Diyabetik ayak yaralarında staphylococcus aureus sıklığı ve bazı biyolojik özelliklerinin belirlenmesi
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Dosyalar
Tarih
2017
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Global olarak hızla artış gösteren ileri derecedeki diyabet hastalarında diyabetik ayak enfeksiyonları oldukça önemlidir. Bu tez çalışmasında, Hatay ili İskenderun Devlet Hastanesi'nde diyabetik ayak yarası bulunan 100 hastadan alınan örneklerde Staphylococcus aureus sıklığı, izolatların farklı sınıftan antimikrobiyallere olan direnç durumları, biyofilm oluşturma yetenekleri ve hidrofobik özelliklerinin (hidrofobisite) belirlenmesi amaçlandı. Yüzeyel sürüntü ve derin doku kültürü örnekleri Mannitol Salt Agara (MSA) ekildi. Kanlı agarda saflaştırılan izolatlar, konvansiyonel, otomatize Vitek-2 ve MALDİ-TOF-MS (Matriks ile desteklenmiş lazer desorpsiyon/iyonizasyon uçuş zamanı kütle spektrometresi) sistemleri ile tanımlandı.. S. aureus izolatlarının antimikrobiyal duyarlılıkları disk difüzyon yöntemiyle, biyofilm üretme yetenekleri Congo Red Agar (CRA), Standart Tüp (ST) ve Mikropleyt (MP) yöntemleri kullanılarak, hidrofobisite özellikleri ise hidrokarbonlara mikrobiyal tutunma testi ile tespit edildi. Bir izolatın 24 saat sonundaki biyofilm üretimi Taramalı Elektron Mikroskopisi (Scanning Electron Microscopy; SEM) yardımıyla da belirlendi S. aureus diyabetik ayak yarası bulunan hastalardan alınan örneklerin %63,5'inden (54/85) izole edildi. İzolatlarının tümü vankomisine duyarlı iken; %38,8'i metisiline dirençli bulunurken; penisilin G (%96,3), ampisillin (%94,4), oksasilin (%64,8), eritromisin (%59,3), rifampisin (%57,4), amoksisilin/klavulanik asit (%53,7), siprofloksasin (%50), sefoksitin (%48,1), tetrasiklin (%38,9), gentamisin (%31,5), sülfametoksazol/trimetoprime (%22,2) ise değişen oranlarda direnç belirlendi. Biyofilm üretme yetenekleri incelenen izolatların tamamı CRA ve MP testleri ile pozitif iken, ST testine göre %96,3 oranında pozitif bulundu. İzolatlar p-ksilen hidrokarbonu ile farklı derecede hidrofobisite göstermiş olup; % 68,5'i orta hidrofobik, %16,7'si güçlü hidrofobik ve %14,8'i hidrofilik olarak değerlendirildi. Bu tez çalışması ile yapılan literatür kaynaklarına göre, diyabetik ayak yaralarından izole edilen biyofilm oluşturan S. aureus suşlarında hidrofobisite özelliği yeni tespit edilmiştir. Çalışma sonuçlarıyla ayrıca, diyabetik ayak yaralarında sıklıkla enfeksiyon etkeni olan S. aureus'un biyofilm oluşturmasını önlemek/biyofilmi ortadan kaldırmak için çeşitli stratejilerin geliştirilip takip edilmesi gerekliliğinin vurgulanması ortaya çıkmıştır.
