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Öğe Antibiotic Susceptibility of Group A B-Hemolytic Streptococci Isolated From Tonsillar Swab Samples in 5-15 Years Old Children(Modestum Ltd, 2014) Dogan, Metin; Aydemir, Ozlem; Guner, Sukru Nail; Feyzioglu, Bahadir; Baykan, MahmutTonsillopharyngitis is a common infectious disease in the pediatric age group. Group A Beta Hemolytic Streptococcus ( GAS) is a main infectious agent of pharyngitis. Optimal therapeutic approach in these patients has been a matter of debate to avoid the complications of infection. The aim of this study was to investigate of antibiotic susceptibility for group A B-hemolytic Streptococci which isolated from tonsillar swab samples of 5-15 years old children. 2599 outpatient children who are 5-15 years old and have general infection symptoms like high fever, weakness, chills-shivering and observed hyperemia at tonsils and pharynx were included in the study. Tonsillopharyngeal culture and antimicrobial susceptibility tests were performed. 319 ( 12,3%) GAS isolates was obtained from tonsillopharyngeal cultures of the 2599 patients. Susceptibility to penicillin, vancomycin, linezolid, cefotaxime, erythromycin, chloramphenicol, and clindamycin were 100%, 100%, 100%, 100%, 97,2%, 98,3%, and 94,7% respectively. Resistance to penicillin was not yet observed, penicillin may safely be chosen to treatment of these infections for non-allergic patients to penicillin. It is considered that culture and antibiotic susceptibility testing may be more useful to for the diagnosis and treatment of these patients.Öğe Antibiotic Susceptibility of Group A B-Hemolytic Streptococci Isolated From Tonsillar Swab Samples in 5-15 Years Old Children(Modestum Ltd, 2014) Dogan, Metin; Aydemir, Ozlem; Guner, Sukru Nail; Feyzioglu, Bahadir; Baykan, MahmutTonsillopharyngitis is a common infectious disease in the pediatric age group. Group A Beta Hemolytic Streptococcus ( GAS) is a main infectious agent of pharyngitis. Optimal therapeutic approach in these patients has been a matter of debate to avoid the complications of infection. The aim of this study was to investigate of antibiotic susceptibility for group A B-hemolytic Streptococci which isolated from tonsillar swab samples of 5-15 years old children. 2599 outpatient children who are 5-15 years old and have general infection symptoms like high fever, weakness, chills-shivering and observed hyperemia at tonsils and pharynx were included in the study. Tonsillopharyngeal culture and antimicrobial susceptibility tests were performed. 319 ( 12,3%) GAS isolates was obtained from tonsillopharyngeal cultures of the 2599 patients. Susceptibility to penicillin, vancomycin, linezolid, cefotaxime, erythromycin, chloramphenicol, and clindamycin were 100%, 100%, 100%, 100%, 97,2%, 98,3%, and 94,7% respectively. Resistance to penicillin was not yet observed, penicillin may safely be chosen to treatment of these infections for non-allergic patients to penicillin. It is considered that culture and antibiotic susceptibility testing may be more useful to for the diagnosis and treatment of these patients.Öğe The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections(Professional Medical Publications, 2014) Aydemir, Ozlem; Aydemir, Yusuf; Ozdemir, MehmetObjectives: Lower respiratory tract infection is one of the most important causes of morbidity and mortality. However establishing a microbial diagnosis for patients with lower respiratory tract infection is still challenging and is often achieved in only half of cases by conventional methods. This study was designed to compare the fast responsive PCR method with the culture method in lower respiratory tract infections and to evaluate the reliability of multiplex PCR method. Methods: One hundred ninety seven patients with the symptoms of acute lower respiratory tract infection, and diagnosed with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease and exacerbations of bronchiectasis were included in the study. Both culture and PCR methods was performed for the isolation of most commonly seen bacteria, from sputum, nasopharyngeal swabs and bronchoalveolar lavage fluid samples. Results: While at least one bacterial isolation was determined in 62 (31.5%) of all patients with culture method, this number increased to 125 (63.5%) with multiplex PCR. The bacteria most commonly identified by PCR were S. pneunnoniae (32%) and H. influenzae (31%). There was a significant difference between PCR and culture in terms of multi-factor detection rates (p < 0.005). Multiple bacteria were detected in only two cases in cultures; however, multiple pathogens were detected in 47 cases with PCR. Conclusions: Conventional methods, such as culture and serology are not always adequate to detect the pathogens in lower respiratory tract. Real-time PCR assays proved highly sensitive and rapid. The prevalence of bacteria and multiple agent detected by real-time PCR compared with culture was substantially higher. Widespread use of PCR methods, by providing the immediate and appropriate agent specific antibiotic treatment of LRTI, will help reduce failure and contributes to a reduction in antibiotic resistance.Öğe Value of multiplex PCR to determine the bacterial and viral aetiology of pneumonia in school-age children(Taylor & Francis Ltd, 2017) Aydemir, Yusuf; Aydemir, Ozlem; Pekcan, Sevgi; Ozdemir, MehmetBackground: Conventional methods for the aetiological diagnosis of community-acquired pneumonia (CAP) are often insufficient owing to low sensitivity and the long wait for the results of culture and particularly serology, and it often these methods establish a diagnosis in only half of cases. Aim: To evaluate the most common bacterial and viral agents in CAP using a fast responsive PCR method and investigate the relationship between clinical/laboratory features and aetiology, thereby contributing to empirical antibiotic selection and reduction of treatment failure. Methods: In children aged 4-15 years consecutively admitted with a diagnosis of CAP, the 10 most commonly detected bacterial and 12 most commonly detected viral agents were investigated by induced sputum using bacterial culture and multiplex PCR methods. Clinical and laboratory features were compared between bacterial and viral pneumonia. Results: In 78 patients, at least one virus was detected in 38 (48.7%) and at least one bacterium in 32 (41%). In addition, both bacteria and viruses were detected in 16 (20.5%) patients. Overall, the agent detection rate was 69.2%. The most common viruses were respiratory syncytial virus and influenza and the most frequently detected bacteria were S. pneumoniae and H. influenzae. PCR was superior to culture for bacterial isolation (41% vs 13%, respectively). Fever, wheezing and radiological features were not helpful in differentiating between bacterial and viral CAP. White blood cell count, CRP and ESR values were significantly higher in the bacterial/mixed aetiology group than in the viral aetiology group. Conclusion: In CAP, multiplex PCR is highly reliable, superior in detecting multiple pathogens and rapidly identifies aetiological agents. Clinical features are poor for differentiation between bacterial and viral infections. The use of PCR methods allow physicians to provide more appropriate antimicrobial therapy, resulting in a better response to treatment, and it may be possible for use as a routine service if costs can be reduced.