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Ghannam IA, Maraqa RM, Qawasmeh DS, Alsous RK, Jaber SMA, Ghatasha IAA, Ghannam YI. Impact of COVID-19 health precautions on asymptomatic Streptococcus pyogenes carriage in palestinian children: a pre- and post-pandemic study. BMC Infect Dis 2024; 24:1104. [PMID: 39367303 PMCID: PMC11451109 DOI: 10.1186/s12879-024-10023-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 09/30/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Streptococcus pyogenes (Group A Streptococcus, GAS) is a significant pathogen that causes diverse infections, ranging from pharyngitis to severe invasive diseases. Asymptomatic carriage in children is pivotal for transmission. The COVID-19 pandemic's health measures, including mask wearing and enhanced hand hygiene, likely influenced GAS transmission dynamics. This study evaluated the impact of these precautions on the prevalence of asymptomatic pharyngeal GAS carriage among schoolchildren in the southern West Bank, Palestine. METHODS This cross-sectional study was conducted in two phases: pre-COVID-19 (November 2019-January 2020) and post-COVID-19 (November 2023-April 2024). Throat swabs were collected from 701 children (345 pre-COVID-19, 356 post-COVID-19) via cluster sampling. The samples were tested with the ABON Strep A rapid test and confirmed by culture. Sociodemographic, health, and household data were also collected. The statistical analyses included descriptive statistics, chi-square tests, and binary logistic regression. RESULTS The prevalence of asymptomatic pharyngeal GAS carriage declined from 15.7% pre-COVID-19 to 10.4% post-COVID-19 (p = 0.038). Significant reductions were observed among urban residents (23.5-10.1%, p = 0.003) and those from medium socioeconomic backgrounds (16.0-9.1%, p = 0.008). Compared with urban residents, rural residents had lower GAS carriage rates (adjusted OR = 0.505, p = 0.023). Carriage rates also decreased among children with frequent sore throats (17.6-7.3%, p = 0.007) and those using private wells (52.5-14.9%, p < 0.001). Higher BMI was a significant risk factor (adjusted OR = 17.68, p < 0.001), whereas frequent tooth brushing (adjusted OR = 0.055, p < 0.001) and hand washing (adjusted OR = 0.367, p < 0.001) were protective factors. CONCLUSIONS COVID-19-related health precautions were correlated with a significant reduction in asymptomatic GAS carriage among Palestinian children. These findings suggest that public health measures, such as mask wearing and hand hygiene, can influence the transmission of respiratory pathogens. Ongoing surveillance and targeted interventions are essential for managing GAS infections, particularly in resource-limited settings.
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Affiliation(s)
- Ibrahim Amer Ghannam
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine.
| | - Rana Mahmoud Maraqa
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine
| | - Duha Shokri Qawasmeh
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine
| | - Rania Khalil Alsous
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine
| | - Sakra Mohammad Abu Jaber
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine
| | - Iman Abd Almuti Ghatasha
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine
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Gebre AB, Fenta DA, Negash AA, Hayile BJ. Prevalence, Antibiotic Susceptibility Pattern and Associated Factors of Streptococcus pyogenes among Pediatric Patients with Acute Pharyngitis in Sidama, Southern Ethiopia. Int J Microbiol 2024; 2024:9282571. [PMID: 39319095 PMCID: PMC11421939 DOI: 10.1155/2024/9282571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 08/12/2024] [Accepted: 09/04/2024] [Indexed: 09/26/2024] Open
Abstract
Background Streptococcus pyogenes is the most frequent cause of pharyngitis and skin infections in children and causes immune complications like rheumatic fever and rheumatoid heart disease (RHD), particularly in developing countries like Ethiopia. The aim of this study was to determine the prevalence, antibiotic resistance pattern, and associated factors of Streptococcus pyogenes among pediatric patients suspected of acute pharyngitis in Sidama Region, Southern Ethiopia. Methods A cross-sectional study was conducted on 213 acute pharyngitis suspected pediatric patients from April to September 2022 at Hawassa University Compressive Specialized Hospital and Yirgalem Hospital. Sociodemographic and clinical data were collected using a structured questionnaire. A throat swab was cultured to isolate S. pyogenes, and antimicrobial susceptibility testing was done using standard bacteriological techniques. Data were