Serotype distribution of Streptococcus pneumoniae in children with invasive diseases in Turkey: 2008-2014.

Successful vaccination policies for protection from invasive pneumococcal diseases (IPD) dependent on determination of the exact serotype distribution in each country. We aimed to identify serotypes of pneumococcal strains causing IPD in children in Turkey and emphasize the change in the serotypes before and after vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) was included and PCV-13 was newly changed in Turkish National Immunization Program. Streptococcus pneumoniae strains were isolated at 22 different hospitals of Turkey, which provide healthcare services to approximately 65% of the Turkish population. Of the 335 diagnosed cases with S. pneumoniae over the whole period of 2008-2014, the most common vaccine serotypes were 19F (15.8%), 6B (5.9%), 14 (5.9%), and 3 (5.9%). During the first 5 y of age, which is the target population for vaccination, the potential serotype coverage ranged from 57.5 % to 36.8%, from 65.0% to 44.7%, and from 77.4% to 60.5% for PCV-7, PCV-10, and PCV-13 in 2008-2014, respectively. The ratio of non-vaccine serotypes was 27.2% in 2008-2010 whereas was 37.6% in 2011-2014 (p=0.045). S. penumoniae serotypes was less non-susceptible to penicillin as compared to our previous results (33.7 vs 16.5 %, p=0.001). The reduction of those serotype coverage in years may be attributed to increasing vaccinated children in Turkey and the increasing non-vaccine serotype may be explained by serotype replacement. Our ongoing IPD surveillance is a significant source of information for the decision-making processes on pneumococcal vaccination.

In vitro susceptibility of Candida species to four antifungal agents assessed by the reference broth microdilution method.

This study was performed to determine the distribution of Candida species isolated from the blood cultures of the patients hospitalized in our hospital and to investigate their antifungal susceptibility. Candida strains were identified at species level by using classical methods and API ID 32C (bioMerieux, France) identification kits. The susceptibility of the strains to amphotericin B, fluconazole, voriconazole, and caspofungin was evaluated by using the reference broth microdilution method in document M27-A3 of the Clinical and Laboratory Standards Institute. Of the 111 Candida strains isolated, 47.7% were identified as C. albicans and 52.3% as non-albicans Candida strains. The MIC ranges were 0.03-1 µg/mL for amphotericin B, 0.125-≥64 µg/mL for fluconazole, 0.03-16 µg/mL for voriconazole, and 0.015-0.25 µg/mL for caspofungin. All Candida strains were susceptible to amphotericin B and caspofungin. 10.8% isolates were resistant to fluconazole and 8.1% isolates were dose-dependent susceptible. While 0.9% isolate was resistant to voriconazole, 0.9% isolate was dose-dependent susceptible. In our study, C. albicans and C. parapsilosis were the most frequently encountered agents of candidemia and it was detected that voriconazole with a low resistance rate might also be used with confidence in the treatment of infections occurring with these agents, primarily besides amphotericin B and caspofungin.

Determination of antimicrobial susceptibility patterns and inducible clindamycin resistance in Staphylococcus aureus strains recovered from southeastern Turkey.

BACKGROUND: In this study, we determined the susceptibility patterns of Staphylococcus aureus strains to various antimicrobials and prevalence of inducible clindamycin resistance (ICR) in these isolates. METHODS: Two hundred and one S aureus strains, isolated from various clinical samples, were included in the study. Antibiotic susceptibilities were studied by disc diffusion method on the basis of the guidelines by the Clinical and Laboratory Standards Institute. The disc diffusion induction test (D test) was applied to determine ICR resistance among erythromycin-resistant S aureus isolates. RESULTS: Of the 201 S aureus strains, 101 (50.2%) were resistant to methicillin. All strains were susceptible to vancomycin, teicoplanin, quinupristin/dalfopristin, and linezolid. It was found that 54 (53.4%) methicillin-resistant S aureus (MRSA) strains were erythromycin resistant, and 40 (39.6%) of them showed constitutive clindamycin resistance. ICR was detected in seven (6.9%) MRSA strains. It was found that 13 (13.0%) methicillin-susceptible S aureus (MSSA) strains were erythromycin resistant. Constitutive clindamycin resistance was seen in one (1.0%) MSSA strain, and ICR was detected in 10 (10.0%) cases. CONCLUSION: There was a high rate of methicillin resistance among S aureus strains in our hospital. However, no statistically significant difference of ICR was observed between MRSA and MSSA strains (p=0.434) or between inpatients and outpatients (p=0.804). It was concluded that ICR should be routinely evaluated in each S aureus case to avoid therapy failure among patients.

The prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in the endocervical swab specimens of symptomatic, asymptomatic and infertile women in Turkey.

PURPOSE: To investigate C. trachomatis and N. gonorrhoeae prevalence in three different female populations in Turkey. METHODS: A total of 370 women, 170 symptomatic, 100 asymptomatic, and 100 infertile, were included. Of the endocervical specimens collected from all women using a Dacron swab, the first one was taken to Stuart's transport medium to culture, while the second one was transferred onto slides to perform direct fluorescent antibody test (DFA) and Gram staining, and the third specimen was used for Becton Dickinson BDProbeTec ET system (BDPT). RESULTS: C. trachomatis was detected in 5.16% of symptomatic, 1.11% of asymptomatic, and 2.15% of infertile women with BDPT. Sensitivity and specificity of the DFA test were 72.73 and 97.85%, respectively. N. gonorrhoeae was detected in 2.42% of symptomatic and in 1.02% of infertile women. N. gonorrhoeae was not detected in any asymptomatic women. In N. gonorrhoeae-positive patients, sensitivity and specificity of culture were 60 and 100%, respectively, while they were 80 and 100% for BDPT. CONCLUSIONS: Prevalence of N. gonorrhoeae and C. trachomatis was detected to be low in Turkish women, and the difference between the groups was not significant. Both agents were more prevalent in subjects over 25 years of age.