THE EFFECT OF LINEZOLID AGAINST VANCOMYCIN-RESISTANT ENTEROCOCCI BY VARIOUS METHODS

Yıl 2024, , 37 - 42, 15.02.2024

Başak Sıla Eyüp , Gülseren Aktaş

https://doi.org/10.26650/JARHS2024-1346413

Öz

Objectives: Enterococci are the causative agents of a variety of infections, particularly healthcare-associated infections. Linezolid is an important antibiotic in the treatment of infections caused by vancomycin-resistant enterococci. However, in recent years, an increasing rate of linezolid resistance has been reported in clinical enterococci strains. The aim of this study was to investigate the in vitro efficacy of linezolid against vancomycin-resistant Enterococcus (VRE) strains isolated from rectal swab samples of inpatients by disc diffusion, microdilution and E-test methods, and thus to evaluate the efficiency of linezolid against VRE strains by qualitative and quantitative methods.

Material and Methods: Fifty VRE strains were defined as enterococci by conventional methods. The efficiency of linezolid in strains was investigated by disk diffusion, E-test and microdilution methods. Species identification of enterococci strains was done with the GP24 Diagnostics kit.

Results: The identification of fifty enterococcal strains using the conventional methods revealed Gram-positive coccus, catalase-negative, bile growth-esculin hydrolysis positive, salt tolerance test (6.5% NaCl) positive, and L-pyrrolidonyl-β-naphthylamide (PYR) test positive. All strains were found to be susceptible to linezolid in disc diffusion, E-test and microdilution tests. In the microdilution test study, the MIC distrubution, MIC50 and MIC90 was detected as 1-2, 2 and 2 µg/mL, respectively. The MIC distribution, MIC50 and MIC90 values of linezolid by E-test were determined as 1-4, 2 and 3 µg/mL, respectively. In the study, 48 (96%) of 50 strains were identified as Enterococcus casseliflavus and 2 (4%) were Enterococcus faecium.

Conclusion: No linezolid resistance was detected in the study. This suggests that linezolid can be used safely in the treatment of VRE-induced infections. It will be important to conduct continuous and comprehensive studies on this subject and to monitor linezolid resistance surveillance.

Anahtar Kelimeler

Vancomycin-resistant enterococci, linezolid, disc diffusion, microdilution, E-test

Proje Numarası

39355

LİNEZOLİDİN VANKOMİSİNE DİRENÇLİ ENTEROKOK SUŞLARINA ETKİSİNİN ÇEŞİTLİ YÖNTEMLERLE ARAŞTIRILMASI

Öz

Amaç: Enterokoklar, özellikle sağlık hizmeti ile ilişkili enfeksiyonlar olmak üzere, çeşitli enfeksiyonların etkenidirler. Linezolid, vankomisine dirençli enterokokların sebep olduğu enfeksiyonların tedavisinde önemli bir antibiyotiktir. Fakat son yıllarda klinik enterokok suşlarında giderek artan oranlarda linezolid direnci rapor edilmektedir. Çalışmada, yatan hastaların rektal sürüntü örneklerinden izole edilen vankomisine dirençli enterokok (VRE) suşlarında linezolidin in vitro etkinliğinin disk difüzyon, E-test ve mikrodilüsyon yöntemleri ile araştırılması ve böylece linezolidin VRE suşlarına etkinliğinin kalitatif ve kantitatif yöntemler ile değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Elli VRE suşu konvansiyonel yöntemler ile enterokok cinsi olarak tanımlanmıştır. Suşlarda, linezolidin etkinliği disk difüzyon, E-test ve mikrodilüsyon metodları ile araştırılmıştır. Enterokok suşlarının tür tanımlaması GP24 Diagnostics kiti ile yapılmıştır.

Bulgular: Elli enterokok suşunun konvansiyonel yöntemlerle tanımlanmasında Gram-pozitif kok, katalaz negatif, safrada üreme-eskülin hidrolizi pozitif, tuz tolerans testi (%6,5 NaCl) pozitif ve L-pirolidonil-βnaftilamid (PYR) testi pozitif olarak belirlenmiştir. Disk difüzyon, E-test ve mikrodilüsyon testleri ile suşların tümü, linezolide duyarlı bulunmuştur. Mikrodilüsyon test çalışmasında linezolid MİK dağılımı, MİK50 ve MİK90 değerleri sırasıyla 1-2, 2 ve 2 µg/mL olarak belirlenmiştir. Linezolidin E-test yöntemiyle yapılan MİK araştırması sonucunda MİK dağılımı, MİK50 ve MİK90 değerleri sırasıyla 1-4, 2 ve 3 µg/mL olarak saptanmıştır. Çalışmada 50 suştan 48’i (%96) Enterococcus casseliflavus ve 2 suş (%4) Enterococcus faecium olarak tanımlanmıştır.

Sonuç: Çalışmada linezolid direnci saptanmamıştır. Bu da linezolidin VRE kaynaklı enfeksiyonların tedavisinde güvenle kullanılabileceği fikrini vermektedir. Bu konuda devamlı ve kapsamlı çalışmaların yapılması ve linezolid direnç sürveyansının izlenmesi önemli olacaktır.

Anahtar Kelimeler

Vankomisine dirençli enterokoklar, linezolid, disk difüzyon, mikrodilüsyon, E-test

Destekleyen Kurum

İstanbul Üniversitesi Araştırma Fonu

Proje Numarası

39355

Kaynakça

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