analyzed using SPSS version 25, and P value of <0.05 was considered as statistically significant. Result Out of 213 throat swabs cultured, 22 (10.3%) with 95% CI (6.6-14.6%) were S. pyogenes positive. All isolates of S. pyogenes were sensitive to penicillin and amoxicillin. In contrast, 8 (36.4%) isolates exhibited resistance to tetracycline, 7 (31.8%) to ceftriaxone, 6 (27.3%) to erythromycin, and 5 (22.7%) isolates showed multidrug resistance. The presence of palatal petechiae (P=0.037) and tonsillar swelling or exudate (P=0.007) were significantly associated with S. pyogenes carriage in children suspected of having acute pharyngitis. Conclusion In this study, the prevalence of S. pyogenes among children suspected with acute pharyngitis was low compared to other studies. The isolates showed a high level of resistance to commonly used antibiotics. Therefore, the treatment of pediatric acute S. pyogenes pharyngitis should depend on an antimicrobial susceptibility test. Furthermore, evaluation of S. pyogenes pediatric acute pharyngitis risk factors and tracking of antibiotic resistance are crucial in the controlling of pediatric acute S. pyogenes pharyngitis.
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Affiliation(s)
- Alemitu Beyene Gebre
- Hawassa University College of Medicine and Health ScienceSchool of Medical Laboratory Science, Hawassa, Ethiopia
| | - Demissie Assegu Fenta
- Hawassa University College of Medicine and Health ScienceSchool of Medical Laboratory Science, Hawassa, Ethiopia
| | | | - Betelihem Jima Hayile
- Hawassa University College of Medicine and Health ScienceSchool of Medical Laboratory Science, Hawassa, Ethiopia
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Darod HH, Melese A, Kibret M, Mulu W. Throat Swab Culture Positivity and Antibiotic Resistance Profiles in Children 2-5 Years of Age Suspected of Bacterial Tonsillitis at Hargeisa Group of Hospitals, Somaliland: A Cross-Sectional Study. Int J Microbiol 2023; 2023:6474952. [PMID: 37065723 PMCID: PMC10098414 DOI: 10.1155/2023/6474952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/11/2022] [Accepted: 03/17/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Tonsillitis is the third most frequently diagnosed infection in the pediatric age and is associated with significant morbidity and loss of school attendance. Throat swab cultures are useful for the confirmation of children with a clinically suspected tonsillitis. However, Somaliland is one of the underdeveloped countries with a low standard of sanitation and poor health seeking culture. Treatment of tonsillitis with antibiotics is irrational and not empirical. This study determined the bacterial throat swab culture positivity and antibiotic resistance profiles of the bacterial isolates among children 2-5 years of age with suspicion of tonsillitis at Hargeisa Group of Hospital, Somaliland. Materials and Methods A cross-sectional study was conducted from March to July 2020. A total of 374 children from 2 to 5 years of age suspicion of tonsillitis was included using a convenient sampling method. Throat swabs were collected, and bacterial isolation and identification were done using standard bacteriological procedures. Antimicrobial susceptibility testing was done using the disk diffusion method. Data on demographic variables and clinical profiles were collected using structured questionnaires. Logistic regression analysis was computed to identify factors associated with bacterial tonsillitis. Results Overall, 120 (32.1%) (95% CI 27.4-36.8%) of children were positive for bacterial throat cultures. Of these, 23 (19.2%) were mixed bacterial isolates. The most frequent bacterial isolates were beta-hemolytic streptococci 78 (55%), Staphylococcus aureus 42 (29%), and Streptococcus pneumoniae 10 (7%). Isolates revealed 83.3-100% rate of resistance to ampicillin. Beta-hemolytic streptococci isolates were 94.9% resistant to ampicillin. S. aureus was resistant to clarithromycin (38%) while S. pneumoniae isolates were 100% resistant to ampicillin. History of tonsillitis (AOR = 0.12; 95% CI = 0.06-0.21), difficulty in swallowing (AOR = 6.99; 95% CI = 3.56-13.73), and attending schools (AOR = 2.98; 95% CI = 1.64-5.42) were found to be associated with positive throat culture. Conclusions Resistance to ampicillin and MDR among beta-hemolytic streptococci and other isolates of throat colonizers in children with clinically suspected of bacterial tonsillitis are major concerns in Hargeisa, Somaliland. Therefore, treatments of cases are recommended to be guided by regular culture and antimicrobial susceptibility testing to prevent complications of tonsillitis and associated antibiotic resistance.
