مقایسه‌ی روش‌های دیسک دیفیوژن و E-Test در بررسی مقاومت به متی‌سیلین در استافیلوکوکوس اپیدرمیدیس‌های جدا شده از نمونه‌های بالینی

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه میکروب شناسی،دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، دانشکده‌ی پزشکی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: در سال‌های اخیر مقاومت آنتی‌بیوتیکی استافیلوکوکوس اپیدرمیدیس نسبت به متی‌سیلین افزایش قابل توجهی یافته است. بنابراین بررسی مقاومت به متی‌سیلین در این باکتری در تعیین الگوی درمانی صحیح، تعیین کننده است. هدف از این مطالعه مقایسه‌ی روش‌های دیسک دیفیوژن و E-Test در بررسی مقاومت به ‌متی‌سیلین در استافیلوکوکوس اپیدرمیدیس‌های جدا شده از نمونه‌های بالینی می‌باشد.روش‌ها: بر روی 146 نمونه‌ی استافیلوکوکوس اپیدرمیدیس تعیین مقاومت به ‌متی‌سیلین با استفاده از روش‌های E-Test و دیسک دیفیوژن انجام شد و این دو روش مورد مقایسه قرار گرفتند.یافته‌ها: 146 نمونه از استافیلوکوکوس اپیدرمیدیس با استفاده از روش‌های E-Test و دیسک دیفیوژن از لحاظ مقاومت به ‌متی‌سیلین مورد بررسی قرار گرفت که در روش E-Test میزان مقاومت 54/70 درصد و در روش دیسک دیفیوژن 64/61 درصد تعیین شد و حساسیت و اختصاصیت آن‌ها به ترتیب در E-Test، 3/95 و 7/94 درصد و در دیسک دیفیوژن به ترتیب 5/86 و 9/80 درصد بیان شد.نتیجه‌گیری: با مقایسه‌ی حساسیت و اختصاصیت روش‌های E-Test و دیسک دیفیوژن مشخص شد که روش E-Test از حساسیت و اختصاصیت بالاتری برخوردار است و روشی سریع‌تر، دقیق‌تر و قابل اطمینان‌تر برای تعیین مقاومت به ‌متی‌سیلین در استافیلوکوکوس اپیدرمیدیس می‌باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparing Disk Diffusion and E-Test Methods in Reviewing Methicillin-Resistance in Staphylococcus Epidermidis Isolated from Clinical Speci-mens

نویسندگان [English]

  • Ebtehaj Pishva 1
  • Sayed Asghar Havaei 1
  • Firooz Arsalani 2
1 Associate Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine and Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: In recent years, antibiotic resistance of staphylococcus epidermidis toward methicillin has been a significant increase. Therefore, reviewing methicillin-resistance is necessary and crucial in determining an appropriate therapeutic pattern. This study aimed to compare disk fusion and E-test methods in reviewing methicillin-resistance in staphylococcus epidermidis isolated from clinical specimens.Methods: Determination of methicillin resistance was conducted through disk fusion and E-test methods on 146 samples of staphylococcus epidermidis and these two methods were compared to each other.Findings: 146 samples of staphylococcus epidermidis were evaluated through disk fusion and E-test methods in terms of methicillin resistance in which the resistant rate of E-test was 70.54 percent and disk fusion was 61.64 percent and their sensitivity and specificity in E-test were 95.3 and 94.7 percent respectively and in disk fusion were 86.5 and 80.9 percent respectively.Conclusion: Assessing the sensitivity and specificity in E-test and disk fusion methods showed that E-test had a higher sensitivity and specificity and also is a faster, more accurate and more reliable method to determine methicillin resistance in staphylococcus epidermidis.

