NIHR Health Protection Research Unit in Antimicrobial Resistance and Healthcare Associated Infections, Imperial College London, United Kingdom.
Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire, United Kingdom.
J Infect. 2017 Jun;74(6):585-589. doi: 10.1016/j.jinf.2017.03.001. Epub 2017 Mar 23.
A prospective observational study was conducted in Royal Marines (RM) recruits to investigate throat carriage of group A Streptococcus (GAS) and incidence of soft tissue infections.
1012 RM recruits were followed through a 32-week training programme, with throat swabs being obtained in weeks 1, 6, 15, and 32. Alongside a separate cohort of 46 RM Young Officers (YO) undergoing training were sampled in parallel.
Carriage of group A Streptococcus was detected in only 5/1012 (0.49%) recruits at the beginning of training and remained low throughout training. There was no association between GAS carriage and development of soft tissue infection. There was no carriage of GAS in the smaller YO cohort at the start of training, (0/46). At week 6, a surge in GAS carriage was detected in 8/46 (17%) YO, that could be ascribed to a cluster of GAS genotype emm83.
Asymptomatic GAS carriage is very infrequent among young adults in England and this should be borne in mind when considering the relevance of a positive throat swab result in symptomatic patients or outbreaks. Despite low prevalence, there is however potential for GAS to rapidly and transiently disseminate among adults during outbreaks.
对皇家海军陆战队新兵进行前瞻性观察研究，以调查 A 组链球菌（GAS）的咽部携带情况以及软组织感染的发病率。
对 1012 名皇家海军陆战队新兵进行了为期 32 周的培训计划，在第 1、6、15 和 32 周时采集咽拭子。同时对同期接受培训的 46 名皇家海军陆战队青年军官（YO）进行了平行采样。
在培训开始时，仅在 5/1012（0.49%）新兵中检测到 GAS 携带，且在整个培训过程中保持低水平。GAS 携带与软组织感染的发展之间没有关联。在培训开始时，较小的 YO 队列中没有 GAS 携带（0/46）。第 6 周时，在 46 名 YO 中有 8 名（17%）检测到 GAS 携带量激增，这可归因于 GAS 基因型 emm83 的聚集。
在英国，年轻人中无症状 GAS 携带非常罕见，因此在考虑阳性咽拭子结果在症状性患者或暴发中的相关性时应考虑到这一点。尽管流行率低，但 GAS 仍有可能在暴发期间在成年人中迅速短暂传播。