Diabetic foot infections are of great importance in patients with advanced diabetes, which is increasing rapidly worldwide. This thesis study aims to determine the incidence of Staphylococcus aureus, the resistance status of the isolates to different class antimicrobials, biofilm formation abilities and hydrophobicity in samples taken from 100 patients with diabetic foot wound in Iskenderun State Hospital in the Province of Hatay, Turkey. Superficial swabs and deep tissue culture samples were planted on Mannitol Salt Agar (MSA). The isolates purified on blood agar were identified by conventional, automated Vitek-2 and MALDI-TOF-MS (Matrix-supported laser desorption/ionization flight time mass spectrometry) systems. The antimicrobial susceptibilities of S. aureus isolates were determined by disk diffusion method, their biofilm production capacities were determined by using the Congo Red Agar (CRA), Standard Tube (ST) and Microplate (MP) methods, and their hydrophobicity properties was determined by the method of microbial adhesion to hydrocarbons. Biofilm production of an isolate at the end of 24 hours was also detected by Scanning Electron Microscopy (SEM). S. aureus was isolated from 63.5% (54/85) of the samples taken from patients with diabetic foot wound. Of the isolates, were found to be susceptible to vancomycin, 38.8% was found to be methicillin resistant as well as varying rates of resistance to penicillin G (96.3%), ampicillin (94.4%), oxacillin (64.8%), erythromycin (59.3%), rifampicin (57.4%), amoxicillin/clavulanic acid (53.7%), ciprofloxacin (50%), cefoxitin (48.1%), tetracycline (38.9%), gentamycin (31.5%), sulfamethoxazole/trimethoprim (22.2%). All the isolates tested for their ability to produce biofilm were positive according to the CRA and MP tests, but only 96.3% was positive with respect to the ST test. The isolates showed hydrophobicity at different degrees with p-xylene hydrocarbon, and 68.5% was moderate hydrophobic, 16.7% was strong hydrophobic and 14.8% was classified as hydrophilic. According to the literature sources that applied in this thesis, hydrophobicity property in the biofilm-producing S. aureus strains, which are isolated from diabetic foot wounds is newly identified. In addition, the study also emphasize the need to develop and follow up various strategies in order to prevent biofilm formation and eliminate biofilms of S. aureus, which is an infectious pathogen frequently seen in diabetic foot wounds.
Diabetic foot infections are of great importance in patients with advanced diabetes, which is increasing rapidly worldwide. This thesis study aims to determine the incidence of Staphylococcus aureus, the resistance status of the isolates to different class antimicrobials, biofilm formation abilities and hydrophobicity in samples taken from 100 patients with diabetic foot wound in Iskenderun State Hospital in the Province of Hatay, Turkey. Superficial swabs and deep tissue culture samples were planted on Mannitol Salt Agar (MSA). The isolates purified on blood agar were identified by conventional, automated Vitek-2 and MALDI-TOF-MS (Matrix-supported laser desorption/ionization flight time mass spectrometry) systems. The antimicrobial susceptibilities of S. aureus isolates were determined by disk diffusion method, their biofilm production capacities were determined by using the Congo Red Agar (CRA), Standard Tube (ST) and Microplate (MP) methods, and their hydrophobicity properties was determined by the method of microbial adhesion to hydrocarbons. Biofilm production of an isolate at the end of 24 hours was also detected by Scanning Electron Microscopy (SEM). S. aureus was isolated from 63.5% (54/85) of the samples taken from patients with diabetic foot wound. Of the isolates, were found to be susceptible to vancomycin, 38.8% was found to be methicillin resistant as well as varying rates of resistance to penicillin G (96.3%), ampicillin (94.4%), oxacillin (64.8%), erythromycin (59.3%), rifampicin (57.4%), amoxicillin/clavulanic acid (53.7%), ciprofloxacin (50%), cefoxitin (48.1%), tetracycline (38.9%), gentamycin (31.5%), sulfamethoxazole/trimethoprim (22.2%). All the isolates tested for their ability to produce biofilm were positive according to the CRA and MP tests, but only 96.3% was positive with respect to the ST test. The isolates showed hydrophobicity at different degrees with p-xylene hydrocarbon, and 68.5% was moderate hydrophobic, 16.7% was strong hydrophobic and 14.8% was classified as hydrophilic. According to the literature sources that applied in this thesis, hydrophobicity property in the biofilm-producing S. aureus strains, which are isolated from diabetic foot wounds is newly identified. In addition, the study also emphasize the need to develop and follow up various strategies in order to prevent biofilm formation and eliminate biofilms of S. aureus, which is an infectious pathogen frequently seen in diabetic foot wounds.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji, Microbiology
