Gerber M A, Randolph M F, Martin N J, Rizkallah M F, Cleary P P, Kaplan E L, Ayoub E M
Department of Pediatrics, University of Connecticut School of Medicine, Farmington.
Pediatrics. 1991 May;87(5):598-603.
Although several outbreaks of group G beta-hemolytic streptococcal (GGBHS) pharyngitis have been described, doubt still remains regarding the etiologic role of GGBHS in acute pharyngitis beyond a limited number of situations. In the winter/spring of 1986/87, throat cultures were obtained from 222 consecutive children seen at a private pediatric office with acute pharyngitis and group A beta-hemolytic streptococci (GABHS) were recovered from 91 children (41%) and GGBHS from 56 children (25%). One patient had both GABHS and GGBHS isolated. This isolation rate of GGBHS was dramatically greater than in previous and subsequent years, and 67% of the GGBHS isolates occurred during an 8-week period. Results of DNA fingerprinting of the 57 isolates of GGBHS demonstrated that 43 (75%) appeared to be the same strain. The patients with GGBHS were comparable to those with GABHS with respect to clinical findings, antistreptolysin-O titer response, and clinical response to antibiotic therapy. However, patients with GGBHS were significantly older (P less than .05). This is the first well-documented, community-wide outbreak of GGBHS pharyngitis and the first respiratory outbreak of GGBHS pharyngitis in a pediatric population. GGBHS may be a more important cause of acute, treatable pharyngitis than had been previously recognized.
尽管已经有几起关于G组β溶血性链球菌(GGBHS)咽炎暴发的报道,但对于GGBHS在急性咽炎中的病因学作用,除了少数情况外,仍存在疑问。在1986/87年冬春季节,从一家私人儿科诊所连续就诊的222名患急性咽炎的儿童中采集了咽拭子培养样本,91名儿童(41%)培养出A组β溶血性链球菌(GABHS),56名儿童(25%)培养出GGBHS。有1名患者同时分离出GABHS和GGBHS。GGBHS的分离率显著高于此前及此后年份,且67%的GGBHS分离株出现在8周内。对57株GGBHS分离株进行DNA指纹图谱分析结果显示,43株(75%)似乎为同一菌株。GGBHS患者在临床表现、抗链球菌溶血素O滴度反应以及对抗生素治疗的临床反应方面与GABHS患者相当。然而,GGBHS患者年龄显著更大(P<0.05)。这是首次有充分记录的社区范围GGBHS咽炎暴发,也是儿科人群中首次出现的GGBHS咽炎呼吸道暴发。GGBHS可能是急性、可治疗性咽炎比之前所认识到的更重要病因。