A Small Cutaneous Anthrax Epidemic in Eastern Turkey

Abstract

Objectives: This study aims to investigate an epidemic of cutaneous anthrax in Tunceli Province, Eastern Turkey. Materials and methods: Seven cases with cutaneous anthrax, admitted to emergency room, were diagnosed and followed at Elazig Harput State Hospital in August 2011. The possible sources of epidemic and clinical characteristics of the patients were evaluated. Results: The mean age of seven cases with cutaneous anthrax was 34.1±8 years, of whom four were male and three were female. All patients were from the same village of Cemisgezek, Tunceli, and all of them had contacted with a dead animal. Amoxicillin/clavulanic acid-resistant Bacillus anthracis was recovered from a patient\' wound. This resistance may be related with the inappropriate use of antibiotics in animal and animal husbandry practices. Conclusion: Most of natural originated anthrax cases are cutaneous. Although the incidence of anthrax has decreased in Turkey, the disease is still endemic in the eastern part of the country.

Keywords

• Anthrax, epidemic, amoxicillin/clavulanic acid, antibiotic resistance

A Small Cutaneous Anthrax Epidemic in Eastern Turkey

Abstract

Keywords

• -

References

1. Lucey D. Bacillus anthracis (Anthrax), In: Mandell GL, Bennett JE, Dolin R eds. Principles and Practice of Infectious Dis- eases, 6th edn. Philadelphia: Elsevier-Churchill Livingstone, 2005:2485-2493.
2. Turnbull P. Anthrax in Humans, In: WHO Anthrax Working Group eds. Anthrax in Humans and Animals, 4th edn. Ge- neva: WHO Pres, 2008:1-208.
3. Sternbach G. The history of anthrax. J Emerg Med 2003; 24:463-467.
4. Ertek M. Current Situation of Anthrax in Turkey. ANKEM Derg 2011; 25: 88-91.
5. Aydın F, Atabay Hİ, Genç O, Atahan H, Bölük M. The Epizo- otiology of Anthrax in Kars District Assessment of Anthrax Cases Recorded Between 1995 and 2000, Some Charac- teristics of Bacillus anthracis Strains Isolated from Various Sources. Kafkas Üniv Vet Fak Derg 2000; 6:55-59.
6. Cavallo JD, Ramisse F, Girardet M, Vaissarie J, Mock M, Her- nandez E. Antibiotic susceptibilities of 96 isolates of Bacillus anthracis isolated in France between 1994 and 2000, Antimi- crob Agent Chemother 2002; 46: 2307-2309.
7. Perçin D. Antibiotic Resistance in Anthrax Bacilli. ANKEM Derg 2011; 25:97-99.
8. Metan G, Doganay M. The Antimicrobial Susceptibility of Bacil- lus anthracis Isolated from Human Cases: A Review of the Turkish Literature. Turkiye Klinikleri J Med Sci 2009; 29: 229- 235.

9. Doganay M, Metan G. Human anthrax in Turkey from 1990 to 2007. Vector Borne Zoonotic Dis 2009;9: 131-140.
10. Hart CA, Beeching NJ. A spotliht on anthrax. Clin Dermatol 2002; 20: 365-375.
11. Brachman PS. Anthrax. In: Evans AS, Brachman PS, eds. Bacterial Infections of Humans, Epidemiology and Control, 3th edn. New York: Plenum Medical, 1991:75.
12. Taş A, Yağız R, Gürcan Ş, Karaoğlu D: Oropharyngeal An- thrax. Turk J Med Sci 2008; 38: 621-623.
13. Lalitha MK, Thomas MK. Penicillin resistance in Bacillus an- thracis. Lancet 1997; 349:1522.
14. Athamna A, Athamna M, Abu-Rashed N, Medlej B, Bast DJ, Rubinstein E. Selection of Bacillus anthracis isolates resis- tant to antibiotics. J Antimicrob Chemother 2004; 54:424- 428.
15. Chen Y, Tenover FC, Koehler TM.Beta-lactamase gene ex- pression in a penicilin-resistant Bacillus anthracis strain. An- timicrob Agents Chemother 2004; 48: 4873-4877.
16. Brook I, Elliott TB, Pryor HI, Sautter TE, Gnade BT, Thakar JH, Knudson GB. In vitro resistance of Bacillus anthracis Sterne to doxycycline, macrolides and quinolones. Int J Anti- microb Agents 2011; 8: 559-562.
17. Price LB, Vogler A, Pearson T, Busch JD, Schupp JM, Keim P. In vitro selection and characterization of Bacillus anthracis mutants with high-level resistance to ciprofloxacin. Antimi- crob Agents Chemother 2003; 47: 2362-2365.
18. Gültekin F, Bakıcı Z, Şencan M, Heper G.The sensitivity to antibiotics of B. anthracis. ANKEM Derg 1990; 4:231.
19. Doganay M, Aydin N. Antimicrobial susceptibility of Bacillus anthracis. Scand J Infect Dis 1991; 23: 333-335.
20. Erdoğan MH, Güneş V, Çitil M. Dairy Cattle Farming in Kars District, Turkey: II. Health Status, Turk J Vet Anim Sci 2004; 28: 745-752.