Sadık AKGÜN, Hakan Sezgin SAYİNER

Metisiline dirençli Staphylococcus aureus'u tespit etmek için bir tanı aracı olarak multipleks PCR kullanılması

Amaç: Bu çalışmanın amacı, yoğun bakım ünitesi (YBÜ) hastalarında izole edilen, metisiline dirençli Staphylococcus aureus (MRSA) için tanısal test ve temas izolasyon stratejilerine ek olarak etkinliği araştırarak, MRSA raporlarını klinisyene daha hızlı bir şekilde iletmek ve tedavideki gecikmeleri önlemekti.Yöntemler: Çalışmaya, 2015 ve 2017 yılları arasında, hastaneye yatırılmış YBÜ hastalarından alınan kültür örneklerinden izole edilen ve koagülaz pozitif olarak tanımlanan 320 Staphylococcus aureus suşu dahil edildi. Yara sürüntüleri alındı ve bakteri kültür işlemleri yapılarak, antibiyotik duyarlılık testi ve identifikasyon işlemleri için değerlendirildi. Swablardan alınan bu kültürler arasında MRSA olarak tanımlanan suşlar daha sonra hızlı Multipleks polimeraz zincir reaksiyonu (PCR) kullanılarak MecA geni için tarandı.Bulgular: 320 suşun 67'sinde, tam otomatik kültür antibiyogram cihazı ile çalışılarak oksasilin direnci saptanarak MRSA tesbit edildi, Ayrıca hızlı Multipleks polimeraz zincir reaksiyonu (PCR) ile çalışıldığında bu 67 suşun 56'sında MecA geni tesbit edilerek, MRSA pozitifliği saptandı.Sonuç: Multiplex PCR kullanarak hızlı tarama analizine bağlı olarak, % 86'dan fazla duyarlılık ile hastalar MRSA için erken tedavi alabildiler. Bu yöntem, bir tanı aracı olarak, diğer hastalıklarda da yararlı olabilir.

Anahtar Kelimeler:

Staphylococcus aureus, Metisiline dirençli Staphylococcus aureus, Multiplex PCR, Yara kültürü

Using multiplex PCR as a diagnostic tool to detect methicillin resistant Staphylococcus aureus

Aim: The goal of this report was to deliver the methicillin resistant Staphylococcus aureus (MRSA) reports to the clinician and prevent the treatment delays, investigating the efficacy in addition to diagnostic testing and contact isolation strategies for intensive care unit (ICU) patients with MRSA.Methods: In this report, 320 Staphylococcus aureus strains identified as coagulase positive were cultured from hospitalized ICU patients between 2015 and 2017. Wound swabs were performed and bacteria cultures were evaluated for identification and antibiotic susceptibility testing using a culture antibiogram. Among these cultures from the swabs, MRSA was identified and subsequently screened for the MecA gene using rapid Multiplex polymerase chain reaction (PCR).Results: MRSA was detected in 67 of 320 strains, because of oxacillin resistance was detected by working with a fully automated culture antibiogram device. In addition, MRSA positivity was detected because of the high MecA gene expression in 56 of these 67 strains using rapid multiplex PCR. Conclusion: With greater than 86% sensitivity, patients were able to get early treatment for MRSA due to the rapid screening analysis using Multiplex PCR. This method, as a diagnostic tool, may be of benefit in other diseases.

Keywords:

Staphylococcus aureus, Multiplex PCR, Methicillin resistant Staphylococcus aureus, Wound culture,

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