Publication: Asymptomatic throat carriage rate and antimicrobial resistance pattern of Streptococcus pyogenes in Nepalese school children
Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative
infections. In addition to pharyngitis and skin infections, GAS are also the causative agent of post-streptococcal infection
syndromes such as acute rheumatic fever (ARF) and post-streptococcal glumerulonephritis (PSG). GAS frequently
colonises in the throat of an asymptomatic person. Pharyngeal carriage rates of GAS among healthy school children vary
with geographical location and seasons.
Objectives: We carried out this preliminary study to determine the throat carriage rate and antimicrobial resistance trend
of Streptococcus pyogenes or Group A streptococcus (GAS) among the Nepalese school children.
Materials and methods: Four schools situated at different locations of Kathmandu valley were included in the study.
Throat swabs from 350 students of age group 5-15 years were collected, immediately transported to the laboratory and
were processed for S. pyogenes following standard microbiological procedures. Antimicrobial susceptibility testing of
the isolates was performed by Kirby Bauer disc diffusion method following CLSI guidelines.
Results: S. pyogenes was isolated from 10.9% (38/350) of the screened children. The GAS colonisation rate was
statistically insignificant (P>0.05) with sex and age sub-groups, although the rate was slightly higher among girls and
age sub-group 9-12 years. No significant difference in carrier rate was observed among different schools (P>0.05).
All isolates were susceptible to azithromycin. No resistance was detected for penicillin and its derivative antibiotic
ampicillin. Highest resistance rate was observed for cotrimoxazole (71.0%) followed by chloramphenicol (7.8%),
ciprofloxacin (5.2%) and erythromycin (5.2%).
Conclusion: Antibiotic resistant GAS isolated from asymptomatic Nepalese school children is a public health concern.
When screened and appropriately treated with antibiotics, carriers can be prevented from spreading of streptococcal
infections in the school environment and the community. Preventing cross infections would ultimately reduce the
incidence of life-threatening sequelae which are debilitating and difficult to treat. It is recommended to conduct regular
screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimise GAS carriage/infections
and resistance.
Key words: Streptococcus pyogenes, Antibiotics Resistance, Throat carriage, Children, Nepal.
Description
Dumre SP 1, Sapkota K 2, Adhikari N 2, Acharya D 2, Karki M3, Bista S 2, Basnyat SR 2, Joshi SK 4
1 National Public Health Laboratry, Teku, Kathmandu, Nepal, 2Department of Microbiology, Kantipur College of Medical Science, Kathmandu, Nepal, 3Central Department of Microbiology, Tribhuwan University, Kirtipur, Nepal, 4Department of Community Medicine, Kathmandu Medical College, Nepal