Görüntüleme
17
İndirme
1
Amaç: Bu çalışmada yoğun bakım ünitesinde yatan hastaların rektal sürüntü örneklerinden vankomisin dirençli enterokokların saptanmasında Enterococcosel agar ve ChromID VRE besiyerinin performanslarının karşılaştırılması amaçlandı. Gereç ve Yöntemler: Yoğun Bakım ünitesinde yatan hastalardan aktif vankomisine dirençli enterokok (VRE) sürveyansı kapsamında alınan rektal sürüntü örnekleri eş zamanlı olarak Enterococosel agar ve Chrom ID VRE agar besiyerlerine ekildikten sonra besiyerleri 37 ⁰C’de etüvde 24-48 saat süreyle inkübe edildi. Enterococosel agar besiyerinde siyah renkte üreyen koloniler olası VRE olarak değerlendirilmeye alındı, bu suşlar kanlı agar besiyerine pasajlandı. Chrom ID VRE agar besiyerinde menekşe rengi üreyen koloniler olası vankomisine dirençli Enterococcus faecium , yeşil renkte üreyen koloniler ise olası Enterococcus faecalis suşları olarak değerlendirmeye alındı. Her iki kromojenik besiyerinde üreyen olası VRE suşlarının doğrulanması E-test yöntemiyle ve otomatize antibiyotik duyarlılık sitemiyle MİK değeri belirlenerek saptandı. Besiyerlerinin duyarlılık, özgüllük, pozitif belirleyicilik değeri (PBD) ve negatif belirleyicilik değeri (NBD)’leri; vankomisin E-test yöntemi ve otomatize antimikrobiyal duyarlılık yöntemiyle saptanan değerler göz önüne alınarak hesaplandı.Vankomisin direncini saptamakta E-test yöntemi ve otomatize sistem birbiriyle %100 uyumluydu. Bulgular: Çalışmaya yoğun bakım ünitesinde yatan hastalardan alınan 159 rektal sürüntü örneği dahil edildi. Rektal sürüntü örneklerinden E-test yöntemiyle ve otomatize antimikrobiyal duyarlılık test yöntemiyle doğrulanmış 21 (%13) VRE saptanırken, 138 (%87 ) örnekte VRE saptanmadı. Enterocosel agar besiyerinin 24 ve 48. saatlerdeki duyarlılık, özgüllük, PBD ve NBD’leri sırasıyla; %95.4, %99.2, %99.2 ve %98.7 idi. Chrom ID VRE agar besiyerinin 24 ve 48. saatlerdeki duyarlılık, özgüllük, PBD ve NBD’leri sırasıyla; %95.4, %81.7, %45.6 ve %99.1 idi. Her iki besiyerininin de 24. ve 48. saatlerdeki duyarlılık ve özgüllük oranları farklılık göstermedi. Enterococcosel agar besiyerinin duyarlılığı ve PBD’i ChromID VRE agar besiyerinden daha yüksekti. Chrom ID VRE agar besiyerinde yalancı pozitiflik oranının (25/159,%16) daha fazla olduğu olduğu saptandı. Enterococosel agar besiyerinde yalancı pozitiflik oranı % 0.6 (1/159) idi. Sonuç: Rektal sürüntü örneklerinde VRE suşlarının saptanmasında Enterococosel agar besiyerinin özgüllük oranının Chrom ID VRE agar besiyerinden daha iyi olduğu saptandı. Ayrıca, Chrom ID VRE agar besiyerinde Gram negatif bakterilere bağlı yalancı pozitifliklerin fazla olması nedeniyle bu besiyerine Gram negatif etkinlikli antibiyotik eklenmesinin yararlı olacağı sonucuna varıldı.
