School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India.
Indian J Med Res. 2009 Dec;130(6):765-71.
BACKGROUND & OBJECTIVE: Group A streptococcus (GAS) causes a wide array of human diseases. Epidemiological picture of streptococcal infection in India is not complete. Hence, disease burden due to GAS in 5-15 yr old school children in northern India was studied and emm typing of GAS isolates was carried out to help in designing prevention strategies.
A cross-sectional survey was carried out among 4249 school children (5-15 yr) from Raipur Rani Block of Panchkula district in Haryana during 2000-2002; 334 children were followed up fortnightly for one year. Standard clinical and microbiological procedures were used for collection of swabs from throat and skin and confirmation of GAS and its emm types.
Of the 4249 children studied, 658 (15.5%) had pharyngitis; 579 of them could be swabbed, of which 2.8 per cent had GAS. From 3591 children without pharyngitis, 3385 who could be swabbed, GAS was found in 1.3 per cent of them. Impetigo was rare (0.7%), but 7.1 per cent (2/28) children had GAS. In the followup study, 17.4 per cent (776/4447 child-contacts) had pharyngitis, 761 could be swabbed and 2.4 per cent had GAS; among those without pharyngitis, 2016 swabs could be taken and GAS was found in 1.3 per cent; whereas only 2.6 per cent (2/75) of skin sores had GAS. Three children had GAS pharyngitis twice during follow up. Fourteen different GAS emm types were found. emm 71, 77 and 81 constituted 69 per cent of the pharyngeal isolates. GAS pharyngitis and impetigo were more common in winters and summers respectively.
INTERPRETATION & CONCLUSION: In north India, pharyngitis was more common than impetigo. Most prevalent emm types of GAS in this region differ from those included in M protein-based vaccines.
酿脓链球菌（GAS）可引起广泛的人类疾病。印度链球菌感染的流行病学情况并不完整。因此，研究了印度北部 5-15 岁学龄儿童的 GAS 疾病负担，并对 GAS 分离株进行 emm 分型，以帮助制定预防策略。
2000-2002 年在哈里亚纳邦潘奇库拉区拉伊普尔·拉尼街区对 4249 名（5-15 岁）学龄儿童进行了横断面调查；对 334 名儿童进行了为期一年的每两周一次的随访。采用标准的临床和微生物学程序从喉咙和皮肤采集拭子，以确认 GAS 及其 emm 型。
在 4249 名研究儿童中，658 名（15.5%）患有咽炎；其中 579 名可进行拭子取样，其中 2.8%为 GAS。在 3591 名无咽炎的儿童中，3385 名可进行拭子取样，其中 1.3%为 GAS。脓疱疮很少见（0.7%），但 7.1%（2/28）的儿童有 GAS。在随访研究中，17.4%（4447 名儿童接触者中的 776 名）患有咽炎，可对 761 名儿童进行拭子取样，其中 2.4%为 GAS；在无咽炎的儿童中，可对 2016 名儿童进行拭子取样，其中 1.3%为 GAS；而仅有 2.6%（75 名儿童皮肤损伤中的 2 名）有 GAS。有 3 名儿童在随访期间两次出现 GAS 咽炎。发现了 14 种不同的 GAS emm 型。emm71、77 和 81 构成咽部分离株的 69%。该地区 GAS 咽炎和脓疱疮分别在冬季和夏季更为常见。
在印度北部，咽炎比脓疱疮更为常见。该地区 GAS 最常见的 emm 型与 M 蛋白疫苗中包含的 emm 型不同。
