Molecular epidemiology of penicillin resistantStreptococcus pneumoniae strains in Turkey. A multicenter study

Abstract

A total of 539 isolates recovered from various clinical sites were collected from 13 hospitals from different regions of Turkey between 1999 and 2002. Susceptibility to penicillin and cefotaxime was determined by the E-test and the remaining antimicrobials were evaluated by disk diffusion tests. Penicillin resistant and intermediate isolates were serotyped and PFGE patterns were analysed. Overall 16 isolates (3%) were resistant to penicillin, and 143 (26.5%) were intermediate. Resistance and intermediate rates were 3.1% and 29.0% respectively in respiratory tract isolates. Multiple resistance (resistance to ≥ 3 antibiotics) occurred in 81.8% of the penicillin resistant isolates and the most frequent resistance phenotype was penicillin+trimethoprim/sulphamethoxazole (37.7%). Minimum inhibitory concentrations of cefotaxime were lower than 1 mg/ml for all the isolates. The highest rate of resistance was observed for trimethoprim/sulphamethoxazole (26.6%) followed by doxycycline (12.6%). Resistance to erythromycin was 10.1%, clindamycin 9.9%, chloramphenicol 4.3%, ofloxacin 5.0% and levofloxacin 0.2%. There was no resistance to vancomycin. Resistant isolates belonged to serogroups 9, 23, and 6. The most frequent serogroups among intermediate isolates were 23, 19, 14, 1, 9, and 6. Five distinct PFGE patterns were observed among penicillin resistant isolates. There was no distinct clustering of specific PFGE patterns in the study centres. No correlation between serotypes, resistance and PFGE patterns was found. There seems to be genetic heterogeneity in Streptococccus pneumoniae isolates in Turkey.

Serotype Distribution and Antibiotic Susceptibility Patterns of Respiratory Isolates of Streptococcus pneumoniae from Hacettepe University Adult Hospital

“…SOAR 2014-2016 yılları arasında yapılan surveyans çalışma sonuçlarına göre Rusya, Bulgaristan, Yunanistan'da florokinolon direnci belirlenmemiştir (12)(13)(14) , Çek Cumhuriyeti'nde ise moksiflokasin ve levofloksasine direnç %0.5 olarak bulunmuştur (15) . Türkiye'de S. pneumoniae izolatlarında, florokinolon direnci bazı çalışmalarda hiç belirlenemezken, bazı çalışmalarda ise oldukça düşük oranlarda (%1.2) bildirilmiştir (17,(24)(25)(26) . Florokinolon grubu antibiyotikler ülkemizde toplumdan kazanılmış pnömonilerde sık kullanılmaktadır, bu nedenle günümüzde direnç sıklığı düşük olmakla birlikte, direnç gelişiminin yakından izlenmesi gerekir.…”