Osman ÇAĞLAYAN, Ünase BÜYÜKKOÇAK, J. Sedef GÖÇMEN

Parenteral nutrisyon sıvılarının koagülaz-negatif stafilokok’ların biyofilm oluşturması üzerine etkisi: Deneysel bir çalışma

Amaç: Çalışmamızda yoğun bakım ünitelerinde (YBÜ)kullanılan parenteral nütrisyon (PN) solüsyonlarının koagülaz negatif stafilokok (KNS)’larda biyofilm oluşumuna etkisi araştırılmıştır.Gereç ve yöntem: Deneyde kan kültürlerden izole edilmiş olan 39 KNS ve ATCC 12228 kodlu referans Staphylococcus epidermidis suşları kullanıldı. Bakteri dilüsyonları için Triptik Soy Buyyon (TSB) besiyeri kullanıldı. Deney ortamları: 1. Glikoz, 2. Amino asit, 3. Lipit, 4. Üçlü karışım (Glikoz, Amino asit, Lipit), 5. Glikoz ve Amino asit, 6. Glikoz ve Lipit, 7. Amino asit ve Lipit, 8. Kontrol (TSB) şeklinde hazırlandı. Biyofilm oluşumu “Kantitatif mikrodilüsyon plak testi” yöntemi ile belirlendi. Yapılan değerlendirmede sınır değerin üzerinde olanlar biyofilm pozitif, altında olanlar ise negatif kabul edildi. Biyofilmi pozitif olanlar da kendi aralarında hafif, orta ve şiddetli olmak üzere 3 gruba ayrıldı. PN solüsyonu içeren 1’den 7’ye deney ortamlarında elde edilen biyofilm pozitif suş sayıları TSB ortamında elde edilenlerle ve birbirleriyle karşılaştırıldı. Bulgular: Üçlü karışım PN sıvısı ile ikili karışım PN sıvılarının (glikoz+lipit, amino asit+lipit karışımlarının) kontrol grubuna göre KNS’ların biyofilm oluşumunu arttırıcı etkilerinin olduğu belirlendi. Biyofilm pozitifliği ortam 1 ve 2’de kontrole göre anlamlı düşükken, 4, 6 ve 7’de anlamlı yüksekti. Ortam 1, 2 ve 3 kendi aralarında; 4, 5, 6 ve 7 de kendi aralarında farksız sonuçlar verdiler. Sonuç: Çalışmamızda PN yapı taşlarından olan glikoz, amino asit ve lipit çözeltilerinin tek başlarına biyofilm oluşumunu azaltıcı, bunların karışımlarının ise artırıcı etkili oldukları tespit edilmiştir. Bu nedenle rutinde üçlü karışım olarak verilen PN solusyonlarının kateter enfeksiyonu riskini arttırdığını söyleyebiliriz.

Effect of parenteral nutrition solutions on biofilm formation of coagulase-negative Staphylococci: An experimental study

Objectives: In our study we investigated the effects of parenteral nutrition (PN) solutions on Coagulase negative staphylococci (CoNS) biofilm production. Materials and methods: Thirty nine CoNS strains isolated from hemocultures and a reference strain (ATCC 12228 Staphylococcus epidermidis) were included. Bacterial dilutions were made in Tryptic Soy Broth (TSB). The experimental mediums were 1. Glucose, 2. Amino acid, 3. Lipid, 4. Glucose+ Amino acid+ lipid, 5. Glucose+ Amino acid, 6. Glucose+ Lipid, 7. Amino acid+ Lipid, and 8. Control (TSB). Biofilm formation was evaluated by “quantitative microdilution plaque test”. The values greater than cut off value are considered as positive. Biofilm positivity was divided into 3 groups (mild, moderate and intensive) and all other strains under cutoff value were accepted as negative. The numbers of biofilm positive strains derived from 1-7. mediums were compared with each other, and with the results of control. Results: The three-component PN solution and two component PN solutions containing glucose+ lipid and amino acid+ lipid were found to increase the biofilm production activity of CoNS when compared to the control group. Slime positivity in medium 1 and 2 was lower than con- trol significantly, in medium 4, 6, and 7 slime positivity was higher considerably. The indifferent results were obtained within the mediums 1, 2, 3 and within the mediums 4, 5, 6, and 7. Conclusions: In our study, it was found that, glucose, amino acid and lipid solutions which were building structures of PN decreased the biofilm production when used solitary. However use of the compounds increased the biofilm production. Therefore, we can conclude that PN solutions given as mixtures in routine practice increase the risk of catheter infection. J Clin Exp Invest 2012; 3(4): 505-509

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