A grubu beta hemolitik streptokokların opasite faktör üretimi ve penisilin,eritromisin duyarlılığı / The production opacity factor of a group beta hemolytic streptococcus and penicillin, erythromycin sensitivity
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Tarih
2007
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Maltepe Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AGBHS farenjit ve tonsillit gibi akut infeksiyonların yanında, ARA ve AGN gibi poststreptokoksik sekelleri nedeniyle de tedavisi ve önlenmesi önemli olan streptokok infeksiyonlarının etkenidir. ARA ve AGN' ye belirli M serotipleri sebep olmaktadır. AGBHS ` leri serotiplendirmek için M proteini, T- paternleri ve serum opasite faktörü gibi geleneksel yöntemler veya moleküler yöntemler kullanılır. SOF, serotiplendirmede kullanılmakta ve ayrıca patogenezi etkileyen bir faktör olarak dikkati çekmektedir. AGBHS'de penisiline direnç tüm dünyada olmamasına rağmen eritromisin için birçok ülkeden yüksek direnç oranları bildirilmiştir. Bu çalışmada, boğaz sürüntü örneklerinden izole edilen 300 AGBHS suşunun eritromisin ve penisilin duyarlılıkları ve bunlardan 200 suşun SOF üretimi araştırılmıştır.Eritromisin ve penisilin duyarlılık çalışmaları agar dilüsyon metodu ile CLSI önerilerine göre yapılmıştır. SOF üretimi, Lancefield HCl ekstraksiyonları kullanılarak mikroplak yöntemiyle araştırılmıştır.Penisiline dirençli suş saptanmamıştır. Eritromisin direnci %5 bulunmuştur. SOF, çalışılan 200 suşun % 50'sinde pozitif olarak tespit edilmiştir.Sonuç olarak, ülkemizde makrolid direnci yüksek olmamakla birlikte bu ilaçların ikinci seçenek olduğu hatırlanmalı ve rasyonel kullanımı sağlanmalıdır. Üst solunum yolu infeksiyonu etkeni olan AGBHS suşlarının yarısının SOF üretmesi nedeniyle, invaziv infeksiyonlara ve non ?süpüratif sekellere neden olan serotiplerin belirlenmesinde de SOF araştırılmasının vazgeçilmez olduğu ortaya konmuştur.ARA, AGN ve invaziv AGBHS infeksiyonlarının önlenmesi için ulusal politikaların üretilmesinde klinik mikrobiyoloji laboratuvarlarında AGBHS'nın doğru tanımlanması ve serotiplerinin belirlenmesi önemlidir.
Group A beta-hemolytic streptococcus (GABHS) is a microorganism causing pharyngytis and tonsillitis and it is prevention and therapy is very important as it has sequels like ARA and AGN. It is known that specific M serotypes cause ARA and AGN. Clinical microbiology laboratory has an essential role in supplying accurate documentation of group A streptococcal infections and vital to national programs for the control of rheumatic fever, rheumatic heart disease, acute post streptococcal glomerulonephritis and severe invasive group A streptococcal infections. Conventional methods like protein M, T-patterns and opacity factor (OF) or molecular methods are used for serotyping of GABHS. Serum opacity factor (SOF) is used for serotyping and also is known to affect the pathogenesis.Although resistance for penicillin in GABHS is not shown worldwide, high resistance rates for erythromycin are reported from many countries. In this study, erythromycin and penicillin sensitivity in 300 GABHS strains, isolated from throat swab specimens, were investigated. Additionally, OF production of 200 GABHS were evaluated. Erythromycin and penicillin sensitivity were detected by agar dilution method as suggested by CLSI and microtitre plate method was used for OF detection by Lancefield HCl extracts. As a result, although no penicillin resistant strains were detected, erythromycin resistance was 5% and out of 200 strains which were evaluated for OF, 50% were OF positive.In conclusion, it is found that macrolide resistance in our country is not high, however it should be remembered that these drugs are the second choice for GABHS therapy and rational usage must be provided. Moreover, as 50 % of GABHS which cause upper respiratory infections were shown to produce OF, SOF detection in GABHS serotyping studies seem to be inevitable.
Group A beta-hemolytic streptococcus (GABHS) is a microorganism causing pharyngytis and tonsillitis and it is prevention and therapy is very important as it has sequels like ARA and AGN. It is known that specific M serotypes cause ARA and AGN. Clinical microbiology laboratory has an essential role in supplying accurate documentation of group A streptococcal infections and vital to national programs for the control of rheumatic fever, rheumatic heart disease, acute post streptococcal glomerulonephritis and severe invasive group A streptococcal infections. Conventional methods like protein M, T-patterns and opacity factor (OF) or molecular methods are used for serotyping of GABHS. Serum opacity factor (SOF) is used for serotyping and also is known to affect the pathogenesis.Although resistance for penicillin in GABHS is not shown worldwide, high resistance rates for erythromycin are reported from many countries. In this study, erythromycin and penicillin sensitivity in 300 GABHS strains, isolated from throat swab specimens, were investigated. Additionally, OF production of 200 GABHS were evaluated. Erythromycin and penicillin sensitivity were detected by agar dilution method as suggested by CLSI and microtitre plate method was used for OF detection by Lancefield HCl extracts. As a result, although no penicillin resistant strains were detected, erythromycin resistance was 5% and out of 200 strains which were evaluated for OF, 50% were OF positive.In conclusion, it is found that macrolide resistance in our country is not high, however it should be remembered that these drugs are the second choice for GABHS therapy and rational usage must be provided. Moreover, as 50 % of GABHS which cause upper respiratory infections were shown to produce OF, SOF detection in GABHS serotyping studies seem to be inevitable.
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Özakkaş, F. (2007). A grubu beta hemolitik streptokokların opasite faktör üretimi ve penisilin,eritromisin duyarlılığı / The production opacity factor of a group beta hemolytic streptococcus and penicillin, erythromycin sensitivity (Yayımlanmamış Yüksek Lisans Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.
