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Sekiz bölmeli kolistinli agar besiyerinde acinetobacter baumannii türlerinde kolistin direncinin saptanması

Year 2021, , 184 - 188, 30.06.2021
https://doi.org/10.18663/tjcl.803042

Abstract

Amaç: Acinetobacter baumannii suşları sıklıkla çoklu ilaç direnci gösteren ve mortalite oranı yüksek opurtunistik nasokomiyal patojenlerdir. Bu çalışmada, Acinetobacter klinik izolatlarında kolistin direnç paterninin tüp dilüsyon ve agar dilüsyon yöntemleriyle kıyaslamalı olarak değerlendirilmesinin yanı sıra rutin kullanımda olmayan sekiz bölmeli kolistinli agar besiyerinin performansının değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışmada, Samsun Eğitim ve Araştırma Hastanesi’de 2018-2019 yılları arasında çeşitli kliniklerinde yatmakta olan 104 hastadan izole edilen ve tam otomatik bakteri identifikasyon cihazında (VITEK 2, Biomerioux, France) tanımlaması yapılmış A.baumannii suşlarının kolistin direnci tüp makro dilüsyon ve agar dilüsyon yöntemleriyle saptandı. Agar dilüsyon testi, sekiz sabit bölmeli tek bir petri kutusunda ve 0,125-16 µg/ml konsantrasyonda kolistin ilaveli Mueller Hinton agar besiyerinde yapıldı. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) verilerine göre yorumlama yapılarak, 2 µg/ml ve altı minimal inhibitor konsantrasyon (MİK) değeri kolistine duyarlı suş olarak kabul edildi.

Bulgular: Çalışmaya dâhil edilen 104 suşun 68’i (%65,4) otomatize sistemde, 66’sı (%63,5) sıvı tüp dilüsyon testinde, 64’ü (%61,5) agar dilüsyon testinde kolistine duyarlı olarak saptandı. Tüp dilüsyon testinde 38 (%36,5) suş kolistine dirençli iken, agar dilüsyon testinde ise 40 (%38,5) suş kolistine dirençli olarak tespit edildi. Direnç testinde 2µg/ml ve altı kolistine duyarlı kabul edildi. Ancak seçilen örneklem grubu nedeniyle direnç testinde 0,125 ve 0,250 µg/ml konsantrasyonlarda kolistin duyarlılığı görülmedi. Tüp dilüsyon yönteminde en fazla görülen MİK değeri 1 µg/ml iken agar dilüsyonunda en fazla görülen MİK değeri 2 µg/ml idi.

Sonuç: Sunduğumuz çalışmada agar ve tüp dilüsyon yöntemleri arasında anlamlı bir fark bulunamamıştır. Sekiz bölmeli tek bir kolistinli agar besiyerinde yapılan direnç çalışması sonucu laboratuvar maliyet avantajı sağlamaktadır.

Supporting Institution

Yok

Project Number

Yok

References

  • 1. Munoz-Price LS, Weinstein RA. Acinetobacter infection. N Engl J Med. 2008; 358: 1271-81.
  • 2. Savcı Ü, Özveren G, Bulut Y, et al. Klinik örneklerden izole edilen Acinetobacter baumannii suşlarının in-vitro duyarlılık durumları. Turk J Clin Lab. 2015; 6: 24-9
  • 3. Owen RJ, Li J, Nation RL et al. In vitro pharmacodynamics of colistin against Acinetobacter baumannii clinical isolates. J Antimicrob Chemother. 2007; 59: 473-7.
  • 4. Li J, Rayner CR, Nation RL, et al. Heteroresistance to colistin in multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother. 2006; 50: 2946-50.
  • 5. Arroyo LA, García-Curiel A, Pachón-Ibañez ME, et al. Reliability of the E-test method for detection of colistin resistance in clinical isolates of Acinetobacter baumannii. J Clin Microbiol. 2005; 43: 903-5.
  • 6. Lo-Ten-Foe JR, de Smet AM, Diederen BM, et al. Comparative evaluation of the VITEK 2, disk diffusion, etest, broth microdilution, and agar dilution susceptibility testing methods for colistin in clinical isolates, including heteroresistant Enterobacter cloacae and Acinetobacter baumannii strains. Antimicrob Agents Chemother. 2007; 51: 3726-30.
  • 7. Tan TY, Ng LS, Poh K. Susceptibility testing of unconventional antibiotics against multiresistant Acinetobacter spp. by agar dilution and Vitek 2. Diagn Microbiol Infect Dis. 2007; 58: 357-61.
  • 8. Tan TY, Ng SY. Comparison of Etest, Vitek and agar dilution for susceptibility testing of colistin. Clin Microbiol Infect. 2007; 13: 541-4.
  • 9. Chew KL, La MV, Lin RTP, et al. Colistin and Polymyxin B Susceptibility Testing for Carbapenem-Resistant and mcr-Positive Enterobacteriaceae: Comparison of Sensititre, MicroScan, Vitek 2, and Etest with Broth Microdilution. J Clin Microbiol. 2017; 55: 2609-16.
  • 10. Satlin MJ, Lewis JS, Weinstein MP, et al. Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) position statements on polymyxin B and colistin clinical breakpoints. Clin Infect Dis. 2020; 121.
  • 11. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing, 30th Edition. CLSI document M100, 2020.
  • 12. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters, version 10.0, 2020.
  • 13. Antibiyotik Duyarlılık Testleri, EUCAST: Uygulama, Yorum ve Uzman Kurallar Editör: Prof. Dr. Deniz Gür Hacettepe Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Ankara. Türk Mikrobiyol Cem Derg. 2016; 46.
  • 14. Singhal L, Sharma M, Verma S, et al. Comparative Evaluation of Broth Microdilution with Polystyrene and Glass-Coated Plates, Agar Dilution, E-Test, Vitek, and Disk Diffusion for Susceptibility Testing of Colistin and Polymyxin B on Carbapenem-Resistant Clinical Isolates of Acinetobacter baumannii. Microb Drug Resist. 2018; 24: 1082-88.
  • 15. Kocagöz T. Mikrobiyolojik Tanıda Klasik Yöntemlerde Yeni Yaklaşımlar. ANKEM Derg. 2013; 27:150-3.
  • 16. Matuschek E, Åhman J, Webster C, et al. Antimicrobial susceptibility testing of colistin- evaluation of seven commercial MIC products against standard broth microdilution for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter spp. Clin Microbiol Infect. 2018; 24: 865-70.

