Delpech Gastón, Sparo Mónica, Baldaccini Beatriz, Pourcel Gisela, Lissarrague Sabina, García Allende Leonardo
School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina.
Hospital Ramón Santamarina, Tandil, Argentina.
J Prev Med Public Health. 2017 Mar;50(2):127-132. doi: 10.3961/jpmph.15.073. Epub 2017 Jan 4.
The aim of this study was to determine the prevalence of asymptomatic carriers of group A β-hemolytic streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status.
Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin.
The carriage of β-hemolytic streptococci was detected in 18.1% of participants, with in 18 participants followed by ssp. in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate.
The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci ( ssp. ) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.
本研究旨在确定生活在农村社区的儿童中A组β溶血性链球菌（GAS）无症状携带者的患病率，并调查急性咽炎发作与携带者状态之间的关联。
2013年9月至11月，从阿根廷农村社区（玛丽亚·伊格纳西娅 - 韦拉）5至13岁的儿童中采集咽拭子。分离株的表型特征通过常规试验进行。采用纸片扩散法检测青霉素、四环素、氯霉素、红霉素和克林霉素的药敏情况。测定青霉素、头孢噻肟、四环素和红霉素的最低抑菌浓度。
18.1%的参与者检测到β溶血性链球菌携带，其中18例为 ，5例为 亚种。8至10岁儿童中GAS比例最高。未检测到去年急性咽炎发作次数与携带者状态之间的显著关联（>0.05）。观察到四环素耐药率为55.5%，大环内酯类耐药表型为11.1%。任何链球菌分离株均未表现出对青霉素、头孢噻肟或氯霉素的耐药性。
本研究表明，在阿根廷农村人群中，GAS在咽喉部携带情况显著，且存在C组链球菌（ 亚种）。这些结果指出，需要对高度易感人群，如农村学龄儿童中的GAS和非GAS携带情况以及抗菌药物耐药性进行持续监测。应考虑开展一项包括不同城市学龄儿童的扩展监测计划，以估计阿根廷GAS携带的患病率。
