Antibiotic Sensitivity of Streptococcus Agalactiae Strains Isolated From Clinical Samples

Abstract

Introduction: Although Streptococcus agalactiae is a member of human normal body flora, it can cause serious infections, especially in the newborn and in the presence of certain predisposing factors. The aim of this study wasto evaluate the susceptibility and clinical properties of S.agalactiae isolates isolated from various clinical specimens. Methods: Antibiotic susceptibilities of 494 S. agalactiae isolates isolated from clinical specimens sent to Sakarya University Medical Faculty Training and Research Hospital between 2017-2019 were analyzed retrospectively. All isolated bacteria were identified by conventional methods and mass spectrophotometry (VITEK-MS®, bioMérieux, France). Antibiotic susceptibility tests were performed with VITEK 2® (bioMérieux, France) system according to EUCAST recommendations. Results: When the demographic characteristics of the patients were examined; 364 (73.6 %) were female and 130 (26.3 %) were male. The average age; 48.6 ± 18.5 in female patients and 60.4 ± 17.0 in male patients. Sample distribution of isolates (n = 494); 349 (70 %) urine were 95 (19.2 %) wounds, 14 (2.8 %) vagen, 13 (2.6 %) blood, 10 (2 %) sterile body fluid, 4 (0.8 %) tracheal aspirate, 2 (0.4 %) sputum, 2 (0.4 %) aspiration specimens, 2 (0.4 %) urethral culture. Antimicrobial susceptibility analysis revealed that all strains were susceptible to penisiline, ampicilin, vancomycin, daptomycin, teicoplanin and linezolid; erythromycin, trimethoprim/sulfamethoxazole, tigecycline and tetracycline susceptibilities were 334 (67.6 %), 442 (89.5 %), 482 (97.5 %), 154 (31.2 %) respectively.. In 47 (9.5 %) of the isolates, inducible type MLSb phenotype was determined. Conclusion: S. agalactia strains were most frequently isolated from urine specimens and female patients. Increasing resistance to bacillin and erythromycin, an alternative to penicillin, which causes serious infections in pregnant women and immunosuppressive individuals should not be ignored and treatment should be directed according to antibiotic susceptibility test results.

Keywords

• Group B Streptococcus,Streptococcus agalactiae,antibiotic resistance

Klinik Örneklerden İzole Edilen Streptococcus Agalactiae Suşlarinin Antibiyotik Duyarliliklari

Abstract

Giriş: Streptococcus agalactiae, insan normal vücut florası üyesi olmasına rağmen özellikle yenidoğanda ve bazı predispozan faktörlerin varlığında ciddi enfeksiyonlara sebep olabilmektedir. Bu çalışmada, çeşitli klinik örneklerden izole edilen S. agalactiae izolatlarının antibiyotiklere duyarlılıklarının ve klinik özelliklerinin değerlendirilmesi amaçlanmıştır. Yöntem: 2017-2019 yılları arasında Sakarya Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi’ne gönderilen klinik örneklerden izole edilen 494 S. agalactiae izolatının antibiyotik duyarlılıkları retrospektif olarak incelenmiştir. İzole edilen tüm bakterilerin identifikasyonu konvansiyonel yöntemler ve kütle spektrofotometresi ile (VITEK-MS®, bioMérieux, Fransa) yapılmıştır. Antibiyotik duyarlılık testleri VITEK 2® (bioMérieux, Fransa) sistemi ile EUCAST önerilerine göre gerçekleştirilmiştir. Bulgular: Hastaların demografik özellikleri incelendiğinde; 364’’ünün (% 73,6) kadın, 130’nun (% 26.3) erkek olduğu görülmüştür. Yaş ortalaması; kadın hastalarda 48,6 ±18,5, erkek hastalarda 60,4 ±17, bulunmuştur. İzolatların (n=494) örnek dağılımı; 349 (% 70) idrar, 95 (% 19,2) yara, 14 (% 2,8) vagen, 13 (% 2,6) kan, 10 (% 2) steril vücut sıvısı, 4 (% 0,8) trakeal aspirat, 2 (% 0,4) balgam, 2 (% 0,4) aspirasyon, 2 (% 0,4) üretral kültür örneği şeklindedir. Antibiyotik duyarlılıkları incelendiğinde tüm suşların penisilin, ampisilin, vankomisin, daptomisin, teikoplanin ve linezolide duyarlı olduğu; eritromisin, trimetoprim/sülfametoksazol tigesiklin ve tetrasiklin duyarlılıklarının ise sırasıyla; 334 (% 67,6), 442 (% 89,5), 482 (% 97,5), 154 (% 31,2) olduğu saptanmıştır. Çalışmaya alınan izolatların 47’sinde (% 9,5) indüklenebilir tipte MLSB fenotipi belirlenmiştir. Sonuç: S. agalactiae suşları, en sık idrar örneklerinden ve kadın hastalardan izole edilmiştir. Bakterinin gebelerde ve immun supresif kişilerde ciddi enfeksiyonlara neden olduğu, penisiline alternatif olan klindamisin ve eritromisine karşı direncin giderek artış göstermesi göz ardı edilmemeli ve tedavi antibiyotik duyarlılık test sonuçlarına göre yönlendirilmelidir.

Keywords

• B grubu Streptokok,Streptococcus agalactiae

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