Gebelerde grup B streptokok kolonizasyonunun değişik besiyerleri kullanılarak gösterilmesi ve serotiplendirilmeleri
Detecting group B streptococcus colonization in pregnants by using  different mediums and serotyping
Yazar: LASER ŞANAL
Danışman: PROF. DR. MAHMUT NEDİM SULTAN
Sağlık Bakanlığı / Tıp Fakültesi / Tıbbi Mikrobiyoloji Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2008
Konu: Mikrobiyoloji = Microbiology

Özet:
Bu çalışmada üçüncü trimestr gebelerde rekto-vajinal Grup B Streptokok (GBS)
kolonizasyon sıklığının saptanması; anne yaşı, gestasyon haftası, eğitim durumu, sigara ve spiral kullanımı gibi faktörlerin GBS kolonizasyon sıklığına etkisinin araştırılması; GBS kolonizasyonunun saptanmasında kullanılan kültür yöntemlerinin karşılaştırılması; izole edilen GBS suşlarının serotiplendirilmesi ve antibiyotik duyarlılıklarının ortaya konulması amaçlanmıştır.
Bu amaçla Gazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniğine başvuran 200 anne adayından vajinal ve rektal örnekler alınmıştır. Alınan örnekler Gazi Üniversitesi Mikrobiyoloji Laboratuarında değerlendirilmiştir.
Çalışmaya alınan 200 anneden 20'sinde (%10) GBS kolonizasyonu saptanmıştır. Gebelerde vajinal örneklerde saptanan GBS kolonizasyon sıklığı rektal örneklerdeki GBS kolonizasyon sıklığından belirgin derecede yüksek bulunmuştur. 
Gebelerde GBS kolonizasyonu ile yaş grupları ve eğitim durumları karşılaştırıldığında, aralarında istatiksel olarak anlamlı bir fark bulunamamıştır. İncelenen gebelerde sigara kullanma alışkanlığı ve spiral kullanma hikayesi olanlarda GBS'lerin vajinal üreme sıklığı anlamlı derecede yüksek bulunmuştur.
Çalışmaya alınan 200 gebe kadından 20'sinde Todd-hewitt besiyerinde üreme saptanmıştır. İzole edilen bu 20 suşun 12'si aynı zamanda Granada besiyerinde pigment vererek üremiştir. Granada besiyerinin % 40 oranında gerçek pozitif kültürleri atladığı görülmüştür.
İzole edilen GBS suşlarının antibiyotik duyarlılıkları incelendiğinde, penisilin ve seftriaksona % 100, kloramfenikol, vankomisin ve siprofloksasine % 95, tetrasikline ise % 40 duyarlılık saptanmıştır. Sonuçlar bu konuyla ilgili daha önce yapılan çalışmalarla uyumlu bulunmuştur.
İzolatların serotiplendirilmesi sonucu en sık gözlenen serotipler tip III (%35), tip Ia (%30) ve tip V (%15) olmuştur.
Bu çalışmada GBS kolonizasyonunun varlığında Granada besiyerinin % 40 oranında gerçek pozitif kültürleri atladığı, Todd-Hewitt besiyerinin ise daha duyarlı olduğu ancak zaman aldığı görülmüştür.
Bu çalışmadan elde edilen veriler ışığında  her iki yöntemin de bu önemli patojen için tek başına tavsiye edilemeyeceği, kombine stratejiler kullanarak ( Todd-hewitt sıvı besiyeri, Granada besiyeri) hem zamandan kazanmanın, hem de duyarlılığı arttırmanın mümkün olabileceği sonucuna varılmıştır.

Abstract:
In this study, it is aimed to detect the recto-vaginal GBS (Group B Streptococus) colonization frequency in third term pregnants, to study the effects of some factors to the colonization frequency of GBS such as mother's age, gestation week, education level, smoking and using spiral, to compare the culture methods that are used to detect the GBS colonization, to serotype and to reveal the antibiotic susceptibilities of the isolated Group B Streptococus strains 
For this aim, vaginal and rectal samples were taken from 200 expectant mothers who applied to the Medical Faculty of Gazi University, Women Healthcare and Birth Medical Clinic. These samples were studied at the Microbiology Laboratory of Gazi University.
Group B Streptococus colonization was detected in the 20 mothers (10%) out of 200 who were studied. GBS colonization frequency of vaginal samples was found significantly higher than the colonization frequency of rectal samples among the pregnants. 
When we compared GBS colonization and age groups, education levels , we could not find a considerable difference between them. Vaginal colonization frequency was found significantly high in the mothers who smoked and used spiral among the examined mothers. 
Growth in Todd-Hewitt broth was detected in the 20 pregnant women out of 200. 12 of these isolated 20 strains grew by extracting pigment in the Granada medium at the same time. It was observed that Granada medium missed 40 % of the real positive cultures. 
When we studied the antibiotic susceptibilities of GBS strains, 100 % sensitivity for penicillin and ceftriaxone, 95 % sensitivity for chloramphenicol, vancomycin and ciprofloxacin, and 40 % sensitivity for tetracycline were discovered. These results were suitable with the previous studies. As a result of serotyping of isolates, the most observed serotypes were type III (35 %), type Ia (30 %), and type V (15 %).
In this study, it was observed that Granada medium missed  40 % of real positive cultures in the existence of GBS colonization, Todd-Hewitt broth was more sensitive but took additional time.
According to data obtained from this study, it is concluded that both of the methods can not be  recommended as a sole method for this important pathogen and by using combined strategies (for example Todd-Hewitt broth and Granada medium) it is possible both to spare time and increase sensitivity.




