Genetic Diversity among Group A Streptococcus Isolated from Throats of Healthy and Symptomatic Children

Chauhan, Suvarcha; Kashyap, Nitin; Kanga, Anil; Thakur, Kamlesh; Sood, Anuradha; Chandel, Lata

doi:10.1093/tropej/fmv092

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…As reported by several studies, all our tested isolates were sensitive to penicillin G (18,28,(31)(32)(33). Hence, penicillin remains the drug of choice for treating GAS infections.…”

Section: Discussionsupporting

confidence: 75%

“…In our study, 9.1% of cases were found resistant to erythromycin, which is lower than the percentage that was found in Brazil, Lebanon, and Spain (15.4%, 10%, and 10.6%, respectively) (18,31,39). This percentage of resistance to erythromycin is higher than the observations of the studies that were done in India, Tunisia, Iran, and Turkey (5.6%, 4.8%, 0%, and 3.8%, respectively) (28,32,33,40). Moreover, the studies conducted in Germany and Italy reported an incremental increase of resistance to erythromycin in GAS strains (24% and 35.8%, respectively) (41,42).…”

Section: Discussioncontrasting

confidence: 55%

“…The distribution of the emm types varies depending on the region. In studies done in Canada, India, and Italy, it was found that emm12 was the most prevalent emm type among children with GAS pharyngitis (28)(29)(30). In a study done in Lebanon, Bahnan and al.…”

Section: Discussionmentioning

confidence: 95%

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The Place of Group A Streptococci in Moroccan Children with Pharyngitis and Emm Type Distribution

Sara

Oumokhtar

Atmani

et al. 2021

Arch Pediatr Infect Dis

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Background: Streptococcus pyogenes is responsible for a wide variety of diseases, including noninvasive and severe invasive infections. The emm gene encodes the M protein that is the avirulence factor and immunological determinant of group A streptococci. Emm typing is the group A Streptococci (GAS) standard molecular typing method based on the amplification of the N terminal hypervariable region of the emm gene. Objectives: The aim of the present study was to determine the prevalence of GAS in children with pharyngitis and determine different types of emm gene in the GAS isolates using emm typing. Methods: The study was carried out over a period of 14 months (from February 2017 to March 2018). Throat samples were collected from cases aged ≤ 18 years with pharyngitis referring to a primary health care center in Fez, Morocco. GAS isolates were subjected to conventional tests to confirm species identification. Antimicrobial susceptibility testing was performed using the standard disk diffusion method. We researched emm gene by a polymerase chain reaction (PCR). Emm types were determined by a sequence-based protocol. Demographic and clinical data were recorded from each patient. Results: From a total of 177 throat samples, 11 isolates (6.2%) were identified as GAS in children with pharyngitis. Antibiotic sensitivity testing revealed that all the GAS isolates were sensitive to penicillin. The sequencing of the PCR products of the emm gene revealed that emm90 was the most obtained emm type (30,77%); while emm75 was the least type observed (7.7%). Conclusions: The emm90 is the most prevalent type detected from patients with tonsillitis. Penicillin and erythromycin are still the foremost effective antibiotics to treat GAS pharyngitis.

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“…As reported by several studies, all our tested isolates were sensitive to penicillin G (18,28,(31)(32)(33). Hence, penicillin remains the drug of choice for treating GAS infections.…”

Section: Discussionsupporting

confidence: 75%

Section: Discussioncontrasting

confidence: 55%

See 1 more Smart Citation

The Place of Group A Streptococci in Moroccan Children with Pharyngitis and Emm Type Distribution

Sara

Oumokhtar

Atmani

et al. 2021

Arch Pediatr Infect Dis

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“…Though the number of female cases are more in this study when compared to male, is not statistically significant. This is similar to the study by Smriti Chauhan et al, (9) .…”

Section: As Seen Insupporting

confidence: 93%

Assessment of Rapid Antigen Detection Testing in Diagnosing Group A Streptococcal Pharyngitis in Comparison with Gold Standard Bacterial Culture

Gurumoorthy¹,

Manjula²

2019

Int.J.Curr.Microbiol.App.Sci

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Acute pharyngitis is a very common illness that can be caused by different viruses and bacteria, Group A streptococci (GAS) being the most common bacterial cause. However, clinical examination cannot be used to differentiate viral and group A strep pharyngitis, even for experienced clinicians. Objectives of the study is to determine the impact of rapid antigen detection testing (RADT) to identify group A beta haemolytic Streptococcus in acute pharyngitis and to compare the RADT with throat swab culture in diagnosing acute GAS pharyngitis. Throat swabs were collected from patients with sore throat. All the samples were tested immediately by Rapid antigen detection test and also cultured on to Blood agar plate for isolation of Group A streptococci. The effectiveness of RADT was analysed against the gold standard culture. Out of 102 samples collected 29 were positive for Streptococcal infection by the gold standard culture, showing a prevalence of 28.4% in symptomatic patients. Of this 29 culture positive cases, RADT was positive for Streptococcal antigen for 20 cases with a sensitivity of 69%. The prevalence of Streptococcal pharyngitis is only 28.4% in clinically suspected cases of 5-15 years age group, the majority of the other cases must be due to viral etiology. Hence it is necessary to screen all the clinically suspected cases for GAS, so that unnecessary antibiotic prescription can be avoided. RADT can be used as a screening test though the sensitivity of RADT is 69%.

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“…8 On the other hand, the nonsuppurative post-streptococcal diseases occur as an autoimmune inflammatory response to GAS infection and affect mainly the heart and the kidney leading to acute rheumatic fever (ARF) and acute glomerulonephritis. 9 ARF follows untreated or inadequately treated GAS throat infection. 10 The incidence of acute rheumatic fever in children aged 5-14 years is 336 500 cases per year, 95% of them occur in less developed countries.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Different Clinical Variables Associated with Group A Streptococcal Throat Infection among Children in Primary Care Practice

2018

The Egypt. J. of Community Medicine

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Background: Group A streptococcus (GAS) is a major cause of morbidity and mortality worldwide. An effective targeting strategy is needed for appropriate antibiotic prescriptions for GAS sore throat. Objective: This study aimed to assess different clinical variables that can guide management of acute sore throat in children. Methods: A diagnostic cross-sectional study was conducted on 225 children, aged ≥ 3 years ,with acute sore throat attending two primary care clinics in Cairo, Egypt. Demographic information, clinical data and throat swabs were collected from the patients after consent from the parents. Results: The mean age of the children was 5.8 years and almost half of them were males, and had on average 3 attacks of sore throat per year. Out of the 225 children 64 (28.4%) had positive GAS cultures and 183 (81.3%) received antibiotics. Of the 183 who received antibiotics, 128 (69.9%) had cultures negative for group A Streptococcus. There was little difference between those with and without GAS for commonly assessed clinical variables such as the absence of cough. The absence of skin rash was the only variable that was statistically significant (92% and 98% respectively, p<0.05) Conclusion: Clinical variables associated with acute sore throat in Egyptian children cannot accurately diagnose GAS throat infection.

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Genetic Diversity among Group A Streptococcus Isolated from Throats of Healthy and Symptomatic Children

Cited by 6 publications

References 12 publications

The Place of Group A Streptococci in Moroccan Children with Pharyngitis and Emm Type Distribution

The Place of Group A Streptococci in Moroccan Children with Pharyngitis and Emm Type Distribution

Assessment of Rapid Antigen Detection Testing in Diagnosing Group A Streptococcal Pharyngitis in Comparison with Gold Standard Bacterial Culture

Assessment of Different Clinical Variables Associated with Group A Streptococcal Throat Infection among Children in Primary Care Practice

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