Publication: Throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes among the asymptomatic 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. Since the 1980s there has been re-emergence in the incidence of invasive S. pyogenes infections and rheumatic
heart disease all over the world and hence throat carriage has assumed of great importance.
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 subgroups, although the rate was slightly higher among girls and age
subgroup 9-12 years. No significant difference in carrier rate was observed among different schools (P>0.05). Highest
resistance rate was observed for Cotrimoxazole (71.05%) followed by Chloramphenicol (7.8%), Ciprofloxacin (5.2%)
and Erythromycin (5.2%). All isolates were susceptible to Azithromycin. No resistance was detected for penicillin and
its derivative and Azithromycin.
Conclusion: Antibiotic resistant GAS isolated from asymptomatic Nepalese children is a concern. When screened
and appropriately treated with antibiotics, carriers can be prevented from spreading of streptococcal infections in the
community. This would ultimately reduce the incidence of life-threatening sequelae which are debilitating and difficult
to treat. It is recommended to conduct regular screening programs and GAS surveillance, and maintain rational use of
antibiotics to keep GAS carriage/ infections and resistance in check.
Key words: Streptococcus pyogenes, Antibiotics Resistance, Children, Throat carriage, Nepal
Description
Dumre SP 1, Sapkota K 2 , Adhikari N 2, Acharya D 2, Karki M1, Basnyat SR 2, Joshi SK 3
1National Public Health Laboratry, Teku, Kathmandu, Nepal; 2Department of Microbiology, Kantipur College of Medical Science, Kathmandu, Nepal, 3Department of Community Medicine, Kathmandu Medical College, Sinamangal, Nepal.