Süleyman DURMAZ, Asli KİRAZ, Turkan Toka ÖZER, Duygu PERCİN

Macrolide-lincosamide-streptogramin B Resistance Phenotypes in Staphylococcus aureus

Staphylococcus aureus toplum ve hastane kaynaklı infeksiyonlarda en sık izole edilen etkenlerdendir. Makrolid-linkozamidstreptogramin B (MLSB) grubu antibiyotikler sıklıkla tercih edilmektedir. Bu çalışmada MLSB grubu antibiyotiklere S. aureus suşlarında görülen direnç fenotiplerinin belirlenmesi amaçlanmıştır. Çalışmaya toplam 182 S. aureus suşu dahil edildi. Suşların metisilin direnci sefoksitin (30µg) diski kullanılarak, MLSB direnç fenotipleri disk yakınlaştırma yöntemi ile eritromisin (15µg) ve klindamisin (2µg) diskleri kullanılarak Clinical and Laboratory Standards Institute (CLSI) önerileri doğrultusunda değerlendirildi. Çalışmaya alınan suşların 38’i (%20.9) metisiline dirençli S. aureus (MRSA), 144’ü (%79.1) metisiline duyarlı S. aureus (MSSA) olarak tespit edilmiştir. Tüm suşların 65’inde (%35.7) MLSB direnci bulunmuştur. MRSA suşlarında MLSB direnci % 84 iken, MSSA suşlarında %23 olarak tespit edilmiş ve bu değerler istatistiksel olarak anlamlı bulunmuştur. MRSA suşlarında yapısal MLSB (%71), MSSA suşlarında ise indüklenebilir MLSB(%16.5)direnci daha fazla bulunmuştur. İndüklenebilir MLSB direncinin azımsanmayacak oranlarda görülmesi nedeni ile mikrobiyoloji laboratuvarlarında D test yönteminin rutin olarak antibiyotik duyarlılık testlerinde kullanılması ve direnç fenotiplerinin belirlenmesinin tedavi başarısızlıklarını önlemede önemli ve doğru bir yaklaşım olduğunu düşündürmüştür

Anahtar Kelimeler:

Staphylococcus aureus, MLSB direnci, D test, metisilin direnci

Macrolide-lincosamide-streptogramin B Resistance Phenotypes in Staphylococcus aureus

Staphylococcus aureus is one of the most frequently isolated pathogens in community and hospital-acquired infections. Macrolide-lincosamide-streptogramin B (MLSB) group antibiotics have frequently been preferred. In this study, it was aimed to determine MLSB group antibiotics resistance phenotypes observed in S. aureus strains. A total of 182 S. aureus strains were included in the study. Methicillin resistance was assessed using the cefoxitin (30μg) disc, MLSB resistance phenotypes were assessed using D zone test with erythromycin (15μg) and clindamycin (2μg) discs according to the Clinical and Laboratory Standards Institute (CLSI) recommendations. Of the strains included in the study, 38 (20.9%) methicillin-resistant S.aureus (MRSA) and 144 (79.1%) methicillin-susceptible S.aureus (MSSA) were identified. MLSB resistance phenotype was found in 65 (35.7%) strains. MLSB resistance was found 84% in MRSA strains and 23% in MSSA strains: There was statistically significant between MRSA and MSSA strains. Constitutional MLSB resistance was found higher in MRSA strains (71%) and however, in MSSA strains was higher inducibleMLSB resistance (16.5%). It is suggested that, using the D test method in routine antibiotic susceptibility testing and determining resistance phenotypes in microbiology laboratories is the right approach and may play an important role in the prevention of treatment failure according to the substantial proportion of inducible resistance MLSB resistance observed.

Keywords:

Staphylococcus aureus, MLSB resistance, D test, methicillin resistance,

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