Şerife Altun, Hatice Uludağ Altun, Çiğdem Ataman Hatipoğlu, Cemal Bulut, Sami Kınıklı, Ali Pekcan Demiröz

Daptomycin and Tigecycline Susceptibility of Vancomycin Resistant Enterococci Isolated from Rectal Swab Cultures

Amaç: Hastane ortamında kolay yayılımı, infeksiyonlarının tedavisinin zor ve mortalite oranlarının yüksek olması nedeni ile çoklu ilaca dirençli vankomisin dirençli enterokoklar (VRE) önemli organizmalardır. Bu çalışmanın amacı; yatan hastalardan alınan rektal sürüntü örneklerinden izole edilen VRE suşlarında in vitro daptomisin ve tigesiklin duyarlılığını belirlemektir.Yöntemler: Çalışmaya Ekim 2010- Şubat 2013 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesinde yatan hastaların rektal sürüntülerinden izole edilen 60 VRE suşu dahil edildi. Ankara Eğitim ve Araştırma hastanesi 600 yataklı 3. basamak bir araştırma hastanesidir. Daptomisin ve tigesiklin için minimum inhibitor konsantrasyon (MIK) değerleri E-test yöntemi (bioMerieux, Fransa) ile belirlendi.Bulgular: Tüm suşlar daptomisine duyarlı olup; üçü (%5) tigesikline dirençli saptandı. Daptomisin için MIK50 ve MIK90 değerleri sırasıyla 1.5 µgr/ml ve 2 µgr/ml saptanırken tigesiklin için 0.064 µg/ml ve 0.125 µg/ml olarak saptandı. Sonuç: Sonuç olarak; tüm suşlar daptomisine duyarlı saptandı. Diğer yandan VRE izolatlarında tigesiklin direnci %5 olarak saptandı. Klinisyenler enterokoklarda tigesiklin direncine karşı dikkatli olmalı ve tigesiklin MIK değerini yakından takip etmelidir

Anahtar Kelimeler:

VRE, daptomisin, tigesiklin, duyarlılık

Daptomycin and Tigecycline Susceptibility of Vancomycin Resistant Enterococci Isolated from Rectal Swab Cultures

Objective: Vancomycin resistant enterococci (VRE) are important healthcare associated multidrug resistant organisms because of their easily spread in the hospital environment, difficulty to cure and high mortality rate. The aim of this study was to evaluate in vitro activity of daptomycin and tigecycline against VRE strains isolated from rectal swab samples of hospitalized patients. Methods: Sixty non-duplicate VRE strains isolated from rectal swabs of hospitalized patients between October 2010 and February 2013 at Ankara Training and Research Hospital were included into the study. Ankara Training and Research Hospital in Ankara in Turkey is a 600 bed, tertiary care, teaching hospital. Minimum inhibitory concentration (MIC) values of daptomycin and tigecycline were determined by E-test method (bioMerieux, France). Results: All of the strains were susceptible to daptomycin, three of them (5%) were resistant to tigecycline. MIC50 and MIC90 values of daptomycin were 1.5 µg/ml and 2 µgr/ml, and of tigecycline were 0.64 µg/ml and 0.125 µg/ml, respectively. Conclusion: As a result; all of the strains were susceptible to daptomycin. On the other hand, resistance to tigecycline was exhibited by 5% of VRE isolates. Clinicians should be aware of the possibility of the emergence of tigecycline nonsusceptibility and should closely monitor tigecycline MICs of enterococci.

Keywords:

VRE, daptomycin, tigecycline, susceptibility,

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