Date: 11 May 2012

Molecular epidemiology of the Bacillus anthracis isolates collected throughout Turkey from 1983 to 2011

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The main perspective of this study was to determine cross-transmissions amongst anthrax cases and provide detailed information regarding the genotypes of Bacillus anthracis isolates circulating in Turkey. A total of 251 B. anthracis isolates were obtained from human (93 isolates), animal (155 isolates), and environmental (three isolates) samples in various provinces of Turkey. All isolates were susceptible to quinolones, vancomycin, tigecycline, and linezolid, but not to ceftriaxone. Excluding human isolates, one of the animal isolates was found to be resistant to penicillin, erythromycin, and doxycycline. Multiple-locus variable-number tandem repeats analysis including 8 loci (MLVA8) revealed 12 genotypes, in which genotype 43 was observed at the highest frequency (41.8 %), followed by genotype 35 (25.5 %) and genotype 27 (10.4 %). Major subtype A3.a was the predominant cluster, including 86.8 % of the isolates. The MLVA25 analysis for the 251 isolates yielded 62 different genotypes, 33 of which had only one isolate, while the remaining 29 genotypes had 2 to 43 isolates, with a total of 218 isolates (86.9 %). These findings indicate very high cross-transmission rates within anthrax cases in Turkey. The genotypes diagnosed in Turkey are populated in the A major cluster. Penicillin prescribed as the first-choice antibiotic for the treatment of anthrax is still effective.

Anthrax Study Group

Mesut Ortatatli: Department of Medical NBC Defense, Gulhane Military Medical Academy, Ankara, Turkey.
Mustafa Zahir Bakici: Department of Clinical Microbiology, Medical Faculty, Cumhuriyet University, Sivas, Turkey.
Selcuk Kilic: Department of Communicable Diseases Research, Refik Saydam National Public Health Agency, Bacterial Zoonoses Research and Reference Laboratory, Ankara, Turkey.
Sevtap Bostanci: Department of Zoonotic Diseases, Turkish Ministry of Health Basic Health Services General Directorate, Ankara, Turkey.
Ebubekir Ceylan: Department of Veterinary Internal Medicine, Veterinary Faculty, University of Yuzuncu Yil, 65080, Van, Turkey
Ahmet Ayyildiz, Department of Clinical Microbiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Sırrı Kilic: Department of Infectious Disease, Medical Faculty, Firat University, Elazig, Turkey.
This study was partly presented as a poster at the International Conference on Bacillus anthracis, B. cereus and B. thuringiensis (Bacillus-ACT 2011), Bruges, Belgium, 7–11 August 2011.