Stafilokoklarda metisilin direncinin farklı yöntemlerle belirlenmesi

Abstract

low for fusidic acid among all isolates and can not be found any resistant isolate againts to vankomycine. 74

VIII. SUMMARY In this study, it is aimed that determination of methicillin resistance among staphylococcus which was isolated from environment specimens and several clinical specimens by different methods and the comparison of sensitivity and specificity of these methods and finding out multiple antibiotic resistance in methicillin resistant staphylococcus. For the investigation of methicillin resistance; Agar Screening Test as a referance test, Oxacillin Disk Diffusion Test, Cefoxitin Disk Diffusion Test, PBP2a Latex Agglutination Test and Microdilution Test are applied. Also for the testing of multiple antibiotic resistance, standart disc-diffusion method was done. The sensitivity of Oxacillin Disk Diffusion Test is found %99.4 with specificity %97.3; sensitivity of Cefoxitin Disk Diffusion Test is found %98.3 with spesifity %97.3; specificity of PBP2a Latex Agglutination Test is found %97.8 with specificity %95.9 and sensitivity of Microdilution Test is found %98.9 with specificity %95.9 in our study. Over all, any statistically significant difference can not be found between these methods (p>0.05). But the sensitivity of PBP2a Latex Agglutination Test is lower comparing to the other tests. In addition, Cefoxitin Disk Diffusion Test as a novel method, is to be found as sensitive as Oxacillin Disk Diffusion Test and could be prefered. In order to determine methicillin resistance exactly, Agar Screening Test which is proposed as a referance test by CLSI, can be used in the case of necessity. Staphylococcus which are sensitive to methicillin are find out to be sensitive to the other antibiotics mostly. More over, staphylococcus which are resistant to methicillin are find out to be resistant to the other antibiotics. When compared in methicillin sensitive and methicillin resistant staphylococcus the difference of resistance ratios was found is although statistically significant for fusidic asit and the other antibiotics, out of fusidic acid (p<0.05). The resistance ratio were very 73low for fusidic acid among all isolates and can not be found any resistant isolate againts to vankomycine. 74