[Serotypes and antimicrobial susceptibilities of invasive group A streptococci identified in eastern Black Sea region of Turkey]

Frequency of invasive group A streptococcus (GAS) infections is increasing worldwide in recent 20 years. Serotypes responsible for these clinical manifestations and their antibiotic susceptibilities should be known in order to establish preventive measures and initiate appropriate treatment. This study was aimed to determine the serotypes, antibiotic susceptibilities and inducible clindamycin resistance among invasive GAS isolated between 2006-2009 period. A total of 22 GAS strains isolated from clinical samples [sterile body fluids (peritoneal, pleural, pericardial, joint and cerebrospinal fluids), blood, tissue biopsy] of the patients (14 male, 8 female; age range: 3-82 years, median age: 59) who admitted to Karadeniz Technical University Faculty of Medicine, Farabi Hospital located in Trabzon province (Eastern Black Sea Region of Turkey), between March 2006 and March 2009 were included in the study. GAS serotypes were determined by the investigation of serum opacity factors (SOF), T proteins and M proteins. SOF production was investigated by microplate method using human serum and SOF types were determined by SOF-inhibition test using specific antisera. T protein types were detected by agglutination method using polyvalent anti-T sera, and M serotypes were detected by capillary precipitation method using M antisera. Antimicrobial susceptibility tests were performed by disk-diffusion method according to CLSI recommendations. SOF were positive in 9 (41%) samples. Use of T antiserum yielded T (n= 8) and U (n= 7) types and M antiserum M1 (n= 4) and M2 (n= 3) types. The overall antibiotic susceptibility rate of the isolates was 68% (15/22) and overall resistance rate was 32% (7/22). All of the GAS strains were found susceptible to benzylpenicillin, ceftriaxone, vancomycin, levofloxacine and linezolid, however 9 (41%) were intermediate susceptible to tetracycline and 1 (4.5%) was intermediate susceptible to erythromycin. Four (18%) strains were found resistant to tetracycline, while three strains (13.5%) were found resistant to chloramphenicol. Inducible clindamycin resistance was found positive only in one strain. The serotypes determined in this study indicated that 33% of our invasive serotypes were covered by the hexavalent vaccine and 62% by the 26-valent vaccine. Multi-center surveillance studies are required to determine the serotype distribution of invasive GAS in Turkey and to provide valuable information for the development of appropriate vaccines in our country.

Pneumococcal conjugate vaccines—a European perspective

Streptococcus pneumoniae is a leading cause of bacterial pneumonia, meningitis, and acute otitis media in children and adults worldwide. In the age group of < 2 years the incidence of invasive pneumococcal disease ranges from approximately 14 cases per 100,000 in Germany and the Netherlands and more than 90 per 100,000 children in Spain. The vulnerability of children to S. pneumoniae can also be demonstrated by the high rate of sequelae (> 20% in Germany) and the high mortality (7.5%) in pneumococcal meningitis. Furthermore, antibiotic resistance of S. pneumoniae is increasing in Europe, particularly in France, Spain, and Eastern European countries, whereas Germany and Northern Europe are only marginally affected. A 7-valent pneumococcal conjugate vaccine (7vPCV) that was shown to be highly efficacious in preventing invasive pneumococcal disease in infants in the USA was licensed in Europe in 2001. It is expected that broad usage of the vaccine would reduce the incidence of invasive pneumococcal disease and the levels of pneumococcal resistance significantly. Important questions have been raised regarding the effectiveness of this vaccine in high-risk populations, serotype replacement, the efficacy of this vaccine in otitis media, and the co-administration of the new vaccine with other standard childhood vaccines used in various European countries. France and Spain currently have the most-wide ranging guidelines recommending pneumococcal vaccination for children. Overall, the development of pneumococcal conjugate vaccines is a significant step in the control of pneumococcal disease in children in Europe. Further progress in pneumococcal vaccine development can be expected from conjugate vaccines including more than seven serotypes (9-valent, 11-valent).

Effects of various adjuvants on efficacy of a vaccine against Streptococcus bovis and Lactobacillus spp in cattle

OBJECTIVE

To determine efficacy of vaccines incorporating QuilA, alum, dextran combined with mineral oil, or Freund adjuvant for immunization of feedlot cattle against Streptococcus bovis and Lactobacillus spp.

ANIMALS

24 steers housed under feedlot conditions.

PROCEDURE

Steers were randomly assigned to 4 experimental groups and a control group. Animals in experimental groups were inoculated on days 0 and 26 with vaccines containing Freund adjuvant (FCA), QuilA, dextran combined with mineral oil (Dex), or alum as adjuvant. Serum anti-S bovis and anti-Lactobacillus IgG concentrations were measured, along with fecal pH, ruminal fluid pH, and number of S bovis and Lactobacillus spp in ruminal fluid.

RESULTS

Throughout the study, serum anti-S bovis and anti-Lactobacillus IgG concentrations for animals in the Dex, QuilA, and alum groups were similar to or significantly higher than concentrations for animals in the FCA group. Serum anti-S bovis and anti-Lactobacillus IgG concentrations were significantly increased on days 26 through 75 in all 4 experimental groups, and there was a linear relationship between anti-S bovis and anti-Lactobacillus IgG concentrations. For animals in the QuilA and Dex groups, mean pH of feces throughout the period of experiment were significantly higher and numbers of S bovis and Lactobacillus spp in ruminal fluid on day 47 were significantly lower than values for control cattle.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that immunization of feedlot steers against S bovis and Lactobacillus spp with vaccines incorporating Freund adjuvant, QuilA, dextran, or alum as an adjuvant effectively induced high, long-lasting serum anti-S bovis and anti-Lactobacillus IgG concentrations. Of the adjuvants tested, dextran may be the most effective.