Guo Mengyang, Hou Xiangping, Shi Wei, Huang Qian, Gao Wei, Dong Limin, Lai Yun, Chen Siyu, Deng Jianghong, Yao Kaihu
National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.
Clinical Laboratory, Sir Run Shaw Alaer Hospital, Zhejiang University School of Medicine, Aral, China.
J Glob Antimicrob Resist. 2025 Jun;43:183-187. doi: 10.1016/j.jgar.2025.04.012. Epub 2025 May 7.
This study examined group A streptococcus(GAS) carriage, emm types, and antibiotic susceptibility in children (6-13 years) in Aral, China, during the post-COVID-19 scarlet fever resurgence, providing regional insights.
The prevalence of GAS carriage was assessed in 1,835 children aged 6-13 years across two surveys at an Aral school in China during the post-COVID-19 resurgence of scarlet fever. GAS isolates were analyzed for emm types, M1 lineage, and antimicrobial susceptibility using culture, PCR, sequencing, and automated methods.
The first survey (885 children) showed a 1.9% isolation rate, highest in 9-year-olds (4.8%) and slightly higher in boys (2.3% vs. 1.5%, P > 0.05). The second survey (950 children) reported a 3.1% rate, peaking at 10 years (6.7%) and also higher in boys (3.5% vs. 2.6%, P > 0.05). Colonization rates were similar overall (P > 0.05), but increased significantly in children aged ≥10 years (1.1% to 3.3%, P = 0.038). No children tested positive for GAS in both sampling rounds, which meant that the two surveys identified distinct host populations colonized by the bacteria. Emm12 prevalence decreased from 76.5% to 55.2% (P > 0.05), while emm1 increased from 11.8% to 31.0% (P > 0.05), with no M1 lineage detected. All isolates were sensitive to penicillin, linezolid, vancomycin, and levofloxacin. Among 33 co-resistant isolates, emm12 accounted for 84.8% and emm1 for 15.2%.
Despite low GAS carriage rates, variations in age distribution and emm types suggest increased bacterial activity, warranting ongoing monitoring for GAS-related diseases.
本研究调查了中国阿拉尔地区新冠疫情后猩红热再次流行期间6至13岁儿童的A组链球菌（GAS）携带情况、emm型别及抗生素敏感性，以提供该地区的相关见解。
在中国阿拉尔一所学校对1835名6至13岁儿童进行了两次调查，评估GAS携带率。采用培养、PCR、测序和自动化方法对GAS分离株进行emm型别、M1谱系及抗菌药物敏感性分析。
第一次调查（885名儿童）显示分离率为1.9%，9岁儿童中最高（4.8%），男孩略高（2.3%对1.5%，P>0.05）。第二次调查（950名儿童）报告分离率为3.1%，10岁时达到峰值（6.7%），男孩也更高（3.5%对2.6%，P>0.05）。总体定植率相似（P>0.05），但≥10岁儿童显著增加（从1.1%增至3.3%，P=0.038）。两轮采样中均无儿童GAS检测呈阳性，这意味着两次调查确定了被该细菌定植的不同宿主群体。Emm12流行率从76.5%降至55.2%（P>0.05），而emm1从11.8%增至31.0%（P>0.05），未检测到M1谱系。所有分离株对青霉素、利奈唑胺、万古霉素和左氧氟沙星敏感。在33株多重耐药分离株中，emm12占84.8%，emm1占15.2%。
尽管GAS携带率较低，但年龄分布和emm型别的变化表明细菌活性增加，有必要持续监测GAS相关疾病。