In this study, it is aimed to detect the recto-vaginal GBS (Group B Streptococus) colonization frequency in third term pregnants, to study the effects of some factors to the colonization frequency of GBS such as mother's age, gestation week, education level, smoking and using spiral, to compare the culture methods that are used to detect the GBS colonization, to serotype and to reveal the antibiotic susceptibilities of the isolated Group B Streptococus strains 
For this aim, vaginal and rectal samples were taken from 200 expectant mothers who applied to the Medical Faculty of Gazi University, Women Healthcare and Birth Medical Clinic. These samples were studied at the Microbiology Laboratory of Gazi University.
Group B Streptococus colonization was detected in the 20 mothers (10%) out of 200 who were studied. GBS colonization frequency of vaginal samples was found significantly higher than the colonization frequency of rectal samples among the pregnants. 
When we compared GBS colonization and age groups, education levels , we could not find a considerable difference between them. Vaginal colonization frequency was found significantly high in the mothers who smoked and used spiral among the examined mothers. 
Growth in Todd-Hewitt broth was detected in the 20 pregnant women out of 200. 12 of these isolated 20 strains grew by extracting pigment in the Granada medium at the same time. It was observed that Granada medium missed 40 % of the real positive cultures. 
When we studied the antibiotic susceptibilities of GBS strains, 100 % sensitivity for penicillin and ceftriaxone, 95 % sensitivity for chloramphenicol, vancomycin and ciprofloxacin, and 40 % sensitivity for tetracycline were discovered. These results were suitable with the previous studies. As a result of serotyping of isolates, the most observed serotypes were type III (35 %), type Ia (30 %), and type V (15 %).
In this study, it was observed that Granada medium missed  40 % of real positive cultures in the existence of GBS colonization, Todd-Hewitt broth was more sensitive but took additional time.
According to data obtained from this study, it is concluded that both of the methods can not be  recommended as a sole method for this important pathogen and by using combined strategies (for example Todd-Hewitt broth and Granada medium) it is possible both to spare time and increase sensitivity.





In this study, it is aimed to detect the recto-vaginal GBS (Group B Streptococus) colonization frequency in third term pregnants, to study the effects of some factors to the colonization frequency of GBS such as mother's age, gestation week, education level, smoking and using spiral, to compare the culture methods that are used to detect the GBS colonization, to serotype and to reveal the antibiotic susceptibilities of the isolated Group B Streptococus strains 
For this aim, vaginal and rectal samples were taken from 200 expectant mothers who applied to the Medical Faculty of Gazi University, Women Healthcare and Birth Medical Clinic. These samples were studied at the Microbiology Laboratory of Gazi University.
Group B Streptococus colonization was detected in the 20 mothers (10%) out of 200 who were studied. GBS colonization frequency of vaginal samples was found significantly higher than the colonization frequency of rectal samples among the pregnants. 
When we compared GBS colonization and age groups, education levels , we could not find a considerable difference between them. Vaginal colonization frequency was found significantly high in the mothers who smoked and used spiral among the examined mothers. 
Growth in Todd-Hewitt broth was detected in the 20 pregnant women out of 200. 12 of these isolated 20 strains grew by extracting pigment in the Granada medium at the same time. It was observed that Granada medium missed 40 % of the real positive cultures. 
When we studied the antibiotic susceptibilities of GBS strains, 100 % sensitivity for penicillin and ceftriaxone, 95 % sensitivity for chloramphenicol, vancomycin and ciprofloxacin, and 40 % sensitivity for tetracycline were discovered. These results were suitable with the previous studies. As a result of serotyping of isolates, the most observed serotypes were type III (35 %), type Ia (30 %), and type V (15 %).
In this study, it was observed that Granada medium missed  40 % of real positive cultures in the existence of GBS colonization, Todd-Hewitt broth was more sensitive but took additional time.
According to data obtained from this study, it is concluded that both of the methods can not be  recommended as a sole method for this important pathogen and by using combined strategies (for example Todd-Hewitt broth and Granada medium) it is possible both to spare time and increase sensitivity.