Kistik fibrozlu hastaların solunum yolu örneklerinden Staphylococcus Aureus'un izolasyonu ve tanımlanmasında Chromagar'ın değeri
Evaluation of chromogenic agar medium for the identification and isoalation of staphylococcus aureus from respiratory samples sof patients with cystic fibrosis
- Tez No: 164468
- Danışmanlar: DOÇ.DR. ZAYRE ERTURAN
- Tez Türü: Yüksek Lisans
- Konular: Mikrobiyoloji, Microbiology
- Anahtar Kelimeler: Staphylococcus aureus, koagülaz negatif stafilokok, kistik fibroz, kromojenik içerikli agar besiyeri, Chromagar-Staph, mannitol tuz agar
- Yıl: 2005
- Dil: Türkçe
- Üniversite: İstanbul Üniversitesi
- Enstitü: Sağlık Bilimleri Enstitüsü
- Ana Bilim Dalı: Mikrobiyoloji ve Klinik Mikrobiyoloji Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 81
Özet
78 ÖZET VE SONUÇ
Özet (Çeviri)
80 SUMMARY and CONCLUSION Evaluation of Chromogenk Agar Medium for the Identification and Isolation of Staphylococcus aureus from Respiratory Samples of Patients with Cystic Fibrosis Key Wordss Staphylococcus aureus, coagulase negative staphylococccus, cystic fibrosis, chromogenic agar medium, Chromagar Staph, mannitol salt agar. In this study, a new chromogenic agar medium Chromagar Staph (CSA) for the presumptive detection and identification of S.aureus was compared to mannitol salt agar (MSA) and 5% sheep blood agar (SBA) on respiratory samples from cystic fibrosis (cf) patients. 306 clinical specimens were obtained from 149 cf patients. The most cultured microorganism was S.aureus. This pathogen was isolated from 66% of the patients. The MRSA rate was found to be 28%. S.aureus-SCV was not isolated from this patients. Of the 183 S.aureus strains 166 (91%), 34 (72%) and 67 (%40) were detected with CSA, MSA and SBA respectively. After 24 hours of incubation, CSA detected 71% of all S.aureus strains, whereas MSA and SBA detected only 45% and 25% respectively. 21% patients harboured KNS in their respiratory tract specimens and 13% had S.aureus together with KNS. CSA and MSA inhibited all microorganisms that were typically found in cf respiratory specimens, like P.aeruginosa which was found in 45% of our patients. In addition although nearly all KNS strains (78.5%) were inhibited on CSA medium 91% of these strains grown on MSA medium. The sensitivity (95%), specifity (86%) and PPV (99%) value of CSA was higher than MSA (85%, 76% and 90% respectively). But the NPV value (60%) was not better than MSA (68%). In 37% of S.aureus positive CSA, this pathogens grow as more than one phenotype. Except of/two specimens, which growed MRSA and MSSA together, the susceptibility results of different colonies were the same. Antibiotic susceptibility testing results were the same from both, by picking colonies directly from CSA, MSA and after subculture on SBA.81 Although the DNAz test did not changed the specifity and PPV values of CSA for the presumptive identification of S. aureus, the NPV and sensitivity values decreased. When the DNAz test was combined with mannitol reaction on MSA, the specifity, sensitivity, PPV and NPV values increased. All values increased to 100% when either medium was used in conjunction with SSP latex reagent or tube coagulase test. In conclusion, the CSA medium was found to be high selective and useful especially in populations like cf whose specimens were containing multiple microorganisms. After shorter incubation time CSA were found to detect more S.aureus strains than MSA and SBA. In addition, CSA medium had the advantage to inhibit the overgrowed of KNS strains. The specifity and sensitivity of CSA for the identification of S.aureus was found to be higher than MSA. Because of the high PPV value, mauve colonies on CSA could be regarded as S.aureus without the need of confirmation tests. But because of the lower NPV value Staphylococcus colonies which had other colours than mauve, must be confirmed with the tube coagulase or SSP latex test. In patient populations which had a high MRSA rate, it is an advantage to have the opportunity for performing susceptibility testing direct from the colonies on the CSA medium.
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