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. 2016 May;71 Suppl 1(Suppl 1):i85-91.
doi: 10.1093/jac/dkw067.

Results from the Survey of Antibiotic Resistance (SOAR) 2002-09 in Turkey

D Torumkuney  1 , D Gur  2 , G Soyletir  3 , N Gurler  4 , Z Aktas  4 , B Sener  2 , A Tunger  5 , G Bayramoglu  6 , I Koksal  6 , A N Yalcin  7 , Y Tanriver  8 , I Morrissey  9 , K Barker  10
Affiliations

Results from the Survey of Antibiotic Resistance (SOAR) 2002-09 in Turkey

D Torumkuney et al. J Antimicrob Chemother. 2016 May.

Abstract

Objectives: 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.

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Figures

Figure 1.
Figure 1.
Percentage susceptibility for antimicrobials against S. pneumoniae during 2002–03, 2004–05 and 2007–09.
Figure 2.
Figure 2.
Percentage susceptibility for test drugs against H. influenzae during 2002–03, 2004–05 and 2007–09.
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