Molecular epidemiology of penicillin resistant Streptococcus pneumoniae strains in Turkey. A multicenter study

Altun B., Gur D., Kocagoz S. , Hascelik G., Unal S.

ANNALS OF MICROBIOLOGY, vol.56, no.3, pp.185-190, 2006 (Journal Indexed in SCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 56 Issue: 3
  • Publication Date: 2006
  • Doi Number: 10.1007/bf03175003
  • Title of Journal : ANNALS OF MICROBIOLOGY
  • Page Numbers: pp.185-190


A total of 539 isolates recovered from various clinical sites were collected from 13 hospitals from different regions of Turkey between 1999 and 2002. Susceptibility to penicillin and cefotaxime was determined by the E-test and the remaining antimicrobials were evaluated by disk diffusion tests. Penicillin resistant and intermediate isolates were serotyped and PFGE patterns were analysed. Overall 16 isolates (3%) were resistant to penicillin, and 143 (26.5%) were intermediate. Resistance and intermediate rates were 3.1% and 29.0% respectively in respiratory tract isolates. Multiple resistance (resistance to 3 antibiotics) occurred in 81.8% of the penicillin resistant isolates and the most frequent resistance phenotype was penicillin+trimethoprim/sulphamethoxazole (37.7%). Minimum inhibitory concentrations of cefotaxime were lower than 1 mg/ml for all the isolates. The highest rate of resistance was observed for trimethoprim/sulphamethoxazole (26.6%) followed by doxycycline (12.6%). Resistance to erythromycin was 10.1%, clindamycin 9.9%, chloramphenicol 4.3%, ofloxacin 5.0% and levofloxacin 0.2%. There was no resistance to vancomycin. Resistant isolates belonged to serogroups 9, 23, and 6. The most frequent serogroups among intermediate isolates were 23, 19, 14, 1, 9, and 6. Five distinct PFGE patterns were observed among penicillin resistant isolates. There was no distinct clustering of specific PFGE patterns in the study centres. No correlation between serotypes, resistance and PFGE patterns was found. There seems to be genetic heterogeneity in Streptococccus pneumoniae isolates in Turkey.