Streptococcus pyogenes ile Enfekte Çocukların Boğaz Örneklerinde Mef (E) ve Erm (B) Genlerinin Varlığı

Öz

Amaç: Streptococcus ile ilgili yapılan antibiyotik direnç çalışmaları, özellikle çocuk boğaz enfeksiyonlarının tedavisinde halk sağlığı ve akılcı antibiyotik kullanımı açısından büyük önem taşımaktadır. Biz de çalışmamızda bu amaçla makrolid direnç genleri mef (E) ve erm (B) 'yi tanımlamayı amaçladık. Yöntem ve Bulgular: Boğaz ağrısı şikayeti ile hastaneye başvuran 51 çocuktan alınan boğaz kültürü örnekleri laboratuvarda değerlendirildi ve gram boyama, katalaz, basitrasin ve PYR testleri ile S. pyogenes tanısı konuldu. Duyarlılık profili Kirby-Bauer disk difüzyon yöntemi ile ve Eritromisin ile klindamisinin minimum inhibitör konsantrasyonu (MİK), VITEK 2 Sistemi ile saptandı. S. pyogenes'te ki makrolid direnci 51 hastada aşağıdaki gibi saptandı; benzilpenisilin %0, eritromisin %74,5, klindamisin %31,4. S. pyogenes hastalarında makrolid direnci mef (E) ve erm (B) genlerinin genetik belirteçleri her gene özel primerler kullanılarak PCR yöntemi ile araştırıldı. İzolatların toplam% 48'i (n = 24) erm (B) için pozitif, % 10'u (n = 5) mef (E) için pozitif, %42'sinde (n = 21) her iki gen birlikte tespit edildi. Sonuç: Çalışmamızın sonuçlarına göre makrolid direnç genleri pozitif hastaların anamnezleri incelendiğinde, hastaneye sık sık boğaz enfeksiyonu ile başvuran ve tedavi aldıktan sonraki birkaç hafta içinde tekrar enfeksiyon yaşayan hastaların olduğu belirlendi. S. pyogenes'te özellikle çocuklarda antimikrobiyal direnç tehdidi nedeniyle, direnci saptamak için ulusal ve şehir sürveyans çalışmalarına ihtiyaç vardır. Bu nedenle araştırmamız, geliştirmeye açık yeni hipotezler ve çalışmalarla desteklenmelidir. Anahtar Kelimeler: Direnç genleri, PCR, Streptococcus pyogenes, Moleküler epidemiyoloji

Anahtar Kelimeler

• PCR
• Direnç geni
• moleküler epidemiyoloji

The Presence of Mef (E) and Erm (B) Genes in Throat Samples of Children Infected with Streptococcus pyogenes

Öz

Aim: Antibiotic resistance studies about the Streptococcus have a great importance for the treatment of especially child throat infections in terms of public health and rational antibiotic use. For this purpose, we aimed to identify the macrolide resistance genes mef(E) and erm(B). Material and Method: The throat culture samples taken from 51 children presenting to the hospital with the complaint of sore throat were evaluated in the laboratory, and S. pyogenes was diagnosed using tests; gram staining, catalase, bacitracin and PYR. Susceptibility profile was determined with the Kirby-Bauer disk-diffusion method and minimum inhibitor concentration(MICs) of erythromycin and clindamycin was determined by VITEK 2 System. Results: S. pyogenes was possible macrolide resistance genes of mef(E) and erm(B) was determined by PCR. Macrolide resistance in S. pyogenes are determined in 51 pateients as follows; benzylpenicillin 0%, erytromycin 74.5%, clindamycin 31.4%. In patients with S. pyogenes, the genetic determinants of macrolide resistance mef(E) and erm(B) genes was investigated with the PCR method using primers specific to each gene. Total of 48% of the isolates (n=24) were positive for erm (B), 10% (n=5) for mef(E), in 42% (n=21) of the isolates both genes were detected. Conclusion: The results of our study show that macrolid resistance genes were found in five of the patients evaluated. When the anamnesis of these patients was examined, it was determined that there were patients that frequently presented to the hospital with throat infections and experienced re-infection within a few weeks after receiving treatment.

Anahtar Kelimeler

• Moleculer epidemiology
• mef(A) and Erm(B)
• Resistant genes
• PCR
• Streptecoccus pyogenes

Kaynakça

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