GEBELERDE GRUP B STREPTOKOK KOLONIZASYONUNUN DEGISIK BESIYERLERI KULLANILARAK GÖSTERILMESI VE SEROTIPLENDIRILMELERI

Bu çalismada üçüncü trimestr gebelerde rekto-vajinal Grup B Streptokok (GBS) kolonizasyon sikliginin saptanmasi; anne yasi, gestasyon haftasi, egitim durumu, sigara ve spiral kullanimi gibi faktörlerin GBS kolonizasyon sikligina etkisinin arastirilmasi; GBS kolonizasyonunun saptanmasinda kullanilan kültür yöntemlerinin karsilastirilmasi; izole edilen GBS suslarinin serotiplendirilmesi ve antibiyotik duyarliliklarinin ortaya konulmasi amaçlanmistir. Bu amaçla Gazi Üniversitesi Tip Fakültesi Kadin Hastaliklari ve Dogum Poliklinigine basvuran 200 anne adayindan vajinal ve rektal örnekler alinmistir. Alinan örnekler Gazi Üniversitesi Mikrobiyoloji Laboratuarinda degerlendirilmistir. Çalismaya alinan 200 anneden 20’sinde (%10) GBS kolonizasyonu saptanmistir. Gebelerde vajinal örneklerde saptanan GBS kolonizasyon sikligi rektal örneklerdeki GBS kolonizasyon sikligindan belirgin derecede yüksek bulunmustur. Gebelerde GBS kolonizasyonu ile yas gruplari ve egitim durumlari karsilastirildiginda, aralarinda istatiksel olarak anlamli bir fark bulunamamistir. Incelenen gebelerde sigara kullanma aliskanligi ve spiral kullanma hikayesi olanlarda GBS’lerin vajinal üreme sikligi anlamli derecede yüksek bulunmustur. Çalismaya alinan 200 gebe kadindan 20’sinde Todd-hewitt besiyerinde üreme saptanmistir. Izole edilen bu 20 susun 12’si ayni zamanda Granada besiyerinde pigment vererek üremistir. Granada besiyerinin % 40 oraninda gerçek pozitif kültürleri atladigi görülmüstür. Izole edilen GBS suslarinin antibiyotik duyarliliklari incelendiginde, penisilin ve seftriaksona % 100, kloramfenikol, vankomisin ve siprofloksasine % 95, tetrasikline ise % 40 duyarlilik saptanmistir. Sonuçlar bu konuyla ilgili daha önce yapilan çalismalarla uyumlu bulunmustur. Izolatlarin serotiplendirilmesi sonucu en sik gözlenen serotipler tip III (%35), tip Ia (%30) ve tip V (%15) olmustur. Bu çalismada GBS kolonizasyonunun varliginda Granada besiyerinin % 40 oraninda gerçek pozitif kültürleri atladigi, Todd-Hewitt besiyerinin ise daha duyarli oldugu ancak zaman aldigi görülmüstür. Bu çalismadan elde edilen veriler isiginda her iki yöntemin de bu önemli patojen için tek basina tavsiye edilemeyecegi, kombine stratejiler kullanarak ( Todd-hewitt sivi besiyeri, Granada besiyeri) hem zamandan kazanmanin, hem de duyarliligi arttirmanin mümkün olabilecegi sonucuna varilmistir.In this study, it is aimed to detect the recto-vaginal GBS (Group B Streptococus) colonization frequency in third term pregnants, to study the effects of some factors to the colonization frequency of GBS such as mother’s age, gestation week, education level, smoking and using spiral, to compare the culture methods that are used to detect the GBS colonization, to serotype and to reveal the antibiotic susceptibilities of the isolated Group B Streptococus strains For this aim, vaginal and rectal samples were taken from 200 expectant mothers who applied to the Medical Faculty of Gazi University, Women Healthcare and Birth Medical Clinic. These samples were studied at the Microbiology Laboratory of Gazi University. Group B Streptococus colonization was detected in the 20 mothers (10%) out of 200 who were studied. GBS colonization frequency of vaginal samples was found significantly higher than the colonization frequency of rectal samples among the pregnants. When we compared GBS colonization and age groups, education levels , we could not find a considerable difference between them. Vaginal colonization frequency was found significantly high in the mothers who smoked and used spiral among the examined mothers. Growth in Todd-Hewitt broth was detected in the 20 pregnant women out of 200. 12 of these isolated 20 strains grew by extracting pigment in the Granada medium at the same time. It was observed that Granada medium missed 40 % of the real positive cultures. When we studied the antibiotic susceptibilities of GBS strains, 100 % sensitivity for penicillin and ceftriaxone, 95 % sensitivity for chloramphenicol, vancomycin and ciprofloxacin, and 40 % sensitivity for tetracycline were discovered. These results were suitable with the previous studies. As a result of serotyping of isolates, the most observed serotypes were type III (35 %), type Ia (30 %), and type V (15 %). In this study, it was observed that Granada medium missed 40 % of real positive cultures in the existence of GBS colonization, Todd-Hewitt broth was more sensitive but took additional time. According to data obtained from this study, it is concluded that both of the methods can not be recommended as a sole method for this important pathogen and by using combined strategies (for example Todd-Hewitt broth and Granada medium) it is possible both to spare time and increase sensitivity

