埃塞俄比亚健康学童中A组链球菌（GAS）的咽部携带率及抗菌药物敏感性模式

Throat carriage rate and antimicrobial susceptibility pattern of group A Streptococci (GAS) in healthy Ethiopian school children.

作者信息

Abdissa Alemseged, Asrat Daniel, Kronvall Göran, Shitu Belay, Achiko Dilachew, Zeidan Mohammed, Yamuah Lawrence K, Aseffa Abraham

机构信息

Armauer Hansen Research Institute, Addis Ababa, Ethiopia.

出版信息

Ethiop Med J. 2011 Apr;49(2):125-30.

PMID:21796912

Abstract

BACKGROUND

Group A Streptococci (GAS) or Streptococcus pyogenes are the most frequent cause of pharyngitis and skin infection in children and lead to post infection complications including acute rheumatic fever and glomerulonephritis. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. There is not much information on the screening of children for carriage of GAS in Ethiopia.

OBJECTIVES

The study aimed at assessing the carriage rate of Group A Streptococci and antimicrobial susceptibility of the isolates in healthy Ethiopian school children.

METHODS

A total of 937 children residing in Addis Ababa (n=491), Gondar (n=265) and Dire-Dawa (n=181) were investigated during a period between November 2004 and January 2005. Throat specimens were collected and cultured using standard procedure. Beta haemolytic streptococci were serogrouped by agglutination tests using specific antisera. Antimicrobial susceptibility testing of the isolates was performed by diffusion method.

RESULTS

The median and the mean ages of the study participants were 11 (range 6-14) years. Girls constituted 52% (486/937) of the study participants. A total of 167 (17.8%) beta haemolytic streptococci were recovered from 937 children investigated GAS accounted for 91/167 (54.5%) of beta hemolytic streptococcal isolates. The carrier rate for GAS was 9.7% (91/937) of the screened children followed by group G with 3.2% (30/937) and group C streptococci with 2.2% (21/937). All GAS isolates were sensitive to oxacillin, penicillin, erythromycin, clindamycin and trimethoprim-sulphamethoxazole. Lower frequency of resistance was observed against tetracycline and vanocmycin.

CONCLUSION

The present study revealed that GAS was the most predominant beta-haemolytic streptococcus among healthy Ethiopian school children. Our results showed that pharyngeal carriage of GAS in school children should not be underestimated. Therefore it is recommended to conduct regular screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimize GAS resistance.

摘要

背景

A 组链球菌（GAS）或化脓性链球菌是儿童咽炎和皮肤感染最常见的病因，并会导致包括急性风湿热和肾小球肾炎在内的感染后并发症。健康学童中 GAS 的咽部携带率因地理位置和季节而异。在埃塞俄比亚，关于筛查儿童 GAS 携带情况的信息不多。

目的

本研究旨在评估埃塞俄比亚健康学童中 A 组链球菌的携带率及分离株的抗菌药敏性。

方法

在 2004 年 11 月至 2005 年 1 月期间，对居住在亚的斯亚贝巴（n = 491）、贡德尔（n = 265）和德雷达瓦（n = 181）的 937 名儿童进行了调查。使用标准程序采集咽拭子标本并进行培养。通过使用特异性抗血清的凝集试验对β溶血性链球菌进行血清分组。分离株的抗菌药敏试验采用扩散法进行。

结果

研究参与者的年龄中位数和平均数为 11 岁（范围 6 - 14 岁）。女孩占研究参与者的 52%（486/937）。在接受调查的 937 名儿童中，共分离出 167 株（17.8%）β溶血性链球菌，其中 GAS 占β溶血性链球菌分离株的 91/167（54.5%）。GAS 的携带率为筛查儿童的 9.7%（91/937），其次是 G 组，携带率为 3.2%（30/937），C 组链球菌携带率为 2.2%（21/937）。所有 GAS 分离株对苯唑西林、青霉素、红霉素、克林霉素和复方新诺明敏感。对四环素和万古霉素的耐药频率较低。