Author/Editor     Tomič, Viktorija
Title     Testi za določanje proti meticilinu odporne bakterije Staphylococcus aureus
Translated title     Tests for detection of methicilin-resistant Staphylococcus aureus
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 45, št. Suppl 2
Publication year     2006
Volume     str. 75-9
Language     slo
Abstract     Background: For successful treatment of staphylococcal infections, it is very important to determine resistance to methicillin very early in the course of treatment, since in clinical terms it means resistance to all beta-lactam antibiotics. Methicillin-resistant S. aureus (MRSA) is well established as an infection control problem in hospitals and long-term care facilities all over the world. For appropriate treatment of MRSA infections and to prevent spreading of MRSA in health-care facilities, early and reliable laboratory detection of MRSA is of utmost importance. False identification of bacterial strains and/or false determination of resistance to methicillin can have serious clinical, epidemiological as well as financial consequences. The aim of our study was to find the combination of tests that would provide reliability, shortest possible time to end result, and affordability in terms of the costs of each test employed in routine MRSA detection. Materials and methods: In this study, 7 different tests for identification of S. aureus and 6 different tests for determination of methicillin resistance were compared. 197 randomly selected staphylococcal isolates (45 methicillin-sensitive S. aureus, 100 MRSA and 52 coagulase-negative staphylococci) and 3 control strains were tested. Results: The sensitivity of our bacterial identification tests was 90% to 100%, and their specificity was 90% to 100%. The sensitivity of our tests for determining methicillin resistance was 94% to 100%, and their specificity was 90.8% to 100%. Conclusion: A combination of Oxacillin Resistance Screening Agar Base (ORSAB) plates, Pastorex Staph Plus latex agglutination test, free coagulase test and oxacillin salt screening plate enabled reliable and cost-effective determination of MRSA isolates.
Summary     Uvod: Resen problem pri zdravljenju stafilokoknih okužb predstavlja odpornost bakterije Staphylococcus aureus proti meticilinu, kar v kliničnem smislu pomeni odpornost proti vsem beta-laktamskim antibiotikom. Proti meticilinu odporen S. aureus (angl. methicillin resistant S. aureus - MRSA) je tudi pomemben bolnišnični higienski problem. Za ustrezno zdravljenje okužb in preprečevanje širjenja MRSA v zdravstvenih in negovalnih ustanovah je zelo pomembna hitra in zanesljiva laboratorijska diagnostika. Napačna identifikacija bakterijskega seva in/ali napačna opredelitev odpornosti proti meticilinu ima hude klinične, epidemiološke in nenazadnje tudi ekonomske posledice. Glavni namen naše raziskave je bil ugotoviti zanesljivost, trajanje izvedbe in ekonomičnost različnih testov za dokazovanje izolatov S. aureus, odpornih proti meticilinu, ter na osnovi ugotovitev sestaviti najprimernejši algoritem za hitro in zanesljivo odkrivanje sevov MRSA. Material in metode: Primerjali smo 7 različnih testov za identifikacijo bakterijske vrste S. aureus in 6 mikrobioloških testov za ugotavljanje odpornosti bakterije S. aureus proti meticilinu. Uporabili smo 197 naključno izbranih izolatov stafilokokov, od katerih je bilo 45 izolatov 75 za meticilin občutljive bakterije S. aureus, 100 izolatov MRSA in 52 izolatov koagulazno nega tivnih stafilokokov. Priključili smo jim 3 kontrolne seve. Rezultati: Občutljivost testov za identifikacijo bakterije S. aureus, ugotovljena v naši raziskavi, je znašala od 90 do 100%, specifičnost med 90 in 100%. Občutljivost testov za ugotavljanje odpornosti proti meticilinu je bila med 94 in 100%, specifičnost med 90,8 in 100%. Zaključek: Kombinacija uporabe gojišča ORSAB (angl. Oxacillin resistance screening agar base), hitrega lateks aglutinacijskega testa Pastorex Staph Plus, testa koagulaze v epruveti in presejalne plošče oksacilin slanega agarja je omogočila dovolj zanesljivo in cenovno ugodno dokazovanje izolatov MRSA.
Descriptors     STAPHYLOCOCCAL INFECTIONS
STAPHYLOCOCCUS AUREUS
METHICILLIN RESISTANCE