Serotype distribution of Streptococcus pneumoniae and pneumococcal vaccine coverage in adults in Turkey between 2015 and 2018

AbstractObjective To evaluate the serotype distribution and antibiotic resistance in pneumococcal infections in adults and to provide a perspective regarding serotype coverage of both current and future pneumococcal vaccines.Patients and methods This passive surveillance study was conducted with the Streptococcus pneumoniae strains isolated from the specimens of patients with pneumonia (materials isolated from bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015 and 2018. Serogrouping and serotyping were performed by latex particle agglutination and by conventional Quellung reaction using commercial type-specific antisera, respectively. The strains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilities by E-test.Results In the whole study group (410 samples from adults aged ≥18 years), the most frequent serotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15, PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillin non-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patients aged <65 and ≥65 years, respectively. About 21.1% and 4.3% of the patients with and without IPD had cefotaxime resistance. Non-susceptibility to erythromycin and moxifloxacin was 38.2% and 1.2%, respectively.Conclusions The results revealed that novel PCV vaccines may provide improved coverage as compared with the currently available vaccine, PCV13. The significant antibiotic resistance rates imply the need to extend the serotype coverage of the vaccines. Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution and incidence changes of IPD cases in the population and to inform policy makers to make necessary improvements in the national immunization programmes.Key messagesThis multicentre study demonstrated the most recent serotype distribution and antibiotic resistance in adult population in Turkey.Shifting from PCV13 to novel conjugated vaccines will significantly increase the coverage.Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution changes and the incidence of cases with invasive pneumococcal disease in the population

Serotype distribution of Streptococcus pneumoniae in children with invasive diseases in Turkey: 2008-2014

WOS: 000371745700019PubMed ID: 26325175Successful vaccination policies for protection from invasive pneumococcal diseases (IPD) dependent on determination of the exact serotype distribution in each country. We aimed to identify serotypes of pneumococcal strains causing IPD in children in Turkey and emphasize the change in the serotypes before and after vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) was included and PCV-13 was newly changed in Turkish National Immunization Program. Streptococcus pneumoniae strains were isolated at 22 different hospitals of Turkey, which provide healthcare services to approximately 65% of the Turkish population. Of the 335 diagnosed cases with S. pneumoniae over the whole period of 2008-2014, the most common vaccine serotypes were 19F (15.8%), 6B (5.9%), 14 (5.9%), and 3 (5.9%). During the first 5y of age, which is the target population for vaccination, the potential serotype coverage ranged from 57.5 % to 36.8%, from 65.0% to 44.7%, and from 77.4% to 60.5% for PCV-7, PCV-10, and PCV-13 in 2008-2014, respectively. The ratio of non-vaccine serotypes was 27.2% in 2008-2010 whereas was 37.6% in 2011-2014 (p=0.045). S. penumoniae serotypes was less non-susceptible to penicillin as compared to our previous results (33.7vs 16.5 %, p=0.001). The reduction of those serotype coverage in years may be attributed to increasing vaccinated children in Turkey and the increasing non-vaccine serotype may be explained by serotype replacement. Our ongoing IPD surveillance is a significant source of information for the decision-making processes on pneumococcal vaccination.PfizerPfizerThis study was supported by Pfizer