Akut tonsillofarenjitli hastalardan izole edilen beta hemolitik streptokokların tiplendirilmesi
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Dosyalar
Tarih
1997
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Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Streptokoksik tonsillofarenjit vakalarının büyük bir kısmından A grubu beta hemolitik streptokoklar(AGBHS) sorumludurlar.Ancak diğer serogruplarda,özellikle C ve G grubu BHS larda akut bakteriyel farenjitin nedeni olabilmektedirler. Selçuk üniversitesi tıp fakültesi klinik bakteriyoloji ve infeksiyon hastalıkları polikliniğine ateş,boğaz ağrısı gibi şikayetlerle başvuran ve akut tonsillofarenjit düşünülen 256 hastanın boğaz kültürleri değerlendirildi.BHS saptanan 113 örneğin streptokok serogruplan lateks aglütinasyon(LA) metodu ile yapıldı ve %84.1 Agrubu, %4.4 B grubu, %7.1 Cgrubu ve %4.4 G grubu olarak tiplendirildi. İzole edilen suşlarm çeşitli antibiyotiklere duyarlılıkları saptandı.AGBHS'lar penisilin ve sefuroksime en yüksek oranda (%97.89) duyarlı bulundular.Amoksisilin ve klaritromisin duyarlılığı %94,73,ampisilin ve sulbaktam-ampisilin duyarlılığı %91.57, sefaleksin duyarlılığı %89.47 veSMX duyarlılığı %82.1 idi. AGBHS' larda eritromisin direnci ise %6.32 olarak belirlendi.AGBHS ların tamamı basitrasine duyarlı bulundu. Nongrup A BHS ların,özellikle C ve G grubu,basitrasine duyarlı olabileceği düşünülmektedir.Bu da basitrasine duyarlı ve dirençli tüm suşlarm tiplendirilmesi gerektiğini göstermektedir. Sonuç olarak;akut tonsillofarenjitli hastalarda erken tanı ve uygun tedavi dikkate alındığında izole edilen BHS ların tiplendirilmesinde LA testi, kültürle beraber kullanıldığında hızlı ve güvenilir bir test olarak göz önüne alınmalı;ayrıca AGBHS ların tedavisinde penisilin birinci seçenek olarak düşünülmelidir.Klaritromisin,eritromisin ve sefuroksim de alternatif tedavide düşünülmelidir.
A Group beta hemolytic streptococci are responsible for majority of streptococcal tonsillopharyngitis cases.But also other serogroups,especially C and G group beta hemolytic streptococci,may cause acute bacterial pharyngitis 256 patients applying to the Selçuk Universty Faculty of Medicine, Clinical Bacteriology and Infectious Diseases Department with complaints of fever and sore throat were evaluated with throat cultures. S ero typing of BHS detected 1 1 3 samples were done by latex agglutination(LA) method and of which %84.1 were typed as group A, %4.4 as group B, %7.1 as group C, %4.4 as group G. Ratios of antibiotic susceptibility of strains were detected. A Group beta hemolytic streptococci had the highest sensitivity to penicillin and cefuroxime (%97.89). Sensitivitiy to amoxicillin and clarithromycin were %94.73 and these were %91.57 for ampicillin and sulbactam-ampicillin, %89.47 for cephalexin, %82.1 for SMX. Erithromycin resistance was found to be %6.32 in AGBHS. All AGBHS were sensitive to bacitracin. It is thought that non AGBHS, especially group C and G might be sensitive to bacitracin and this shows that all strains sensitive and resistant to bacitracin should be serotyped. Considering early diagnosis and suitable treatment of acute tonsillopharyngitis patients LA test, when was used with culture, should be accepted as a fast and reliable method for evaluating isolated BHS. Besides, penicillins still remains as distinguished modality for treatment of AGBHS. Erithromycine and the other macrolides,and cefuroxime should be considered as alternative treatment.
A Group beta hemolytic streptococci are responsible for majority of streptococcal tonsillopharyngitis cases.But also other serogroups,especially C and G group beta hemolytic streptococci,may cause acute bacterial pharyngitis 256 patients applying to the Selçuk Universty Faculty of Medicine, Clinical Bacteriology and Infectious Diseases Department with complaints of fever and sore throat were evaluated with throat cultures. S ero typing of BHS detected 1 1 3 samples were done by latex agglutination(LA) method and of which %84.1 were typed as group A, %4.4 as group B, %7.1 as group C, %4.4 as group G. Ratios of antibiotic susceptibility of strains were detected. A Group beta hemolytic streptococci had the highest sensitivity to penicillin and cefuroxime (%97.89). Sensitivitiy to amoxicillin and clarithromycin were %94.73 and these were %91.57 for ampicillin and sulbactam-ampicillin, %89.47 for cephalexin, %82.1 for SMX. Erithromycin resistance was found to be %6.32 in AGBHS. All AGBHS were sensitive to bacitracin. It is thought that non AGBHS, especially group C and G might be sensitive to bacitracin and this shows that all strains sensitive and resistant to bacitracin should be serotyped. Considering early diagnosis and suitable treatment of acute tonsillopharyngitis patients LA test, when was used with culture, should be accepted as a fast and reliable method for evaluating isolated BHS. Besides, penicillins still remains as distinguished modality for treatment of AGBHS. Erithromycine and the other macrolides,and cefuroxime should be considered as alternative treatment.
Açıklama
Anahtar Kelimeler
Tonsil, Tonsiller, Streptococcus agalactiae, Pharyngitis, Farenjit
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Erayman, İ. (1997). Akut tonsillofarenjitli hastalardan izole edilen beta hemolitik streptokokların tiplendirilmesi. Selçuk Üniversitesi, Yayımlanmış tıpta uzmanlık tezi, Konya.