کلیدواژه‌ها [English]

  • Staphylococcus epidermidis
  • Methicillin
  • E-Test
  • Disk fusion
  1. Forbes BA, Sahm DF, Weissfeld AS. Types of nosocomial infections. Bailey & scott's diagnostic microbiology. 12th ed. Philadelphia: Mosby; 2002. p. 68-9.
  2. Lim SM, Webb SA. Nosocomial bacterial infections in Intensive Care Units. I: Organisms and mechanisms of antibiotic resistance. Anaesthesia 2005; 60(9): 887-902.
  3. Von Eiff EC, Jansen B, Kohnen W, Becker K. Infections associated with medical devices: pathogenesis, management and prophylaxis. Drugs 2005; 65(2): 179-214.
  4. Barrau K, Boulamery A, Imbert G, Casalta JP, Habib G, Messana T, et al. Causative organisms of infective endocarditis according to host status. Clin Microbiol Infect 2004; 10(4): 302-8.
  5. Ziebuhr W. Staphylococcus aureus and Staphylococcus epidermidis: emerging pathogens in nosocomial infections. Contrib Microbiol 2001; 8: 102-7.
  6. Garrett DO, Jochimsen E, Murfitt K, Hill B, McAllister S, Nelson P, et al. The emergence of decreased susceptibility to vancomycin in Staphylococcus epidermidis. Infect Control Hosp Epidemiol 1999; 20(3): 167-70.
  7. Dickinson TM, Archer GL. Phenotypic expression of oxacillin resistance in Staphylococcus epidermidis: roles of mecA transcriptional regulation and resistant-subpopulation selection. Antimicrob Agents Chemother 2000; 44(6): 1616-23.
  8. Hebert GA. Hemolysins and other characteristics that help differentiate and biotype Staphylococcus lugdunensis and Staphylococcus schleiferi. J Clin Microbiol 1990; 28(11): 2425-31.
  9. Hebert GA, Crowder CG, Hancock GA, Jarvis WR, Thornsberry C. Characteristics of coagulase-negative staphylococci that help differentiate these species and other members of the family Micrococcaceae. J Clin Microbiol 1988; 26(10): 1939-49.
  10. Kloos WE, Bannerman TL. Update on clinical significance of coagulase-negative staphylococci. Clin Microbiol Rev 1994; 7(1): 117-40.
  11. Mack D, Davies AP, Harris LG, Rohde H, Horstkotte MA, Knobloch JK. Microbial interactions in Staphylococcus epidermidis biofilms. Anal Bioanal Chem 2007; 387(2):
  12. -408.
  13. Vuong C, Voyich JM, Fischer ER, Braughton KR, Whitney AR, DeLeo FR, et al. Polysaccharide intercellular adhesin (PIA) protects Staphylococcus epidermidis against major components of the human innate immune system. Cell Microbiol 2004; 6(3): 269-75.
  14. Arciola CR, Campoccia D, Gamberini S, Donati ME, Pirini V, Visai L, et al. Antibiotic resistance in exopolysaccharide-forming Staphylococcus epidermidis clinical isolates from orthopaedic implant infections. Biomaterials 2005; 26(33): 6530-5.
  15. Koksal F, Yasar H, Samasti M. Antibiotic resistance patterns of coagulase-negative staphylococcus strains isolated from blood cultures of septicemic patients in Turkey. Microbiol Res 2009; 164(4): 404-10.
  16. Hiramatsu K, Cui L, Kuroda M, Ito T. The emergence and evolution of methicillin-resistant Staphylococcus aureus. Trends Microbiol 2001; 9(10): 486-93.
  17. Hiramatsu K, Katayama Y, Yuzawa H, Ito T. Molecular genetics of methicillin-resistant Staphylococcus aureus. Int J Med Microbiol 2002; 292(2): 67-74.
  18. Chambers HF. Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications. Clin Microbiol Rev 1997; 10(4): 781-91.
  19. York MK, Gibbs L, Chehab F, Brooks GF. Comparison of PCR detection of mecA with standard susceptibility testing methods to determine methicillin resistance in coagulase-negative staphylococci. J Clin Microbiol 1996; 34(2): 249-53.
  20. Martins A, Cunha ML. Methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci: epidemiological and molecular aspects. Microbiol Immunol 2007; 51(9): 787-95.