Determining colistin resistance in acinetobacter baumannii species in eight-compartment colistin agar medium

Year 2021, , 184 - 188, 30.06.2021
https://doi.org/10.18663/tjcl.803042

Abstract

Aim: Acinetobacter baumannii strains are opportunistic nosocomial pathogens that are frequently multi-drug resistant and have a high mortality rate. In this study, we aimed at evaluating the colistin resistance pattern in Acinetobacter clinical isolates through comparison using tube dilution and agar dilution methods, as well as the performance of a single petri dish with eight compartments that is not in routine use.

Material and Methods: In the study, A. baumannii, which was isolated from 104 patients hospitalized in Samsun Training and Research Hospital between 2018 and 2019 in various clinics and identified in the automatic bacteria identification device (VITEK 2, Biomerioux, France). The colistin resistance of the strains was determined by tube dilution and agar dilution methods. Agar dilution test was performed in a single petri dish with eight compartments and Mueller Hinton Agar Medium supplemented with colistin at a concentration of 0.125-16 µg/ml. The results were interpreted according to The European Committee on Antimicrobial Susceptibility Testing (EUCAST) data, and a Minimal Inhibitory Concentration (MIC) value of 2 µg/ml and less was accepted as a colistin sensitive strain.

Results: Of the 104 strains included in the study, 68 (65.4%) were sensitive to colistin in the automated system, 66 (63.5%) in the liquid tube dilution test, and 64 (61.5%) in the agar dilution test. While 38 (36.5%) strains were resistant to colistin in the tube dilution test, 40 (38.5%) strains were found to be resistant to colistin in agar dilution test. 2µg/ml and less was accepted as sensitive to colistin in the resistance test. However, due to the chosen sample group, no colistin sensitivity was observed at 0.125 and 0.250 µg/ml concentrations in the resistance test. While the most seen MIC value in the tube dilution method was 1 µg/ml, the most seen MIC value in agar dilution was 2 µg/ml.

Conclusion: In the study, no significant difference was found between agar and tube dilution methods. The laboratory provided a cost advantage to the as a result of the resistance study performed on a single colistin agar medium with eight compartments.