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Affiliation(s)
- Hamda Hussein Darod
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Addisu Melese
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mulugeta Kibret
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wondemagegn Mulu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Biochemistry and Microbiology, Laboratory of Microbiology, Faculty of Science, Ghent University, Ghent, Belgium
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Salinas Salvador B, Moreno Sánchez A, Carmen Marcén G, Molina Herranz D, Arana Navarro T, García Vera C. Retrospective study on the effectiveness and safety of the shortened 5- to 7-day antibiotic regimen for acute streptococcal pharyngotonsillitis compared to the classic 10-day regimen. An Pediatr (Barc) 2022; 97:398-404. [PMID: 36302708 DOI: 10.1016/j.anpede.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/03/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Antibiotherapy regimens for management of acute streptococcal pharyngitis traditionally last 10 days, but the development of resistance to different antimicrobials has motivated the exploration of shorter courses. MATERIAL AND METHODS We selected patients given a diagnosis of streptococcal pharyngitis in 2 paediatric caseloads of 1 primary care centre between June 2016 and April 2020. We compared outcomes in patients treated with 8- to 10-day courses versus 5- to 7-day courses. RESULTS The analysis included 350 care episodes (252 patients). Sixty-four percent were managed with 8- to 10-day courses of antibiotherapy (group 1) and 36% with 5- to 7-day courses (group 2). There were no significant differences in the incidence of streptococcal pharyngitis or scarlet fever in the 3 months that followed (OR, 0.98; 95% confidence interval [CI], 0.46-2.03), with similar percentages in both groups (9.8% vs 9.5%). Overall, without differentiating based on the type of infection (streptococcal pharyngitis, scarlet fever or other streptococcal infections), we found similar outcomes (OR, 0.81; 95% CI, 0.41-1.59): 13.4% in group 1 and 11.1% in group 2. We also found no differences in the frequency of adverse events documented in the health records (OR, 0.29; 95% CI, 0.04-2.44): 2.7% in group 1 and 0.8% in group 2. CONCLUSIONS In our experience, a shorter antibiotic course (5-7 days) is not less effective or more unsafe for management of acute streptococcal pharyngitis than the traditional 10-day course.
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Affiliation(s)
| | | | - Gema Carmen Marcén
- Servicio de Pediatría, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Salinas Salvador B, Moreno Sánchez A, Carmen Marcén G, Molina Herranz D, Arana Navarro T, García Vera C. Estudio retrospectivo sobre la efectividad y seguridad de la pauta antibiótica reducida a 5-7 días en la faringoamigdalitis aguda estreptocócica comparada con la pauta clásica de 10 días. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Barsenga S, Mitiku H, Tesfa T, Shume T. Throat carriage rate, associated factors, and antimicrobial susceptibility pattern of group A Streptococcus among healthy school children in Jigjiga City, Eastern Ethiopia. BMC Pediatr 2022; 22:227. [PMID: 35473515 PMCID: PMC9040231 DOI: 10.1186/s12887-022-03294-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Group A Streptococcus has been recognized as an important human pathogen and it remains among the top ten causes of mortality from an infectious disease. Group A Streptococcus throat carriage plays an important role in the development of infection and transmission to contacts. In Ethiopia, there is little information about screening of children for group A Streptococcus carriage. Objective This study was aimed to assess the magnitude of throat carriage, associated factors, and antimicrobial susceptibility pattern of group A Streptococcus among healthy school children in Jigjiga city, Eastern Ethiopia from 12 April to 27 May 2021. Method A cross-sectional study was conducted enrolled by simple random sampling. Data on socio-demographic and related characteristics were gathered using pretested structured questionnaire. The throat sample was collected from 462 healthy school children and immediately transported to Jigjiga University Sultan Sheik Hassan referral hospital laboratory for investigation. Identification of group A Streptococcus was done by colony characterstics, gram staining, catalase negativity, bacitracin sensitivity, and Pyrrolidonyl arylamidase tests. Antibiotic susceptibility test was done on Muller-Hinton agar containing 5% sheep blood by modified Kirby-Bauer disc diffusion method. The data were coded, cleaned, and entered onto EpiData Version 3.1 then exported to SPSS version 26.0 for analysis. Bivariate and multivariable logistic regression through adjusted odds ratio (AOR) was used to determine the relationship between culture-positivity rates of GAS and predictor variables. A p-value < 0.05 was taken as statistically significant on multivariable analysis. Results The overall prevalence of group A Streptococcus throat culture rate was 10.6% (95%CI; 8.1%—13.7%). Previous family member who had a sore throat, children living with larger families (more than 11 members), and children living with non-immediate families were significantly associated with culture-positivity rates of GAS. Children who live with a family member with a sore throat compared with those who lived with in a family with no history of sore throat (AOR = 2.51; 95%CI 1.09–5.73), children who live with a large family comared to children living in families with less members (AOR = 4.64; 95% CI 1.53–14.1), and children who live with non-immediate families compared to children living with their mothers (AOR = 3.65; 95% CI 1.39 – 9.61), showed significant association with group A Streptococcus carriage rate. Resistance to all other antibiotics tested was low (< 5%). Multidrug resistance was found in 4.1% of isolates. Conclusion The present study showed 10.6% throat carriage of group A Streptococcus. Family member with a sore throat, having a large family, and living with non-immediate families have all been identified as independent predictors of carriage prevalence.
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Affiliation(s)
- Shamil Barsenga
- Department of Medical Laboratory Sciences, Jigjiga University, College of Medicine and Health Sciences, Jigjiga, Ethiopia
| | - Habtamu Mitiku
- Department of Medical Laboratory Sciences, Haramaya University, College of Health and Medicine Sciences, P.O.Box- 235, Harar, Ethiopia
| | - Tewodros Tesfa
- Department of Medical Laboratory Sciences, Haramaya University, College of Health and Medicine Sciences, P.O.Box- 235, Harar, Ethiopia
| | - Tadesse Shume
- Department of Medical Laboratory Sciences, Haramaya University, College of Health and Medicine Sciences, P.O.Box- 235, Harar, Ethiopia.
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Donders G, Greenhouse P, Donders F, Engel U, Paavonen J, Mendling W. Genital Tract GAS Infection ISIDOG Guidelines. J Clin Med 2021; 10:jcm10092043. [PMID: 34068785 PMCID: PMC8126195 DOI: 10.3390/jcm10092043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/18/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023] Open
Abstract
There has been an increasing worldwide incidence of invasive group A streptococcal (GAS) disease in pregnancy and in the puerperal period over the past 30 years. Postpartum Group A streptococci infection, and in particular streptococcal toxic shock syndrome (TSS) and necrotizing fasciitis, can be life threatening and difficult to treat. Despite antibiotics and supportive therapy, and in some cases advanced extensive surgery, mortality associated with invasive group A streptococcal postpartum endometritis, necrotizing fasciitis, and toxic shock syndrome remains high, up to 40% of postpartum septic deaths. It now accounts for more than 75,000 deaths worldwide every year. Postpartum women have a 20-fold increased incidence of GAS disease compared to non-pregnant women. Despite the high incidence, many invasive GAS infections are not diagnosed in a timely manner, resulting in potentially preventable maternal and neonatal deaths. In this paper the specific characteristics of GAS infection in the field of Ob/Gyn are brought to our attention, resulting in guidelines to improve our awareness, early recognition and timely treatment of the disease. New European prevalence data of vaginal GAS colonization are presented, alongside two original case histories. Additionally, aerobic vaginitis is proposed as a supplementary risk factor for invasive GAS diseases.
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Affiliation(s)
- Gilbert Donders
- Femicare, Clinical Research for Women, 3300 Tienen, Belgium;
- Department of Obstetrics and Gynecology, University Hospital Antwerp, 2000 Antwerp, Belgium
- Regional Hospital H Hart, 3300 Tienen, Belgium
- Correspondence: ; Tel.: +32-38-214413
| | | | | | - Ulrike Engel
- Department of Ob/Gyn Maternité, Centre Hospitalier, 1210 Luxembourg, Luxembourg;
| | - Jorma Paavonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, 00260 Helsinki, Finland;
| | - Werner Mendling
- German Centre for Infections in Gynaecology and Obstetrics, St. Anna Hospital, 42109 Wuppertal, Germany;
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Edem KB, Ikpeme EE, Akpan MU. Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria. JOURNAL OF CHILD SCIENCE 2021. [DOI: 10.1055/s-0040-1722274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractSurveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross-sectional study of 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer's exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were susceptible to penicillin. None of the tested isolates was susceptible to co-trimoxazole. The prevalence of streptococcal throat carriage in the study area was low. There were no Group A Streptococcus isolates suggesting an evolving epidemiology of BHS disease in the study area.
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Affiliation(s)
- Kevin B. Edem
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Enobong E. Ikpeme
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Mkpouto U. Akpan
- Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
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Rahmadhany A, Advani N, Djer M, Handryastuti S, Safari D. Prevalence and predicting factors of Group A beta-hemolytic Streptococcus carrier state in primary schoolchildren. Ann Pediatr Cardiol 2021; 14:471-475. [PMID: 35527766 PMCID: PMC9075561 DOI: 10.4103/apc.apc_280_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/17/2021] [Accepted: 06/15/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Aim and Objectives: Material and Methods: Results: Conclusion:
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Wangilisasi S, Chillo P, Kimambo D, Janabi M, Kamuhabwa A. Throat Colonization and Antibiotic Susceptibility of Group a β-Hemolytic Streptococci Among Rheumatic Heart Disease Patients Attending a Cardiac Referral Hospital in Tanzania, a Descriptive Cross-Sectional Study. Front Surg 2020; 7:57. [PMID: 33094103 PMCID: PMC7527597 DOI: 10.3389/fsurg.2020.00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/16/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Secondary prophylaxis against repeated attacks of acute rheumatic fever is an important intervention in patients with rheumatic heart disease (RHD), and it aims to prevent throat infection by group A β-hemolytic streptococcus (GAS); however, its implementation faces many challenges. This study aimed to assess throat colonization, antibiotic susceptibility, and factors associated with GAS colonization among patients with RHD attending care at Jakaya Kikwete Cardiac Institute in Dar-es-Salaam, Tanzania. Methods: A descriptive cross-sectional study of RHD patients attending the Jakaya Kikwete Cardiac Institute was conducted from March to May 2018, where we consecutively enrolled all patients known to have RHD and coming for their regular clinic follow-up. A structured questionnaire was used to obtain patients' sociodemographic information, factors associated with GAS colonization, and status of secondary prophylaxis use and adherence. Throat swabs were taken and cultured to determine the presence of GAS, and isolates of GAS were tested for antibiotic susceptibility using Kirby–Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute version 2015. Antibiotics of interest were chosen according to the Tanzanian Treatment Guidelines. Results: In total, 194 patients with RHD were enrolled, their mean age was 28.4 ± 16.5 years, and 58.2% were females. Only 58 (29.9%) patients were on regular prophylaxis, 39 (20.1%) had stopped taking prophylaxis, whereas 97 (50.0%) had never been on prophylaxis. Throat cultures were positive for GAS in 25 (12.9%) patients. Patients who stopped prophylaxis were 3.26 times more likely to be colonized by GAS when compared to patients on regular prophylaxis. Majority (96%) of GAS isolates were susceptible to penicillin, ceftriaxone, and ciprofloxacin, whereas the highest resistance (20%) was observed with vancomycin. No GAS resistance was observed against penicillin. Conclusion: The prevalence of GAS throat colonization is high among this population and is associated with stopping prophylaxis. The proportion of patients on regular secondary prophylaxis is unacceptably low, and interventions should target both patients' and physicians' barriers to effective secondary prophylaxis.
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Affiliation(s)
- Sarah Wangilisasi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Pilly Chillo
- Department of Internal Medicine (Section of Cardiology), School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- *Correspondence: Pilly Chillo ;
| | - Delilah Kimambo
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Mohammed Janabi
- Department of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Appolinary Kamuhabwa
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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DeWyer A, Scheel A, Webel AR, Longenecker CT, Kamarembo J, Aliku T, Engel ME, Bowen AC, Bwanga F, Hovis I, Chang A, Sarnacki R, Sable C, Dale JB, Carapetis J, Rwebembera J, Okello E, Beaton A. Prevalence of group A β-hemolytic streptococcal throat carriage and prospective pilot surveillance of streptococcal sore throat in Ugandan school children. Int J Infect Dis 2020; 93:245-251. [PMID: 31972290 DOI: 10.1016/j.ijid.2020.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Group A β-hemolytic Streptococcus (GAS), also known as Streptococcus pyogenes, is responsible for an annual 600 million cases of acute pharyngitis globally, with 92% of those infections occurring in low-resource settings. Further knowledge of the acute streptococcal pharyngitis burden in low-resource settings is essential if serious post-streptococcal complications - rheumatic fever (RF) and its long-term sequel rheumatic heart disease (RHD) - are to be prevented. METHODS Two studies were conducted in school-aged children (5-16 years): a cross-sectional study of streptococcal pharyngeal carriage followed by a prospective cohort study of streptococcal sore throat over 4 weeks from March to April 2017. RESULTS The cross-sectional study revealed an overall prevalence of GAS carriage of 15.9% (79/496, 95% confidence interval 12.8-19.5%). Among 532 children enrolled in the prospective cohort study, 358 (67%) reported 528 sore throats, with 221 (41.1%) experiencing at least one GAS-positive sore throat. The overall GAS-positive rate for sore throat was 41.8% (221/528). CONCLUSIONS The GAS pharyngeal carriage rates seen in Uganda (15.9%, 95% confidence interval 12.8-19.5%) are higher than the most recent pooled results globally, at 12% (range 6-28%). Additionally, pilot data suggest a substantially higher percentage of sore throat that was GAS-positive (41.8%) compared to pooled global rates when active recruitment is employed.
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Affiliation(s)
- Alyssa DeWyer
- Children's National Health System, Department of Cardiology 111 Michigan Ave NW, Washington DC, USA.
| | - Amy Scheel
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Allison R Webel
- Frances Payne Bolton School of Nursing Case Western Reserve University, Cleveland, Ohio
| | - Chris T Longenecker
- University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Twalib Aliku
- Uganda Heart Institute, Mulago Hospital Complex, Kampala, Uganda
| | - Mark E Engel
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Asha C Bowen
- University of Western Australia, Perth, WA; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA; Perth Children's Hospital, Perth, WA
| | - Freddie Bwanga
- Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ian Hovis
- Children's National Health System, Department of Cardiology 111 Michigan Ave NW, Washington DC, USA
| | - Aileen Chang
- Department of Dermatology, University of California, San Francisco, 505 Paranassus Avenue, San Francisco, CA, 94143, USA
| | - Rachel Sarnacki
- Children's National Health System, Department of Cardiology 111 Michigan Ave NW, Washington DC, USA
| | - Craig Sable
- Children's National Health System, Department of Cardiology 111 Michigan Ave NW, Washington DC, USA
| | - James B Dale
- Medicine, University of Tennessee, Memphis, TN, USA
| | - Jonathan Carapetis
- University of Western Australia, Perth, WA; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA; Perth Children's Hospital, Perth, WA
| | | | - Emmy Okello
- Uganda Heart Institute, Mulago Hospital Complex, Kampala, Uganda
| | - Andrea Beaton
- Cincinnati Children's Hospital Medical Center, Cincinnati Ohio, USA
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Anja A, Beyene G, S/Mariam Z, Daka D. Asymptomatic pharyngeal carriage rate of Streptococcus pyogenes, its associated factors and antibiotic susceptibility pattern among school children in Hawassa town, southern Ethiopia. BMC Res Notes 2019; 12:564. [PMID: 31500654 PMCID: PMC6734480 DOI: 10.1186/s13104-019-4601-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/03/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives The aim of this study was to determine the asymptomatic pharyngeal carriage rate of S. pyogenes, antimicrobial pattern and related risk factors among school children in Hawassa, southern Ethiopia. Results Out of 287 school children’s screened, 35 (12.2%) were colonized with S. pyogenes. The carriage rate was significantly associated with factors such as sex (female p = 0.013) occupational status of mother (p = 0.002), lower income source (500–900 ETB, 1000–1500 ETB) (p = 0.001, and p = 0.042), history of hospitalization (p = 0.00) and residence of the children (p = 0.002). High level resistant to tetracycline and low level to vancomycin were observed, while penicillin, amoxicillin, erythromycin, chloramphenicol, and ceftriaxone were found to be effective.
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Affiliation(s)
- Asrat Anja
- Dilla University College of Medicine, Dilla, Ethiopia
| | - Getenet Beyene
- Jimma University Institute of Health Sciences, Jimma, Ethiopia
| | | | - Deresse Daka
- Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia.
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Othman AM, Assayaghi RM, Al-Shami HZ, Saif-Ali R. Asymptomatic carriage of Streptococcus pyogenes among school children in Sana'a city, Yemen. BMC Res Notes 2019; 12:339. [PMID: 31200755 PMCID: PMC6570875 DOI: 10.1186/s13104-019-4370-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/05/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Streptococcus pyogenes is the most frequent cause of pharyngitis and skin infections in children. It is also the causative agent of dangerous immune-complications such as rheumatic fever and rheumatic heart disease which are common in Yemen. The aim of this study was to determine the throat carriage rate of Streptococcus pyogenes among asymptomatic school children in Sana'a city. RESULTS A cross-sectional study was conducted from December to March of years 2012-2016. A total of 813 asymptomatic school children whose antistreptolysin O test was negative were included. The mean age of the students was 10.5 ± 2.8 years with a range from 5 to 15 years old. Throat swab and blood sample were taking from each student. One hundred and four (12.8%) healthy students were found to be Streptococcus pyogenes carriers. Pharyngeal Streptococcus pyogenes carriage rate was statistically insignificant among different age groups. However, it was found to be more common among females (66, 15%) than males (38, 10%) with statistically significant difference (χ2 = 4.52, P = 0.04). This study showed a high asymptomatic carriage rate of Streptococcus pyogenes in the throat of healthy school children in Sana'a city, Yemen.
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Affiliation(s)
- Arwa Mohammed Othman
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sanaa, Yemen.
| | - Rowa Mohammed Assayaghi
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sanaa, Yemen
| | - Huda Zaid Al-Shami
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sanaa, Yemen
| | - Riyadh Saif-Ali
- Biochemistry Department, Faculty of Medicine and Health Sciences, Sanaa University, Sanaa, Yemen
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