Aim: The aim of this study is to compare performance of Enterecoccosel Agar and ChromID VRE on detecting vancomycin-resistant enterococci from rectal swab specimens of the patients in intensive care unit. Material and Methods: Rectal swab specimens taken from the patients in intensive care unit were simultaneously plated in both Enterococosel agar and ChromID VRE agar, and then, they were incubated in incubator at 37°C for 24-48 hours. Black colonies on Enterococcosel agar were identified as possible VRE. Purple and pink colonies on ChromID VRE agar were identified as possible vancomycin resistant Enterococcus faecium. Green colonies on ChromID VRE agar were identified as possible vancomycin resistant Enterococcus faecalis. Vancomycin resistance was confirmed by vancomycin E-test and automated antimicrobial susceptibility test through the MIC values. The sensitivity, specificity, positive predictive value (PBD) and negative predictive value (NBD) of the agars were calculated by taking into account the values determined by the vancomycin E-test method and the automated antimicrobial susceptibility method. In detecting vancomycin resistance, the E-test method and the automated antimicrobial susceptibility method were found to be 100% compatible. Results: For the study, 159 rectal swabs taken from patients in intensive care unit were analyzed. 21 (13%) VRE, which are confirmed by E-test and automated antimicrobial susceptibility test, were detected in rectal swab specimens, but VRE was not detected in 138 (87%) specimens. Sensitivity, specificity, PBD and NBD of enterococcal agar at 24 and 48 hours were; 95.4%, 99.2%, 99.2% and 98.7%, respectively. Sensitivity, specificity, PBD and NBD of Chrom ID VRE agar at 24 and 48 hours were; 95.4%, 81.7%, 45.6% and 99.1%, respectively. Sensitivity and specificity rates at 24th and 48th hours of both agars did not differ. Sensitivity and PBD of Enterococcocel agar were higher than ChromID VRE agar. It was found that the false positive rate (25/159, 16%) was greater in Chrom ID VRE agar. The false positive rate on Enterococosel agar was 0.6% (1/159). Conclusion: In conclusion, this study revealed that the specificity rate of Enterococcosel agar in detecting VRE from rectal swabs was higher than ChromID agar. However, it is recommended that an antibiotic for gram negative bacteria should be included in ChromID agar in order to prevent false positive results.
Aim: The aim of this study is to compare performances of Enterecoccosel Agar and ChromID VRE on detecting vancomycin-resistant enterococci from rectal swab specimens of the patients in intensive care unit. Material and Methods: Rectal swab specimens taken from the patients in intensive care unit were simultaneously plated in both Enterococosel agar and ChromID VRE agar, and then, they were incubated in incubator at 37°C for 24-48 hours. Black colonies on Enterococcosel agar were identified as possible VRE. Purple and pink colonies on ChromID VRE agar were identified as possible vancomycin resistant Enterococcus faecium. Green colonies on ChromID VRE agar were identified as possible vancomycin resistant Enterococcus faecalis. Vancomycin resistance were confirmed by vancomycin E-test and automated antimicrobial susceptibility test through the MIC values. The sensitivity, specificity, positive predictive value (PBD) and negative predictive value (NBD) of the agars were calculated by taking into account the values determined by the vancomycin E-test method and the automated antimicrobial susceptibility method. In detecting vancomycin resistance, the E-test method and the automated antimicrobial susceptibility method were found to be 100% compatible. Results: For the study, 159 rectal swabs taken from patients in intensive care unit were analyzed. 21 (13%) VRE, which are confirmed by E-test and automated antimicrobial susceptibility test, were detected in rectal swab specimens, but VRE was not detected in 138 (87%) specimens. Sensitivity, specificity, PBD and NBD of enterococcal agar at 24 and 48 hours were; 95.4%, 99.2%, 99.2% and 98.7%, respectively. Sensitivity, specificity, PBD and NBD of Chrom ID VRE agar at 24 and 48 hours were; 95.4%, 81.7%, 45.6% and 99.1%, respectively. Sensitivity and specificity rates at 24th and 48th hours of both agars did not differ. Sensitivity and PBD of Enterococcocel agar were higher than ChromID VRE agar. It was found that the false positive rate (25/159, 16%) was greater in Chrom ID VRE agar. The false positive rate on Enterococosel agar was 0.6% (1/159). Conclusion : In conclusion, this study revealed that the specifity rate of Enterococcosel agar in detecting VRE from rectal swabs was higher than ChromID agar. However, it is recommended that an antibiotic for gram negative bacteria should be included in ChromID agar in order to prevent false positive results.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
Makale Detay 
Benzer Makaleler
PDF Görüntüle
Dergi Bilgisi
Eseri Dinleyin
Alıntı Yap
Bu Sayfayı Yazdırın
Paylaş
Mendeley