Project Number

Yok

References

  • 1. Munoz-Price LS, Weinstein RA. Acinetobacter infection. N Engl J Med. 2008; 358: 1271-81.
  • 2. Savcı Ü, Özveren G, Bulut Y, et al. Klinik örneklerden izole edilen Acinetobacter baumannii suşlarının in-vitro duyarlılık durumları. Turk J Clin Lab. 2015; 6: 24-9
  • 3. Owen RJ, Li J, Nation RL et al. In vitro pharmacodynamics of colistin against Acinetobacter baumannii clinical isolates. J Antimicrob Chemother. 2007; 59: 473-7.
  • 4. Li J, Rayner CR, Nation RL, et al. Heteroresistance to colistin in multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother. 2006; 50: 2946-50.
  • 5. Arroyo LA, García-Curiel A, Pachón-Ibañez ME, et al. Reliability of the E-test method for detection of colistin resistance in clinical isolates of Acinetobacter baumannii. J Clin Microbiol. 2005; 43: 903-5.
  • 6. Lo-Ten-Foe JR, de Smet AM, Diederen BM, et al. Comparative evaluation of the VITEK 2, disk diffusion, etest, broth microdilution, and agar dilution susceptibility testing methods for colistin in clinical isolates, including heteroresistant Enterobacter cloacae and Acinetobacter baumannii strains. Antimicrob Agents Chemother. 2007; 51: 3726-30.
  • 7. Tan TY, Ng LS, Poh K. Susceptibility testing of unconventional antibiotics against multiresistant Acinetobacter spp. by agar dilution and Vitek 2. Diagn Microbiol Infect Dis. 2007; 58: 357-61.
  • 8. Tan TY, Ng SY. Comparison of Etest, Vitek and agar dilution for susceptibility testing of colistin. Clin Microbiol Infect. 2007; 13: 541-4.
  • 9. Chew KL, La MV, Lin RTP, et al. Colistin and Polymyxin B Susceptibility Testing for Carbapenem-Resistant and mcr-Positive Enterobacteriaceae: Comparison of Sensititre, MicroScan, Vitek 2, and Etest with Broth Microdilution. J Clin Microbiol. 2017; 55: 2609-16.
  • 10. Satlin MJ, Lewis JS, Weinstein MP, et al. Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) position statements on polymyxin B and colistin clinical breakpoints. Clin Infect Dis. 2020; 121.
  • 11. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing, 30th Edition. CLSI document M100, 2020.
  • 12. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters, version 10.0, 2020.
  • 13. Antibiyotik Duyarlılık Testleri, EUCAST: Uygulama, Yorum ve Uzman Kurallar Editör: Prof. Dr. Deniz Gür Hacettepe Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Ankara. Türk Mikrobiyol Cem Derg. 2016; 46.
  • 14. Singhal L, Sharma M, Verma S, et al. Comparative Evaluation of Broth Microdilution with Polystyrene and Glass-Coated Plates, Agar Dilution, E-Test, Vitek, and Disk Diffusion for Susceptibility Testing of Colistin and Polymyxin B on Carbapenem-Resistant Clinical Isolates of Acinetobacter baumannii. Microb Drug Resist. 2018; 24: 1082-88.
  • 15. Kocagöz T. Mikrobiyolojik Tanıda Klasik Yöntemlerde Yeni Yaklaşımlar. ANKEM Derg. 2013; 27:150-3.
  • 16. Matuschek E, Åhman J, Webster C, et al. Antimicrobial susceptibility testing of colistin- evaluation of seven commercial MIC products against standard broth microdilution for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter spp. Clin Microbiol Infect. 2018; 24: 865-70.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Selim Görgün

Project Number Yok
Publication Date June 30, 2021
Published in Issue Year 2021

Cite

APA Görgün, S. (2021). Sekiz bölmeli kolistinli agar besiyerinde acinetobacter baumannii türlerinde kolistin direncinin saptanması. Turkish Journal of Clinics and Laboratory, 12(2), 184-188. https://doi.org/10.18663/tjcl.803042
AMA Görgün S. Sekiz bölmeli kolistinli agar besiyerinde acinetobacter baumannii türlerinde kolistin direncinin saptanması. TJCL. June 2021;12(2):184-188. doi:10.18663/tjcl.803042
Chicago Görgün, Selim. “Sekiz bölmeli Kolistinli Agar Besiyerinde Acinetobacter Baumannii türlerinde Kolistin Direncinin Saptanması”. Turkish Journal of Clinics and Laboratory 12, no. 2 (June 2021): 184-88. https://doi.org/10.18663/tjcl.803042.
EndNote Görgün S (June 1, 2021) Sekiz bölmeli kolistinli agar besiyerinde acinetobacter baumannii türlerinde kolistin direncinin saptanması. Turkish Journal of Clinics and Laboratory 12 2 184–188.
IEEE S. Görgün, “Sekiz bölmeli kolistinli agar besiyerinde acinetobacter baumannii türlerinde kolistin direncinin saptanması”, TJCL, vol. 12, no. 2, pp. 184–188, 2021, doi: 10.18663/tjcl.803042.
ISNAD Görgün, Selim. “Sekiz bölmeli Kolistinli Agar Besiyerinde Acinetobacter Baumannii türlerinde Kolistin Direncinin Saptanması”. Turkish Journal of Clinics and Laboratory 12/2 (June 2021), 184-188. https://doi.org/10.18663/tjcl.803042.
JAMA Görgün S. Sekiz bölmeli kolistinli agar besiyerinde acinetobacter baumannii türlerinde kolistin direncinin saptanması. TJCL. 2021;12:184–188.
MLA Görgün, Selim. “Sekiz bölmeli Kolistinli Agar Besiyerinde Acinetobacter Baumannii türlerinde Kolistin Direncinin Saptanması”. Turkish Journal of Clinics and Laboratory, vol. 12, no. 2, 2021, pp. 184-8, doi:10.18663/tjcl.803042.
Vancouver Görgün S. Sekiz bölmeli kolistinli agar besiyerinde acinetobacter baumannii türlerinde kolistin direncinin saptanması. TJCL. 2021;12(2):184-8.


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