Beta hemolytic Streptococci strains isolated from clinical specimens, their characteristics and antibiotic susceptibility

Abstract

Aim: Beta Hemolytic Streptococcus (BHS) species play a role in many infections, such as urinary tract infection, skin/soft tissue infections, neonatal meningitis, sepsis, pneumonia as well as upper respiratory tract infections like tonsillopharyngitis. The aim of this study was to determine the types of BHS species, their infectious characteristics and antibiotic susceptibility profiles in clinical specimens. 

Methods: In this cross-sectional study, infectious features of 1276 streptococcus strains isolated from 1110 (87%) outpatients and 166 (13%) inpatients between January 2014 and June 2019 at our laboratory and antimicrobial susceptibility of the 320 strains were analyzed retrospectively. 

Results: Retrospective analysis of 1276 BHS isolates revealed that 48.6% were group B, 33.9% were group A, 9.6% were group F, 5.7% were group C and 2.2% were group G BHS. Among isolated BHS infections, 42.9% caused urinary tract infection, 34.6% caused tonsillitis/tonsillopharyngitis, 15.7% were isolated from skin/soft tissue infections, 3% were found in the bloodstream, and 1% in meningitis, pneumonia, conjunctivitis, and peritonitis. About 2.8% Group B Streptococcus were considered vaginal colonization. Among all patients, 11.2% had more than one underlying disease. All isolates were susceptible to penicillin, vancomycin, linezolid and tigecycline. Erythromycin, clindamycin, and tetracycline resistance rates were determined as 5%, 2%, 40% respectively for Group A and 34%, 11%, 90%, respectively for Group B Streptococcus.

Conclusion: Early diagnosis and appropriate antibiotherapy are important parameters in the management of streptococcal infections. Although there is no penicillin resistance in beta-hemolytic streptococci, we think that antibiotic susceptibility should be closely monitored due to increasing clinical failures, penicillin Minimal inhibitory concentration (MIC) values, and macrolide and fluoroquinolone resistance, especially in Group B Streptococcus.

Keywords

• Antibiotic susceptibility,Infection,Beta Hemolytic Streptococcus spp

Klinik örneklerden izole edilen beta-hemolitik streptokok suşları, özellikleri ve antibiyotik duyarlılığı

Öz

Amaç: Beta Hemolitik Streptococcus (BHS) türleri, idrar yolu enfeksiyonu, cilt/yumuşak doku enfeksiyonları, tonsillofarenjit gibi üst solunum yolu enfeksiyonları, yenidoğanda menenjit, sepsis ve pnömoni gibi birçok enfeksiyonda rol oynar. Bu çalışmanın amacı klinik örneklerden izole edilen BHS türlerini, enfeksiyon özelliklerini ve antibiyotik duyarlılık profillerini belirlemektir.

Yöntemler: Laboratuvarımızda Ocak 2014 - Haziran 2019 tarihleri arasında, 1110 (%87) ayaktan ve 166 (%13) yatarak tedavi gören hastadan izole edilen 1276 beta hemolitik streptokok (BHS) suşu, özellikleri ve 320 suşun antimikrobiyal duyarlılığı retrospektif olarak incelendi. Çalışmanın tipi kesitsel çalışmadır. 

Bulgular: Toplam 1276 BHS izolatının; %48,6 grup B, %33,9 grup A, %9,6 grup F, %5,7 grup C ve %2,2 grup G BHS idi. İncelenen BHS enfeksiyonlarının; %42,9'u idrar yolu enfeksiyonu, %34,6'sı tonsillit/tonsillofarenjit, %15,7'si cilt/yumuşak doku enfeksiyonu, %3' ü kan dolaşımı enfeksiyonu ve %1'i menenjit, pnömoni, konjonktivit ve peritonit idi. %2,8 Grup B Streptokok izolatı vajinal kolonizasyon olarak kabul edildi. Hastaların %11,2'sinde birden fazla altta yatan hastalık vardı. Tüm izolatlar penisilin, vankomisin, linezolid ve tigesikline duyarlıydı. Eritromisin, klindamisin ve tetrasiklin direnci Grup A Streptokok ve Grup B Streptokok için sırasıyla %5, %2, %40 ve %34, %11, %90 olarak belirlendi.

Sonuç: Erken tanı ve uygun antibiyoterapi streptokok enfeksiyonlarının tedavisinde önemli parametrelerdir. Beta-hemolitik streptokoklarda penisilin direnci olmasa da, klinik başarısızlıkların varlığı, özellikle Grup B Streptokok 'da penisilin Minimal İnhibitör Konsantrasyonu (MİK) değerlerinin artışı, makrolid ve florokinolon direncinin artması nedeniyle antibiyotik duyarlılığının yakından izlenmesi gerektiğini düşünüyoruz.

Anahtar Kelimeler

• Antibiyotik duyarlılığı,Enfeksiyon,Beta hemolitik Streptococcus spp

Kaynakça

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