Antibiotic Susceptibility of Group A

Öz

Tonsillopharyngitis is a common infectious disease in the pediatric age group. Group A Beta Hemolytic Streptococcus (GAS) is a main infectious agent of pharyngitis. Optimal therapeutic approach in these patients has been a matter of debate to avoid the complications of infection. The aim of this study was to investigate of antibiotic susceptibility for group A β-hemolytic Streptococci which isolated from tonsillar swab samples of 5-15 years old children. 2599 outpatient children who are 5-15 years old and have general infection symptoms like high fever, weakness, chills-shivering and observed hyperemia at tonsils and pharynx were included in the study. Tonsillopharyngeal culture and antimicrobial susceptibility tests were performed. 319 (12,3%) GAS isolates was obtained from tonsillopharyngeal cultures of the 2599 patients. Susceptibility to penicillin, vancomycin, linezolid, cefotaxime, erythromycin, chloramphenicol, and clindamycin were 100%, 100%, 100%, 100%, 97,2%, 98,3%, and 94,7% respectively.Resistance to penicillin was not yet observed, penicillin may safely be chosen to treatment of these infections for non-allergic patients to penicillin. It is considered that culture and antibiotic susceptibility testing may be more useful to for the diagnosis and treatment of these patients.

Anahtar Kelimeler

• Streptococcus pyogenes, antibiotic, susceptibility, children

Antibiotic Susceptibility of Group A

Öz

Tonsillofarenjit pediatrik yaş grubunda sık görülen bir enfeksiyon hastalığıdır. A Grubu Beta Hemolitik Streptokokar (GAS) en sık farenjit etkenlerindendir. Bu enfeksiyonun komplikasyonlarını önlemek bakımından en uygun tedavi yaklaşımı tartışma konusu olmuştur. Bu çalışmanın amacı, 5-15 yaş grubu çocukların tonsiller sürüntü örneklerinden izole edilen A Grubu β-hemolitik Streptokokların antibiyotik duyarlılık oranlarının araştırılmasıdır. 5-15 yaş grubunda, yüksek ateş, halsizlik, üşüme-titreme gibi genel enfeksiyon belirtileri ile polikliniğe başvuran, bademcik ve farinkste hiperemi gözlemlenen 2599 çocuk hasta çalışmaya dahil edildi. Boğaz kültürü ve antibiyotik duyarlılık testleri yapıldı. 2599 hastanın tonsillo-faringial kültürlerinden 319’unda (12,3%) GAS izole edilmiştir. Penisilin, vankomisin, linezolid, sefotaksim, eritromisin, kloramfenikol ve klindamisin duyarlılık oranları sırasıyla % 100, % 100,% 100,% 100,% 97,2, %98,3 ve % 94,7 olarak bulunmuştur. Bu enfeksiyonların tedavisinde, penisilin dienci bulunmadığından, penisilin alerjisi olmayan hastalar için güvenle seçilebilir. Bu hastaların tanı ve tedavisinde, kültür ve antibiyotik duyarlılık testlerinin yapılmasının daha yararlı olabileceği düşünülmektedir. Anahtar kelimeler: Streptococcus pyogenes, antibiyotik, duyarlılık, çocuklar

Anahtar Kelimeler

• Streptococcus pyogenes, antibiyotik, duyarlılık, çocuklar

Kaynakça

1. American Academy of Pediatrics (AAP) (2012). Red Book: 2012 Report of the Committee on Infectious iseases. Pickering LK, ed. 29th ed. Elk Grove Village, IL: American Academy of Pediatrics.
2. Van Howe RS, Kusnier LP. Diagnosis and management of pharyngitis in a pediatric population based on cost-effec- tiveness and projected health outcomes. Pediatrics 2006; 117: 609-19.
3. Bisno AL, Gerber MA, Gwaltney JM , Kaplan EL, Schwartz RH. Practice guidelines for the diagnosis and manage- ment of group A streptococcal pharyngitis. Clin Infect Dis 2002;35:113–25.
4. Institute for Clinical Systems Improvement (ICSI). Health Care Guideline: Diagnosis and Treatment of Respiratory Illness in Children and Adults. First Edition. Bloomington, MN: Institute for Clinical Systems Improvement.
5. Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Beneden CV (2012). Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. IDSA Guideline for GAS Pharyngitis CID 2007; pp 1-17.
6. Brundage JF, Gunzenhauser JD, Longfield JN, et al. Epidemiology and control of acute respiratory disease with emphasis on group A beta-hemolytic Streptococcus: a decade of U.S. Army experience. Pediatrics 1996; 97: 964–70.
7. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibil- ity testing; 18th informational supplement. CLSI/NCCLS M100-S18. Clinical and Laboratory Standards Institute, Wayne, Pennsylvania 2008.
8. WHO Expert Consultation on Rheumatic Fever and Rheumatic Heart Disease. Rheumatic fever and rheumatic heart disease: report of a WHO Expert Consultation, 29 October - 1 November 2001. Geneva 2004.

9. Nordet P, Lopez R, Dueñas A, Sarmiento L. Prevention and control of rheumatic fever and rheumatic heart disease: the Cuban experience (1986–1996–2002). Cardiovasc J Africa 2008;19: 135-40.
10. Santos O, Weckx LLM, Pignatari ACC, Pignatari SSN. Detection of group A beta-hemolytic Streptococcus em- ploying three different detection methods: Culture, rapid antigen detecting test, and molecular assay. BJID 2003; 7: 297-300.
11. Omurzakova NA, Yamano Y, Saatova GM, Alybaeva MS, Nishioka K, Nakajima T. Prevalence of group A β-hemolytic Streptococcus among children with tonsillopharyngitis in Kyrgyzstan: The difficulty of diagnostics and therapy. Open Rheumatol J 2010;4: 39-46.
12. Morais VMS, Orsi AR, Maranhão FCA, Castro TMPPG, Castro KCB, Silva DMW. Prevalence of β-hemolytic Streptococcus in children with special health care needs. Braz J Otorhinolaryngol 2012; 78:110-5.
13. Martin JM, Green M, Barbadora KA, Wald ER. Group A Streptococci among school-aged children: Clinical charac- teristics and the carrier state. Pediatrics 2004;114:1212-9.
14. Danchin MH, Rogers S, Selvaraj G, et al. The burden of group A streptococcal pharyngitis in Melbourne families. Indian J Med Res 2004;119: 144-7.
15. Doğan M, Feyzioğlu B, Çimen Ö, et al. Investigation of anti- biotic susceptibility for group A β-hemolytic Streptococci which isolated at tonsillar swab samples of 5-15 years old children. XXXIII. Turkish Microbiology Congress, Congress book; Bodrum, 2008; pp 652.
16. Haczyński J, Chmielik M, Bardadin J, et al. A comparative study of cefaclor vs amoxicillin/clavulanate in tonsillo- pharyngitis. Med Sci Monit 2003;9: 29-35.
17. Özakkafi F, Aksungar FB, Topkaya AE. Examination of antibiotic susceptibility of group A Beta-hemolytic Streptococci. ANKEM J 2007; 21: 10-3 (in Turkish).
18. Eryilmaz M, Akin A, Akan OA. The antibiotic susceptibili- ties of group A beta-hemolytic Streptococci isolated from throat cultures. ANKEM J 2006; 20:10-2(in Turkish).
19. İnan N, Erdoğan H, Berkiten R. Grouping and antibiotic resistance of beta-hemolytic Streptococci isolated from various clinical samples. Klimik J 2003;16: 118-120(in Turkish).