title: Epidemiology of penicillin resistance in Streptococcus pneumoniae isolates in Kayseri, Turkey.
abstract: OBJECTIVE
  To determine the penicillin resistance and serotype distribution of Streptococcus pneumoniae strains and to identify clonal relationships of isolates resistant to penicillin by means of pulsed-field gel electrophoresis (PFGE).
  
  
  METHODS
  In total, 193 S. pneumoniae strains were isolated from clinical specimens between November 1997 and January 2000. Susceptibility testing was carried out by E test, and serotyping by the Quellung reaction. Clonal relationship was analyzed by using PFGE with smaI endonuclease.
  
  
  RESULTS
  Of the S. pneumoniae isolates, 23% were intermediately resistant to penicillin. There were no high-level resistant pneumococci. The majority of isolates intermediately resistant to penicillin were of serogroups/serotypes 19, 23, 14 and 1, in descending order of frequency. There were eight major clones in strains intermediately resistant to penicillin. It was seen that serogroups in the 23-valent polysaccharide vaccine, 7-valent, 9-valent, and 11-valent vaccine formulations caused 92%, 75%, 78% and 87% of pneumococcal diseases in our region, respectively.
  
  
  CONCLUSIONS
  Penicillin resistance in S. pneumoniae is relatively uncommon in Kayseri. All vaccine formulations can prevent the majority of pneumococcal diseases, and there is genetic heterogeneity in intermediately penicillin-resistant pneumococci in this region.
authors.affiliation: Department of Microbiology, University of Erciyes, Kayseri, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Esel
authors.forename: B
authors.initials: B
authors.lastname: Sümerkan
authors.forename: S
authors.initials: S
authors.lastname: Kocagöz
mesh_terms: D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D008826:Microbial Sensitivity Tests; D010400:Penicillin G / Q000494:pharmacology*; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology*; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D014421:Turkey / Q000453:epidemiology
chemical_list: D010406:Penicillins; D010400:Penicillin G