title: Results from the Survey of Antibiotic Resistance (SOAR) 2002-09 in Turkey.
abstract: OBJECTIVE
  To investigate changes in antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae from the Survey of Antibiotic Resistance (SOAR) in community-acquired respiratory tract infections (CA-RTIs) between 2002 and 2009 in Turkey.
  
  
  METHODS
  Previously published SOAR data were used for this analysis. MICs were determined using Etest(®) gradient strips or disc diffusion. Susceptibility against a range of antimicrobial agents was assessed using CLSI breakpoints.
  
  
  RESULTS
  A total of 900 S. pneumoniae isolates were analysed: 2002-03 (n = 75), 2004-05 (n = 301) and 2007-09 (n = 524). Four antibiotics were tested consistently throughout and three showed a statistically significant decrease in susceptibility (P < 0.0001): penicillin (74.7% susceptible in 2002-03; 67.8% in 2004-05; and 47.2% in 2007-09); cefaclor (85.3% in 2002-03; 78.7% in 2004-05; and 53.5% in 2007-09) and clarithromycin (85.3% in 2002-03; 82.7% in 2004-05; and 61.9% in 2007-09). Susceptibility to amoxicillin/clavulanic acid did not significantly change (100% in 2002-03; 98.7% in 2004-05; and 97.7% in 2007-09). A total of 930 H. influenzae isolates were analysed: 2002-03 (n = 133), 2004-05 (n = 379) and 2007-09 (n = 418). Four antibiotics were also consistently tested: ampicillin, amoxicillin/clavulanic acid, clarithromycin and cefaclor. All showed >90% susceptibility, but only cefaclor susceptibility significantly reduced (P < 0.0001) over time (99.2% in 2002-03; 96.3% in 2004-05; and 90.4% in 2007-09).
  
  
  CONCLUSIONS
  In S. pneumoniae from Turkey, there has been a clear statistically significant reduction in susceptibility to key antibiotics since 2002, but not to amoxicillin/clavulanic acid (or amoxicillin). However, susceptibility in H. influenzae remained stable. Continued surveillance is required to monitor future changes in antibiotic susceptibility for CA-RTI bacteria.
authors.affiliation: GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK didem.x.torumkuney@gsk.com.
authors.forename: D
authors.initials: D
authors.lastname: Torumkuney
authors.affiliation: Hacettepe University Medical Faculty, Department of Medical Microbiology, Ankara, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Gur
authors.affiliation: Marmara University Medical Faculty, Department of Medical Microbiology, Istanbul, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Soyletir
authors.affiliation: Istanbul University, Istanbul Medical Faculty, Department of Medical Microbiology, Istanbul, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Gurler
authors.affiliation: Istanbul University, Istanbul Medical Faculty, Department of Medical Microbiology, Istanbul, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Aktas
authors.affiliation: Hacettepe University Medical Faculty, Department of Medical Microbiology, Ankara, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Sener
authors.affiliation: Ege University Medical Faculty, Department of Medical Microbiology, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Tunger
authors.affiliation: Karadeniz Technical University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Bayramoglu
authors.affiliation: Karadeniz Technical University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Koksal
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: A N
authors.initials: AN
authors.lastname: Yalcin
authors.affiliation: GlaxoSmithKline Turkey, Buyukdere Cad. 1. Levent Plaza, No. 173, B Blok, 34394 Istanbul, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Tanriver
authors.affiliation: IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Morrissey
authors.affiliation: GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK.
authors.forename: K
authors.initials: K
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology / Q000382:microbiology; D006193:Haemophilus influenzae / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents