Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

Throat Carriage Rate and Antimicrobial Resistance of Streptococcus pyogenes In Rural Children in Argentina

  • Delpech, Gaston (School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires) ;
  • Sparo, Monica (School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires) ;
  • Baldaccini, Beatriz (School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires) ;
  • Pourcel, Gisela (School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires) ;
  • Lissarrague, Sabina (Hospital Ramon Santamarina) ;
  • Allende, Leonardo Garcia (Center of Biochemical Studies)
  • Received : 2015.12.17
  • Accepted : 2016.12.18
  • Published : 2017.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The aim of this study was to determine the prevalence of asymptomatic carriers of group A ${\beta}-hemolytic$ streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status. Methods: Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin. Results: The carriage of ${\beta}-hemolytic$ streptococci was detected in 18.1% of participants, with Streptococcus pyogenes in 18 participants followed by S. dysgalactiae ssp. equisimilis in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate. Conclusions: The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiae ssp. equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.

Keywords

References

  1. Mazon A, Gil-Setas A, Sota de la Gandara LJ, Vindel A, Saez-Nieto JA. Transmission of Streptococcus pyogenes causing successive infections in a family. Clin Microbiol Infect 2003;9(6):554-559. https://doi.org/10.1046/j.1469-0691.2003.00567.x
  2. Lopardo HA, Vidal P, Sparo M, Jeric P, Centron D, Facklam RR, et al. Six-month multicenter study on invasive infections due to Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis in Argentina. J Clin Microbiol 2005;43(2):802-807. https://doi.org/10.1128/JCM.43.2.802-807.2005
  3. Pichichero ME, Casey JR. Defining and dealing with carriers of group A streptococci. Contemp Pediatr 2003;20(1):46-53.
  4. Desjardins M, Delgaty KL, Ramotar K, Seetaram C, Toye B. Prevalence and mechanisms of erythromycin resistance in group A and group B Streptococcus: implications for reporting susceptibility results. J Clin Microbiol 2004;42(12):5620-5623. https://doi.org/10.1128/JCM.42.12.5620-5623.2004
  5. Mc Murry LM, Levy SB. Tetracycline resistance in gram-positive bacteria. In: Fischetti VA, editor. Gram-positive pathogens. Washington, DC: ASM Press; 2006, p. 660-677.
  6. Lopardo HA, Hernandez C, Vidal P, Vazquez M, Rosaenz L, Rubinstein G, et al. Erythromycin-resistant Streptococcus pyogenes in Argentina. Medicina (B Aires) 2004;64(2):143-145.
  7. Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal diseases. Lancet Infect Dis 2005;5(11):685-694. https://doi.org/10.1016/S1473-3099(05)70267-X
  8. Clinical and Laboratory Standards Institute. M100-S23: performance standards for antimicrobial susceptibility testing; twenty-third informational supplement; 2013 [cited 2017 Mar 3]. Available from: file:///C:/Users/user/Downloads/CLSI%202013.pdf.
  9. Takeuchi T, Kawakita S. A follow-up study of throat carriers of streptococci among schoolchildren in Otsu City. Jpn Circ J 1985;49(12):1254-1257. https://doi.org/10.1253/jcj.49.1254
  10. National Committee of Pediatric Infectology. Blue book of pediatric infectology. Buenos Aires: Argentine Society of Pediatrics; 1998, p. 513-515 (Spanish).
  11. Kreikemeyer B, Klenk M, Podbielski A. The intracellular status of Streptococcus pyogenes: role of extracellular matrix-binding proteins and their regulation. Int J Med Microbiol 2004;294(2-3):177-188. https://doi.org/10.1016/j.ijmm.2004.06.017
  12. Benouda A, Sibile S, Ziane Y, Elouennass M, Dahani K, Hassani A. Place of Streptococcus pyogenes in the throat infection in Morocco and overview of its susceptibility to antibiotics. Pathol Biol (Paris) 2009;57(1):76-80 (French). https://doi.org/10.1016/j.patbio.2008.08.003
  13. Tellechea AL, Salvo MG, Mendez JH, Cavagnari BM. Group A beta-hemolytic Streptococcus frequency in the throat of symptomatic patients younger than 15 years, by age group. Arch Argent Pediatr 2012;110(6):516-519 (Spanish). https://doi.org/10.5546/aap.2012.516
  14. Gracia M, Diaz C, Coronel P, Gimeno M, Garcia-Rodas R, Rodriguez- Cerrato V, et al. Antimicrobial susceptibility of Streptococcus pyogenes in Central, Eastern, and Baltic European countries, 2005 to 2006: the cefditoren surveillance program. Diagn Microbiol Infect Dis 2009;64(1):52-56. https://doi.org/10.1016/j.diagmicrobio.2008.12.018
  15. Lopardo HA, Hernandez C, Vidal P. Antimicrobial resistance in Streptococcus pyogenes. An eleven-year surveillance in a pediatric hospital from Buenos Aires. Acta Bioquim Clin Latinoam 2004;38(2):151-157 (Spanish).
  16. Liu X, Shen X, Chang H, Huang G, Fu Z, Zheng Y, et al. High macrolide resistance in Streptococcus pyogenes strains isolated from children with pharyngitis in China. Pediatr Pulmonol 2009;44(5):436-441. https://doi.org/10.1002/ppul.20976
  17. Nielsen HU, Hammerum AM, Ekelund K, Bang D, Pallesen LV, Frimodt-Moller N. Tetracycline and macrolide co-resistance in Streptococcus pyogenes: co-selection as a reason for increase in macrolide-resistant S. pyogenes? Microb Drug Resist 2004; 10(3):231-238. https://doi.org/10.1089/mdr.2004.10.231
  18. Ayer V, Tewodros W, Manoharan A, Skariah S, Luo F, Bessen DE. Tetracycline resistance in group a streptococci: emergence on a global scale and influence on multiple-drug resistance. Antimicrob Agents Chemother 2007;51(5):1865-1868. https://doi.org/10.1128/AAC.01341-06
  19. Feng L, Lin H, Ma Y, Yang Y, Zheng Y, Fu Z, et al. Macrolide-resistant Streptococcus pyogenes from Chinese pediatric patients in association with Tn916 transposons family over a 16- year period. Diagn Microbiol Infect Dis 2010;67(4):369-375. https://doi.org/10.1016/j.diagmicrobio.2010.03.014
  20. Bingen E, Bidet P, Mihaila-Amrouche L, Doit C, Forcet S, Brahimi N, et al. Emergence of macrolide-resistant Streptococcus pyogenes strains in French children. Antimicrob Agents Chemother 2004;48(9):3559-3562. https://doi.org/10.1128/AAC.48.9.3559-3562.2004

Cited by

  1. Clinical Screening Tools to Diagnose Group A Streptococcal Pharyngotonsillitis in Primary Care Clinics to Improve Prescribing Habits vol.25, pp.6, 2017, https://doi.org/10.21315/mjms2018.25.6.2
  2. Microorganisms causing respiratory diseases in children in relation to age and diagnosis vol.11, pp.4, 2017, https://doi.org/10.15421/022085