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Cultivation and sensitivity of the stems of Streptococcus pyogenes from the mucus of nasopharynx and ears in children and their sensitivity to {$\beta$}-lactam antibiotics and makrolids
SIVOKOVÁ, Jaroslava
The topic Cultivation and sensitivity of the stems of Streptococcus pyogenes from the mucus of nasopharynx and ears in children and their sensitivity to {$\beta$}-lactam antibiotics and makrolids occupied my mind because I was interested in the question if the increased consumption of antibiotics and the following resistance occur also in this bacterium. Except for gaining practical knowledge on cultivation and identification of Streptococcus pyogenes bacteria the objective of the thesis was the investigation of its sensitivity to {$\beta$}-lactam antibiotics and makrolids. Further I was intersted in how the doctors for children and teenagers proceed in case of suspicion of streptococcus disease of upper airways. Also this topic was one of the objectives. The thesis is composed of two parts, theoretical and practial ones. In the theoretical part I first came out of available information on Streptococcus pyogenes bacteria. I describe its morphology and characteristics, factors of patogenics and virulence. This information is used during the cultivation of bacteria and its following identification. Further I mention the diseases which are caused by pyogenous streptococci. The part is also the description of antibiotics which are recommended for the treatment of the diseases caused by this bacteria. The second part includes the methods of cultivation and identification of Streptococcus pyogenes which are used in microbiology laboratory Laboma mikrobiologická laboratoř s.r.o. (Laboma microbiology laboratory Inc.). Identification methods come out of the application of PYR-test, latex agglutination and the use of identification system Api 20 Strep in ambiguous results. The results gained in microbiology laboratory show that the capture of Streptococcus pyogenes bacteria in diseases of upper airways created 4,4% from all smears sent into the laboratory. These diseases showed seasonal occurrence with the maximum in spring and winter. The results of sensititivity have shown that the sensitivity to penicilin was in 100% and to erythromycin in 91.6%. Cross-resistance between erythromycin and clindamycin ocurred in 57 cases (4.5 %). According to my investigation Streptococcus pyogenes caused otitis in 13 cases (2.7%). The highest ocurrence of otites caused by Streptococcus pyogenes emerged in spring. The stems isolated from ear mucuos were sensitive to penicilin in 100% and to erythromycin in 92.3%. These results apply to the material sent to microbiology laboratory Laboma mikrobiologická laboratoř s.r.o. (Laboma microbiology laboratory Inc.). To gain a complete picture I visited 20 doctors for children and teenagers who were willing to fill in my questionnaire. After the evaluation I found out that all questioned doctors are waiting for the results of cultivation and sensitivity of the stem to antibiotics if the clinical state of a patient is not serious. In preference they apply penicilin. Control smear is carried by most of the doctors only in recurrent infections. From the data of the laboratory I found out that three doctors send the material to the culture investigation and the following sensitivity of the stem to antibiotics after the failure of treatment in a patient.
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