  21. Mirsalehian A, Jabalameli F, Alizadeh S. Comarison of disk agar diffusion susceptibility testing and PCR in detection of methicillin resistance Staphylococcus aureus. Tehran Univ Med J 2003; 61(6):420-5.
  22. Hedin G, Lofdahl S. Detecting methicillin-resistant Staphylococcus epidermidis--disc diffusion, broth breakpoint or polymerase chain reaction? APMIS 1993; 101(4): 311-8.
  23. Olsson-Liljequist B, Larsson P, Ringertz S, Lofdahl S. Use of a DNA hybridization method to verify results of screening for methicillin resistance in staphylococci. Eur J Clin Microbiol Infect Dis 1993; 12(7): 527-33.
  24. McDonald CL, Maher WE, Fass RJ. Revised interpretation of oxacillin MICs for Staphylococcus epidermidis based on mecA detection. Antimicrob Agents Chemother 1995; 39(4): 982-4.
  25. Ferreira RB, Iorio NL, Malvar KL, Nunes AP, Fonseca LS, Bastos CC, et al. Coagulase-negative staphylococci: comparison of phenotypic and genotypic oxacillin susceptibility tests and evaluation of the agar screening test by using different concentrations of oxacillin. J Clin Microbiol 2003; 41(8): 3609-14.
  26. Hussain Z, Stoakes L, Lannigan R, Longo S, Nancekivell B. Evaluation of screening and commercial methods for detection of methicillin resistance in coagulase-negative staphylococci. J Clin Microbiol 1998; 36(1): 273-4.
  27. Perazzi B, Fermepin MR, Malimovka A, Garcia SD, Orgambide M, Vay CA, et al. Accuracy of cefoxitin disk testing for characterization of oxacillin resistance mediated by penicillin-binding protein 2a in coagulase-negative staphylococci. J Clin Microbiol 2006; 44(10): 3634-9.
  28. Rosser SJ, Alfa MJ, Hoban S, Kennedy J, Harding GK. E test versus agar dilution for antimicrobial susceptibility testing of viridans group streptococci. J Clin Microbiol 1999; 37(1): 26-30.
  29. De GM, Pacifico L, Tufi D, Panero A, Boccia A, Chiesa C. Phenotypic detection of nosocomial mecA-positive coagulase-negative staphylococci from neonates. J Antimicrob Chemother 1999; 44(3): 351-8.
  30. York MK, Gibbs L, Chehab F, Brooks GF. Comparison of PCR detection of mecA with standard susceptibility testing methods to determine methicillin resistance in coagulase-negative staphylococci. J Clin Microbiol 1996; 34(2): 249-53.
  31. Hedin G, Lofdahl S. Detecting methicillin-resistant Staphylococcus epidermidis--disc diffusion, broth breakpoint or polymerase chain reaction? APMIS 1993; 101(4): 311-8.
  32. McDonald CL, Maher WE, Fass RJ. Revised interpretation of oxacillin MICs for Staphylococcus epidermidis based on mecA detection. Antimicrob Agents Chemother 1995; 39(4): 982-4.
  33. Perazzi B, Fermepin MR, Malimovka A, Garcia SD, Orgambide M, Vay CA, et al. Accuracy of cefoxitin disk testing for characterization of oxacillin resistance mediated by penicillin-binding protein 2a in coagulase-negative staphylococci. J Clin Microbiol 2006; 44(10): 3634-9.
  34. Tveten Y, Jenkins A, Digranes A, Melby KK, Allum AG, Kristiansen BE. Comparison of PCR detection of mecA with agar dilution and Etest for oxacillin susceptibility testing in clinical isolates of coagulase-negative staphylococci. Clin Microbiol Infect 2004; 10(5): 462-5.
  35. Gerberding JL, Miick C, Liu HH, Chambers HF. Comparison of conventional susceptibility tests with direct detection of penicillin-binding protein 2a in borderline oxacillin-resistant strains of Staphylococcus aureus. Antimicrob Agents Chemother 1991; 35(12): 2574-9.
  36. Chambers HF. Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications. Clin Microbiol Rev 1997; 10(4): 781-91.