title: Antimicrobial susceptibility and resistance mechanisms of methicillin resistant Staphylococcus aureus isolated from 12 Hospitals in Turkey.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important nosocomial pathogens and is also emerging in Turkish hospitals. The aim of this study was to determine the antimicrobial susceptibility profiles of MRSA isolated from Turkish hospitals.
  
  
  METHODS
  A total of 397 MRSA strains isolated from 12 hospitals in Turkey were included to present study. Antimicrobial susceptibilities were tested using agar dilution method. Presence of ermA, ermB, ermC, msrA, tetM, tetK, linA and aac-aph genes were studied by PCR.
  
  
  RESULTS
  All strains were susceptible to vancomycin and linezolid. The susceptibility rates for fusidic acid, lincomycin, erythromycin, tetracyclin, gentamycin, kanamycin, and, ciprofloxacin were 91.9%, 41.1%, 27.2%, 11.8%, 8.5%, 8.3% and 6.8%, respectively. Lincomycin inactivation was positive for 3 isolates. Of 225 erythromycin resistant isolates 48 had ermA, 20 had ermC, and 128 had ermA-C. PCR was negative for 15 strains. Of 3 isolates with lincomycin inactivation one had linA and msrA. Of 358 gentamycin resistant isolates 334 had aac-aph and 24 were negatives. Among 350 tetracyclin resistant isolates 314 had tetM. Of 36 tetM negative isolates 10 had tetK.
  
  
  CONCLUSIONS
  MRSA isolates from Turkish hospitals were multiresistant to antimicrobials. Quinolone and gentamycin resistance levels were high and macrolide and lincosamide resistance were relatively low. Susceptibility rates for fusidic asid were high. Linezolide and vancomycin resistance are not emerged. The most common resistance genes were ermA, tetM and aac-aph. Evolution of antimicrobial susceptibilities and resistance genes profiles of MRSA isolates should be surveyed at regional and national level for accurate treatment of patients and to control dissemination of resistance genes.
authors.affiliation: ADU BILTEM Epidemiology Unit, Aydin, Turkey. omeryildiz83@gmail.com.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Yıldız
authors.affiliation: Medical Faculty Medical Microbiology Department, Ondokuz Mayıs University, Samsun, Turkey. cobanay2003@gmail.com.
authors.forename: Ahmet Yılmaz
authors.initials: AY
authors.lastname: Çoban
authors.affiliation: Katip Çelebi University, Atatürk Training and Research Hospital, Izmir, Turkey. asgam@mynet.com.
authors.forename: Aslı Gamze
authors.initials: AG
authors.lastname: Şener
authors.affiliation: Bozyaka Training and Research Hospital, Izmir, Turkey. seherayten@gmail.com.
authors.forename: Seher Ayten
authors.initials: SA
authors.lastname: Coşkuner
authors.affiliation: Medical Faculty Medical Microbiology Department, Karadeniz Technical University, Trabzon, Turkey. gulcinbay@hotmail.com.
authors.forename: Gülçin
authors.initials: G
authors.lastname: Bayramoğlu
authors.affiliation: Medical Faculty Medical Microbiology Department, Yüzüncü Yıl University, Van, Turkey. hguducu@hotmail.com.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Güdücüoğlu
authors.affiliation: GATA Haydarpaşa Training Hospital, Istanbul, Turkey. ozyurtm2002@yahoo.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Özyurt
authors.affiliation: Medical Faculty Medical Microbiology Department, Canakkale Onsekiz Mart University, Çanakkale, Turkey. otkun2000@yahoo.com.
authors.forename: Müşerref
authors.initials: M
authors.lastname: Tatman-Otkun
authors.affiliation: Yüksek Ihtisas Hospital, Ankara, Turkey. nihalkarabiber@hotmail.com.
authors.forename: Nihal
authors.initials: N
authors.lastname: Karabiber
authors.affiliation: Medical Faculty Medical Microbiology Department, Celal Bayar University, Manisa, Turkey. nozkutuk@hotmail.com.
authors.forename: Nuri
authors.initials: N
authors.lastname: Özkütük
authors.affiliation: Medical Faculty Medical Microbiology Department, Afyon Kocatepe University, Afyon, Turkey. aktepef@hotmail.com.
authors.forename: Orhan
authors.initials: O
authors.lastname: Aktepe
authors.affiliation: Medical Faculty Infectious Disease and Clinical Microbiology Department, Adnan Menderes University, Aydın, Turkey. serkanoncu@hotmail.com.
authors.forename: Serkan
authors.initials: S
authors.lastname: Öncü
authors.affiliation: Medical Faculty Medical Microbiology Department, Selçuk University, Konya, Turkey. draslanugur@gmail.com.
authors.forename: Uğur
authors.initials: U
authors.lastname: Arslan
authors.affiliation: ADU BILTEM Epidemiology Unit, Aydin, Turkey. bbozdogan@gmail.com.|Medical Faculty, Medical Microbiology Department, Adnan Menderes University, 09010, Aydin, Turkey. bbozdogan@gmail.com.
authors.forename: Bülent
authors.initials: B
authors.lastname: Bozdoğan
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D005798:Genes, Bacterial; D006761:Hospitals; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000382:microbiology*; D014421:Turkey
chemical_list: D000900:Anti-Bacterial Agents