Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses

ALPAY, H. Cengiz; Aral, Murat; Keleş, Erol

Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses

Erol KELEŞ, (Fırat Üniversitesi, Tıp Fakültesi, Kulak Burun Boğaz Anabilim Dalı, Elazığ, Türkiye)

Murat ARAL, (Kahramanmaraş Sütçü İmam Üniversitesi, Tıp Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı, Kahramanmaraş, Türkiye)

H. Cengiz ALPAY (Fırat Üniversitesi, Tıp Fakültesi, Kulak Burun Boğaz Anabilim Dalı, Elazığ, Türkiye)

Kulak Burun Boğaz İhtisas Dergisi

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Yıl: 2006 Cilt: 16 Sayı: 1 Sayfa Aralığı: 18 - 24 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses

Öz:

Amaç: Kronik sinüzit nedeniyle fonksiyonel endoskopik sinüs cerrahisi hastaların sinüslerinden alınan kültür materyallerinden izole edilen Streptokok pnömoni, Streptokok viridans, A grubu hemolitik streptokok'larm antibiyotik dirençleri araştırıldı. Hastalar ve Yöntemler: Çalışmaya, kronik sinüzit nedeniyle fonksiyonel endoskopik sinüs cerrahisi uygulanan 93 hasta (63 erkek, 30 kadın; ort. yaş 36±17.47; dağılım 19-68) alındı. Cerrahi girişim öncesi nazal mukoza, deri ve komşu yapılar olası bir kontaminasyonu önlemek amacıyla povidone-iodine solüsyonuyla temizlendi. Tüm hastalardan povidone-iodine solüsyonu uygulamadan önce ve sonra burun sürüntü örnekleri alındı. Ameliyat sırasında da etmoid sinüsten ve maksiller sinüs ostiumundan kültür için materyal alındı. Kültürlerde izole edilen Streptokok pnömoni, Streptokok viridans ve A grubu hemolitik streptokoklara antibiyotik duyarlılık testleri yapıldı. Bulgular: Ameliyat öncesi burun sürüntü kültürlerinden povidone-iodine solüsyonu uygulamadan önce 58 hastadan (%62.3) 72 aerop bakteri üremesi olurken, povidone-iodine solüsyonu uygulandıktan sonra alınan kültürlerde 12 hastadan (%12.9) toplam 16 izolasyon oldu. Ameliyat sırasında maksiller sinüslerden alınan kültürlerde hastaların %95.6'sında (89/93), etmoid sinüsten alınan kültürlerde ise %91.3'ünde (85/93) mikroorganizma izole edildi. Her iki sinüste de en sık izole edilen mikroorganizma koagülaz negatif stafilokok, ikinci sıklıkta viridans streptokoklar daha sonra sırasıyla koagülaz pozitif stafilokok, Streptokok pnömoni we A grubu hemolitik streptokok idi. İzole edilen viridans streptokok susunun %33.3'ü tetrasikline, %23.8'i kloramfenikole, %19.04'ü penisiline dirençli bulunurken, A grubu hemolitik streptokok susunun tümü penisilin, ofloksasin, seftriakson, sefepime duyarlı, %50'si eritromisin ve kloramfenikole, tamamı tetrasikline dirençli bulundu. İzole edilen Streptokok pnömoni suşlarının %25'i pensiline, %66.6'sı trimetoprim/sülfametoksazole, %41.6'sı eritromisine, %58.3'ü tetrasikline, %33.3'ü kloramfenikole ve %16.6'sı rifampine dirençliydi. İzole edilen suşların tümü vankomisine duyarlıydı. Sonuç: Kronik sinüzitli hastalardan sık olarak izole edilen Streptokok pnömoni, viridans streptokoklar ve A grubu hemolitik streptokok ların antimikrobiyal duyarlılıklarının araştırılmasının, klinikte uygulanacak ampirik tedavinin seçilmesinde ve kronik sinüzitli hastalarda viridans streptokok'ların tedavide göz önünde bulundurulması gerektiğini düşünüyoruz.

