Klinik ?rneklerden izole edilen beta-hemolitik Streptokok su?lar?, ?zellikleri ve antibiyotik duyarl?l???

摘要

Ama?: Beta Hemolitik Streptococcus (BHS) türleri, idrar yolu enfeksiyonu, cilt/yumu?ak doku enfeksiyonlar?, tonsillofarenjit gibi üst solunum yolu enfeksiyonlar?, yenido?anda menenjit, sepsis ve pn?moni gibi bir?ok enfeksiyonda rol oynar. Bu ?al??man?n amac? klinik ?rneklerden izole edilen BHS türlerini, enfeksiyon ?zelliklerini ve antibiyotik duyarl?l?k profillerini belirlemektir. Y?ntemler: Laboratuvar?m?zda Ocak 2014 - Haziran 2019 tarihleri aras?nda, 1110 (%87) ayaktan ve 166 (%13) yatarak tedavi g?ren hastadan izole edilen 1276 beta hemolitik streptokok (BHS) su?u, ?zellikleri ve 320 su?un antimikrobiyal duyarl?l??? retrospektif olarak incelendi. ?al??man?n tipi kesitsel ?al??mad?r. Bulgular: Toplam 1276 BHS izolat?n?n; %48,6 grup B, %33,9 grup A, %9,6 grup F, %5,7 grup C ve %2,2 grup G BHS idi. ?ncelenen BHS enfeksiyonlar?n?n; %42,9'u idrar yolu enfeksiyonu, %34,6's? tonsillit/tonsillofarenjit, %15,7'si cilt/yumu?ak doku enfeksiyonu, %3' ü kan dola??m? enfeksiyonu ve %1'i menenjit, pn?moni, konjonktivit ve peritonit idi. %2,8 Grup B Streptokok izolat? vajinal kolonizasyon olarak kabul edildi. Hastalar?n %11,2'sinde birden fazla altta yatan hastal?k vard?. Tüm izolatlar penisilin, vankomisin, linezolid ve tigesikline duyarl?yd?. Eritromisin, klindamisin ve tetrasiklin direnci Grup A Streptokok ve Grup B Streptokok i?in s?ras?yla %5, %2, %40 ve %34, %11, %90 olarak belirlendi. Sonu?: Erken tan? ve uygun antibiyoterapi streptokok enfeksiyonlar?n?n tedavisinde ?nemli parametrelerdir. Beta-hemolitik streptokoklarda penisilin direnci olmasa da, klinik ba?ar?s?zl?klar?n varl???, ?zellikle Grup B Streptokok 'da penisilin Minimal ?nhibit?r Konsantrasyonu (M?K) de?erlerinin art???, makrolid ve florokinolon direncinin artmas? nedeniyle antibiyotik duyarl?l???n?n yak?ndan izlenmesi gerekti?ini dü?ünüyoruz. Aim: Beta Hemolytic Streptococcus (BHS) species play a role in many infections, such as urinary tract infection, skin/soft tissue infections, neonatal meningitis, sepsis, pneumonia as well as upper respiratory tract infections like tonsillopharyngitis. The aim of this study was to determine the types of BHS species, their infectious characteristics and antibiotic susceptibility profiles in clinical specimens. Methods: In this cross-sectional study, infectious features of 1276 streptococcus strains isolated from 1110 (87%) outpatients and 166 (13%) inpatients between January 2014 and June 2019 at our laboratory and antimicrobial susceptibility of the 320 strains were analyzed retrospectively. Results: Retrospective analysis of 1276 BHS isolates revealed that 48.6% were group B, 33.9% were group A, 9.6% were group F, 5.7% were group C and 2.2% were group G BHS. Among isolated BHS infections, 42.9% caused urinary tract infection, 34.6% caused tonsillitis/tonsillopharyngitis, 15.7% were isolated from skin/soft tissue infections, 3% were found in the bloodstream, and 1% in meningitis, pneumonia, conjunctivitis, and peritonitis. About 2.8% Group B Streptococcus were considered vaginal colonization. Among all patients, 11.2% had more than one underlying disease. All isolates were susceptible to penicillin, vancomycin, linezolid and tigecycline. Erythromycin, clindamycin, and tetracycline resistance rates were determined as 5%, 2%, 40% respectively for Group A and 34%, 11%, 90%, respectively for Group B Streptococcus. Conclusion: Early diagnosis and appropriate antibiotherapy are important parameters in the management of streptococcal infections. Although there is no penicillin resistance in beta-hemolytic streptococci, we think that antibiotic susceptibility should be closely monitored due to increasing clinical failures, penicillin Minimal inhibitory concentration (MIC) values, and macrolide and fluoroquinolone resistance, especially in Group B Streptococcus.