Ali Korhan SIĞ, Alev ÇETİN DURAN, Tuğba KULA ATİK, Nermin ÖZEN, Onur IRMAK, Muradiye YARAR

Klinik örneklerden izole edilen Staphylococcus aureus izolatlarının sıklığı ve antibiyotik duyarlılık sonuçlarının değerlendirilmesi: Üç Yıllık Veri

Amaç: Stafilokoklar hem toplum hem de hastane kaynaklı enfeksiyonlara neden olabilmektedir ve Staphylococcus aureus bu cinste en başta gelmektedir. Son yıllarda, metisilin dirençli S.aureus (MRSA), vankomisine orta düzeyde duyarlı S.aureus (VISA) ve vankomisine dirençli S.aureus (VRSA) suşları ciddi bir sorun olarak ortaya çıkmışlardır. Diğer antibiyotiklere karşı artan direnç de ayrı bir sorundur. Bu çalışmadaki amaç, üçüncü basamak bir hastanede çeşitli klinik örneklerden izole edilen S.aureus suşlarının sıklığını ve antibiyotik duyarlılıklarını araştırmaktır. Yöntem: Çeşitli klinik örneklerin (üriner sistem, solunum, yara, apse, doku, katater ucu ve dış kulak yolu) Ocak 2017'den Aralık 2019'a kadar XXX hastanesindeki kültürleri çalışmaya dahil edilmiştir. Üremiş S.aureus suşları ve antibiyotik duyarlılıkları geriye dönük araştırılmıştır. Bulgular: Toplamda 765 S.aureus suşu izole edilmiştir ve bunların 165 tanesi metisilin dirençlidir (MRSA; %21.9). Yıllara göre MRSA oranları arasında istatistiksel fark bulunamamıştır (p=0.772). Vankomisin, teikoplanin ya da linezolid e dirençli bir suşa rastlanmamıştır. En yüksek direnç oranı penisilinlere karşı bulunmuştur (n=646/728, %88.7). Üç yıllık dönemde antibiyotik direncinde hiçbir antibiyotik için anlamlı fark gözlenmemiştir. Sonuç: UAMDSS verilerine göre azalan MRSA oranları gözlensede, CAESAR raporu Türkiye'nin daha mücadelenin başında olduğuna işaret etmektedir. Yerel ve/veya ulusal antimikrobiyal yönetimi programları Türkiye'de de aktiftir, ancak daha sert ve geniş önlemlere ihtiyaç vardır.

Anahtar Kelimeler:

stafilokoklar, metisilin, MRSA, EUCAST, CLSI

Distribution of Clinical Staphylococccus aureus Isolates and Antibiotic Resistance Profile: Three-Year Data

Objective: Staphylococci cause community-acquired and hospital-acquired infections, and Staphylococcus aureus is one of leading agents. In the last decades methicillin-resistant S.aureus (MRSA), vancomycin-intermediate S.aureus (VISA) and vancomycin-resistant S.aureus (VRSA) became as major concerns. Resistance to other antibiotics is also another growing issue. The aim of this study was to investigate the prevalence of S.aureus species and to evaluate susceptibilities to antimicrobial agents in a state (tertiary) hospital. Methods: Clinical cultures from various samples (urinary tract, respiratory, wound, abscess, tissue, catheter and external auditory) obtained from January 2017 to December 2019 in XXX hospital were included in the study. Isolated S.aureus strains and their antibiotic susceptibilities were retrospectively evaluated. Results: A total of 765 S.aureus strains were isolated. 165 S.aureus strains were found as methicillin resistant (MRSA; 21.9%). There was not any statistically significant difference in MRSA rates among evaluated years (p=0.772). There was not any strain that was resistant to vancomycin, teicoplanin and/or linezolid. The highest rate was observed in penicillin resistance (n=646/728, 88.7%). There was not any statistically significant alteration in the resistance rates of all tested antibiotics during the three-year period. Conclusions: Despite dwindling MRSA rates in UAMDSS, CAESAR report indicates that Turkey seems to be in the beginning phase of this struggle. Local and/or national antimicrobial stewardship programs are in effect in Turkey, but further measures are required.

Keywords:

staphylococci, methicillin, MRSA, EUCAST, CLSI,

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