Anahtar Kelime: Streptococcus İlaç direnci, bakteriyel Viridans streptokok Anti-bakteriyel ajanlar Streptococcus pneumoniae Etmoid sinüs Sinüzit Maksiller sinüs Kronik hastalık

Konular: Cerrahi

Maksiller ve etmoid sinüslerden izole edilen streptokok pnömoni, streptokok viridans ve A grubu hemolitik streptokok'ların antibiyotik dirençlaeri

Öz:

Objectives: To investigate antibiotic sensitivities of Streptococcus pneumoniae, Viridans streptococci and Group A hemolytic Streptococci isolated from the culture materials obtained from the sinuses of patients undergoing functional endo-scopic sinus surgery due to chronic sinusitis. Patients and Methods: We recruited 93 patients (63 males, 30 females; mean age 36±17.47; range 19 to 68 years) who were undergoing functional endoscopic sinus surgery due to chronic sinusitis into this study. Before the surgical intervention, in order to eliminate a possible contamination from skin and neighboring structures, nasal mucosa was cleansed with povidone-iodine solution. Nasal smear samples were obtained from all the patients before and after applying povidone-iodine solution. Streptococcus pneumoniae, Viridans streptococci and Group A hemolytic Streptococci that were isolated from the cultures were tested for antibiotic sensitivity. Results: In the preoperative nasal smear cultures, total number of anaerobic bacteria isolated from 58 patients (62.3%) before applying povidone-iodine was 72, following the application of povidone-iodine a total of 16 microorganisms were identified from 12 (%12.9) patients. Microorganisms were isolated from 95.6% (89/93) of the samples obtained from maxillary sinuses and 91.3% (85/93) of the samples obtained from ethmoid sinuses. The most commonly identified microorganisms from both sinuses were coagulase (-) staphylococcus followed by Viridans streptococci, coagulase (+) staphylococcus, Streptococcus pneumoniae and Group A hemolytic streptococci. For the Viridans streptococcal strains that were isolated, 33.3% were resistant to tetracycline, 23.8% to chlorampheni-col, and 19.04% to penicillin. A hemolytic streptococci strains were sensitive to penicilin, ofloxacine, ceftriaxone and cefepime in all groups; however they had 50% resistance to eritromycin and chloramphenicol and 100% resistance to tetracycline. The resistance pattern of the isolated Streptococcus pneumoniae strains were as follows: 25% to penicillin, 66.6% to trimethoprim/sulphometaxa-zole, 41.6% to eritromycin, 58.3% to tetracycline, 33.3% to chloramphenicol and 16.6% to rifampin. All of the isolated strains were sensitive to vancomycin. Conclusion: We suggested that identification of the strains that are resistant to penicillin and other antibiotics is an important tool for choosing the empirical treatment to the Streptococcus pneumoniae, Viridans streptococci and group A hemolytic streptococci in clinical practice. Viridans streptococci which were frequently isolated from chronic sinusitis patients should be kept in mind.

Anahtar Kelime: Maxillary Sinus Chronic Disease Streptococcus Drug Resistance, Bacterial Viridans Streptococci Anti-Bacterial Agents Streptococcus pneumoniae Ethmoid Sinus Sinusitis

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Keleş E, Aral M, ALPAY H (2006). Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. , 18 - 24.
Chicago	Keleş Erol,Aral Murat,ALPAY H. Cengiz Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. (2006): 18 - 24.
MLA	Keleş Erol,Aral Murat,ALPAY H. Cengiz Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. , 2006, ss.18 - 24.
AMA	Keleş E,Aral M,ALPAY H Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. . 2006; 18 - 24.
Vancouver	Keleş E,Aral M,ALPAY H Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. . 2006; 18 - 24.
IEEE	Keleş E,Aral M,ALPAY H "Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses." , ss.18 - 24, 2006.
ISNAD	Keleş, Erol vd. "Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses". (2006), 18-24.

APA	Keleş E, Aral M, ALPAY H (2006). Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. Kulak Burun Boğaz İhtisas Dergisi, 16(1), 18 - 24.
Chicago	Keleş Erol,Aral Murat,ALPAY H. Cengiz Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. Kulak Burun Boğaz İhtisas Dergisi 16, no.1 (2006): 18 - 24.
MLA	Keleş Erol,Aral Murat,ALPAY H. Cengiz Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. Kulak Burun Boğaz İhtisas Dergisi, vol.16, no.1, 2006, ss.18 - 24.
AMA	Keleş E,Aral M,ALPAY H Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. Kulak Burun Boğaz İhtisas Dergisi. 2006; 16(1): 18 - 24.
Vancouver	Keleş E,Aral M,ALPAY H Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses. Kulak Burun Boğaz İhtisas Dergisi. 2006; 16(1): 18 - 24.
IEEE	Keleş E,Aral M,ALPAY H "Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses." Kulak Burun Boğaz İhtisas Dergisi, 16, ss.18 - 24, 2006.
ISNAD	Keleş, Erol vd. "Antibiotic sensitivities of Streptococcus pneumoniae, viridans streptococci and group A hemolytic streptococci isolated from the maxillary and ethmoid sinuses". Kulak Burun Boğaz İhtisas Dergisi 16/1 (2006), 18-24.