Prevalence of Beta-Hemolytic Streptococci Groups A, C, and G in Patients with Acute Pharyngitis

Overview

Journal J Lab Physicians

Specialty Pathology

Date 2016 Mar 26

PMID 27013813

Citations 4

Authors

Trupti B Naik

Shobha D Nadagir

Asmabegaum Biradar

Affiliations

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Abstract

Context: Group A beta-hemolytic streptococci (GAS) is the most frequently isolated pathogen in acute pharyngitis. However, the role of Group C (GCS) and Group G (GGS) streptococci in disease burden is under recognized. The present study is carried out to find out the prevalence of acute pharyngitis caused by the different serogroups of streptococci and antibiotic susceptibility pattern of these streptococcal isolates.

Study And Design: A cross sectional study.

Materials And Methods: A total of 218 throat swabs from patients with acute pharyngitis and 82 from healthy controls were collected and processed as per standard protocol. Samples were inoculated on blood agar and Streptococcus selective agar. Isolates were identified by the conventional method and serogrouped by latex agglutination test using Remel Streptex kit.

Results: Beta-hemolytic streptococci (BHS) were isolated from 34 (15.59%) of pharyngitis patients and 11 (13.41%) of the healthy carrier. Among pharyngitis, GAS was isolated from 20 (9.17%), GCS 7 (3.21%), and GGS 7 (3.21%) patients. Carriage rate of GAS was 6 (7.31%) and GCS, 5 (6.09%). Vancomycin (100%), amoxyclavulanic acid (90%), levofloxacin (85%), and cephotaxime (80%) were found to be most effective antibiotics. Comparatively, higher drug resistance was observed among GCS and GGS to all the drugs used in the study except for levofloxacin.

Conclusions: Although rate of pharyngitis associated with GCS and GGS is marginally lower than GAS, their carriage rate among healthy and relative higher drug resistance emphasizes the need for periodic surveillance of infection by the different serogroups of BHS.

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References

Bramhachari P, Kaul S, McMillan D, Shaila M, Karmarkar M, Sriprakash K . Disease burden due to Streptococcus dysgalactiae subsp. equisimilis (group G and C streptococcus) is higher than that due to Streptococcus pyogenes among Mumbai school children. J Med Microbiol. 2009; 59(Pt 2):220-223. DOI: 10.1099/jmm.0.015644-0. View

Menon T, Lloyd C, Jacob S . Should bacitracin sensitivity be used in the presumptive identification of group A streptococci?. Indian J Med Microbiol. 2005; 23(4):275. View

De Melo M, Figueiredo A, Ferreira-Carvalho B . Antimicrobial susceptibility patterns and genomic diversity in strains of Streptococcus pyogenes isolated in 1978-1997 in different Brazilian cities. J Med Microbiol. 2003; 52(Pt 3):251-258. DOI: 10.1099/jmm.0.04938-0. View

Al-Charrakh A, Al-Khafaji J, Al-Rubaye R . Prevalence of β-hemolytic groups C and F streptococci in patients with acute pharyngitis. N Am J Med Sci. 2012; 3(3):129-36. PMC: 3336899. DOI: 10.4297/najms.2011.3129. View

Jing H, Ning B, Hao H, Zheng Y, Chang D, Jiang W . Epidemiological analysis of group A streptococci recovered from patients in China. J Med Microbiol. 2006; 55(Pt 8):1101-1107. DOI: 10.1099/jmm.0.46243-0. View

Nandi S, Kumar R, Ray P, Vohra H, Ganguly N . Group A streptococcal sore throat in a periurban population of northern India: a one-year prospective study. Bull World Health Organ. 2001; 79(6):528-33. PMC: 2566441. View

Kumar R, Vohra H, Chakraborty A, Sharma Y, Bandhopadhya S, Dhanda V . Epidemiology of group A streptococcal pharyngitis & impetigo: a cross-sectional & follow up study in a rural community of northern India. Indian J Med Res. 2010; 130(6):765-71. View

Menon T, Shanmugasundaram S, Kumar M, Kumar C . Group A streptococcal infections of the pharynx in a rural population in south India. Indian J Med Res. 2004; 119 Suppl:171-3. View

Ho P, Johnson D, Yue A, Tsang D, Que T, Beall B . Epidemiologic analysis of invasive and noninvasive group a streptococcal isolates in Hong Kong. J Clin Microbiol. 2003; 41(3):937-42. PMC: 150310. DOI: 10.1128/JCM.41.3.937-942.2003. View

10.

Ekelund K, Skinhoj P, Madsen J, Konradsen H . Invasive group A, B, C and G streptococcal infections in Denmark 1999-2002: epidemiological and clinical aspects. Clin Microbiol Infect. 2005; 11(7):569-76. DOI: 10.1111/j.1469-0691.2005.01169.x. View

11.

Sindhulina C, Geethalakshmi S, Thenmozhivalli P, Jose J, Brahmadathan K . Bacteriological and molecular studies of group A streptococcal pharyngitis in a south Indian hospital. Indian J Med Microbiol. 2008; 26(2):197-8. DOI: 10.4103/0255-0857.40545. View

12.

Mathur P, Kapil A, Das B, Dhawan B, Dwivedi S . Invasive beta-haemolytic streptococcal infections in a tertiary care hospital in northern India. J Med Microbiol. 2002; 51(9):791-792. DOI: 10.1099/0022-1317-51-9-791. View

13.

Lloyd C, Jacob S, Menon T . Pharyngeal carriage of group A streptococci in school children in Chennai. Indian J Med Res. 2006; 124(2):195-8. View

14.

Fox J, Marcon M, Bonsu B . Diagnosis of streptococcal pharyngitis by detection of Streptococcus pyogenes in posterior pharyngeal versus oral cavity specimens. J Clin Microbiol. 2006; 44(7):2593-4. PMC: 1489465. DOI: 10.1128/JCM.00797-06. View

15.

Efstratiou A, Emery M, Lamagni T, Tanna A, Warner M, George R . Increasing incidence of group A streptococcal infections amongst injecting drug users in England and Wales. J Med Microbiol. 2003; 52(Pt 6):525-526. DOI: 10.1099/jmm.0.05167-0. View

16.

Penalba Citores A, Riano Mendez B, Maranon Pardillo R, Miguez Navarro C, Vazquez Lopez P, Guerrero Soler M . [Incidence of streptococcal pharyngitis]. An Pediatr (Barc). 2007; 67(3):220-4. DOI: 10.1016/s1695-4033(07)70610-0. View