1323-1336.
  • Ito T, Ma XX, Takeuchi F, (2004). Novel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrC. Antimicrobc Agents Chemother. 48, 2637-2651.
  • Ito T, Okuma K, Ma XX, (2003). Insights on antibiotic resistance of Staphylococcus aureus from its whole genome: genomic island SCC. Drug Resist Update. 6, 41-52.
  • Kaszanyitzky EJ, Janosi S, Egyed Z, (2003). Antibiotic resistance of staphylococci from humans, food and different animal species according to data of the Hungarian resistance monitoring system in 2001. Acta Vet Hung. 51, 451-64.
  • Katayama Y, Ito T, Hiramatsu K, (2000). A new class of genetic element, Staphylococcus cassette chromosome mec, encodes methicillin resistance in Staphylococcus aureus. Antimicrob Agents Chemother. 44, 1549-1555.
  • Kawano J, Shimizu A, Saitoh Y, (1996). Isolation of methicillin- resistant coagulase-negative staphylococci from chickens. J Clin Microbiol. 34, 2072-2077.
  • Kireçci E, Çolak A, (2002). Kuru dönem başlangıcında subklinik mastitisli ineklerden izole edilen stafilokok suşlarında metisilin direnci. Kafkas Üniv Vet Fak Derg. 8, 98-100.
  • Kurt D Reed, Mary E Stemper, Sanjay K Shukla, (2007). Pulsed-field gel electrophoresis of MRSA in methicillinresistant Staphylococcus aureus (MRSA) protocols ebook MRSA protocol. Yinduo Ji. 321,59-70.
  • Leonard FC, Markey BK, (2007). Meticillin-resistant Staphylococcus aureus in animals: a review. Vet. J. doi:10.1016/ j.tvjl.2006.11.008.
  • Lilenbaum W, Nunes EL, Azeredo MA, (1998). Prevalence and antimicrobial susceptibility of staphylococci isolated from the skin surface of clinically normal cats. Lett Appl Microbiol. 27, 224-28.
  • Ma XX, Ito T, Tiensasitorn C, (2002). Novel type of staphylococcal cassette chromosome mec identified in community- acquired methicillin-resistant Staphylococcus aureus strains. Antimicrob Agents Chemother. 46, 1147-1152.
  • Maiden MC, Bygraves JA, Feil E, Morelli G, Russell JE, Urwin R, Zhang Q, Zhou J, Zurth K, Caugant DA, Feavers IM, Achtman M, Spratt BG, (1998). Multilocus sequence typing: a portable approach to the identification of clones within populations of pathogenic microorganisms. Proc Natl Acad Sci USA. 95, 3140-3145.
  • Maira-Litran T, Kropec A, Goldmann D, Pier GB, (2004). Biologic properties and vaccine potential of the staphylococcal poly N-acetyl glucosamine surface polysaccharide. Vaccine. 22, 872-879.
  • Medleau L, Long RE, Brown J, (1986). Frequency and antimicrobial susceptibility of Staphylococcus species isolated from canine pyodermas. Am J Vet Res. 47, 229– 231.
  • Neeling AJ, Van Den Broek MJ, Spalburg EC, van Santen-Verheuvel MG, Dam-Deisz WDC, Boshuizen HC, van de Giessen AW, van Duijkeren E, Huijsdens XW, (2007). High prevalence of Methicillin resistant Staphylococcus aureus in pigs. Vet Microbiol. 22, 366-372.
  • Nunes SF, Bexiga R, Cavaco LM, (2007). Technial Note: Antimicrobial Susceptibility of Portuguese Isolates of Staphylococcus aureus and Staphylococcus epidermidis in Subclinical Bovine Mastitis. J Dairy Sci. 90, 3242-46.
  • Peacock SJ, (2005). Staphylococcus. Topley & Wilson’s Microbiology and Microbial Infections. 10th Ed. Hodder Arnold, London, United Kingdom, p. 771-832.
  • Ryden C, Yacoub AI, Maxe I, (1989). Specific binding of bone sialoprotein to Staphylococcus aureus isolated from patients with osteomyelitis. Eur J Biochem. 184, 331-336.
  • Schneewind O, Model P, Fischetti VA, (1992). Sorting of Protein A to the staphylococcal cell wall. Cell. 70, 267-281.
  • Shopsin B, Gomez M, Montgomery SO, (1999). Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. J Clin Microbiol. 37, 3556-63.
  • Soll DR, Lockhart SR, Pujol C, (2003). Laboratory procedures for the epidemiological analysis of microorganism. Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH. Eds. In Manual of Clinical Microbiology. ASM press, Washington. p.139-161.
  • Ugur A, Ceylan Ö, (2003). Occurrence of resistance to antibiotics, metals, in clinical strains of Staphylococcus aureus spp. Arch Medical Res. 34, 130-136.
  • Ünal S, Ulusoy S, Usluer G, (2004). Staphylococcus aureus Direnç mekanizmaları. Önemli gram pozitif bakteri enfeksiyonları. Ankara Bilimsel Tıp Yayınevi. s.23-38.
  • Weese JS, Archambault M, Willey BM, Dick H, Hearn P, Kreiswirth BN, (2005). Methicillin-resistant Staphylococcus aureus in Horses and Horse Personnel, 2000-2002. Emerg Infect Dis. 11, 430-435.
  • Weller TMA, (2000). Methicillin-resistant Staphylococcus aureus typing methods: wich should be the international standard? J Hosp Infect. 44, 160-172.
  • Zhang K, McClure JA, Elsayed S, (2005). Novel multiplex PCR assay for characterization and concomitant subtyping of staphylococcal cassette choromosome mec types I to V in methicillinresistant Staphylococcus aureus. J Clin Microbiol. 43, 5026-5033.