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Asymptomatic throat carriage rate and antimicrobial resistance pattern of Streptococcus pyogenes in Nepalese school children  [PDF]
SP Dumre,K Sapkota,M Adhikari,D Acharya,M Karki,S Bista,SR Basnyat,SK Joshi
Kathmandu University Medical Journal , 2009, DOI: 10.3126/kumj.v7i4.2760
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%), ciprofl oxacin (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. DOI: 10.3126/kumj.v7i4.2760 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 392-396
Infección y colonización faríngea asintomática de ni?os por Streptococcus pyogenes
Restrepo Lozada,Mary Alejandra; Múnera Jaramillo,María Isabel; Ramírez Puerta,Blanca Susana; Acu?a Ramos,Clara Patricia;
Iatreia , 2012,
Abstract: objective: to establish the frecuency of streptococcus pyogenes infection or asymptomatic carriage in a group of children, by means of a rapid antigendetection test. methods: a cross-sectional study was carried out in a non-probabilistic sample of 144 children aged between 3 and 13 years, in two educational institutions in bogotá and medellin. a single throat specimen was obtained from each child to carry out the rapid test; demographic data and information on pertinent symptoms and signs were obtained by means of a survey. mean and standard deviation and percentages were calculated according to the nature of the variables. results: average age was 5.5 ± 2.8 years, with even distribution by gender. twenty one children (14,6%) were positive for s. pyogenes; out of them, 10 had possible infection and 11 were asymptomatic throat carriers. forty five children (31.3%) reported pharyngeal symptoms and 10 (22.2%) out of them were positive in the rapid test. ninety nine children (68.7%) were asymptomatic and of them 11 (11.1%) were also positive. discussion: management protocols for s. pyogenes infection would benefit from the detection based on rapid tests.
Antibiogram Sensitivity Pattern of Streptococcus pyogenes and Streptococcus pneumoniae Isolated from Patients with Sore Throat and Pneumonia Infections  [PDF]
Uzma Malik,Noor-us-Saba,Ali Abbas Qazilbash
Pakistan Journal of Biological Sciences , 2005,
Abstract: Strains of Streptococcus pyogenes and Streptococcus pneumoniae, isolated from clinical samples (125 throat swabs and 100 sputum) from patients suffering from sore throat and pneumonia infections, were subjected to a series of culture sensitivity tests against known antibiotics to determine their antibiogram patterns. Of the S. pyogenes isolates, all were found to be sensitive to penicillin and cefrioxone, whereas some of the strains showed complete resistance against cotrimoxazole (88.9%), oxacillin (22.2%), cephradine (22.2%) and erythromycin (11.1%). As for the S. pneumoniae strains, all the isolates in this study were sensitive to vancomycin and cephradine, whereas 80% showed complete resistance to kanamycin, 60% to gentamycin, 20% to cotrimoxazole, 20% to tetracycline and 10% to penicillin. Strains of S. pneumoniae (20%) displayed intermediate resistance to erythromycin. Inadequate diagnostic procedures, un-supervised, improper use of antibiotics and easy access to prescription drugs may contribute to the rise of resistant strains. To combat such trends approved strategies must encompass legislative enforcement through strict enforcement of the laws related to sales of prescription drugs, involvement of clinicians, pharmacies and civil society pressure groups to ensure the rational and correct use of prescription drugs.
Prevalence of asymptomatic pharyngel carriage of B-hemolytic Group A Streptococcus pyogens among school going children of age 5-12 years in Bharatpur, Nepal  [PDF]
S Raza,KK Kundu,SK Dutta
Journal of Kathmandu Medical College , 2013, DOI: 10.3126/jkmc.v2i1.10537
Abstract: Background: β- haemolytic Group A Streptococcus pyogens infection is a common cause of bacterial pharyngitis among children. Children are the target population for pharyngitis as well as other suppurative and non-suppurative infections. Objectives: The objectives of this study are to find out the rate of asymptomatic throat carriage of Streptococcus pyogens and to study antibiotic susceptibility pattern of the isolates. Methods: Total 106 randomly selected children between five to 12 years were included in this study. Throat swabs collected were inoculated on 5% sheep blood agar and incubated for 24-48 hours at 37°C. Identifi cation of Group A Streptococcus pyogens was done by β-haemolytic colony, Bacitracin sensitivity, Co-trimoxazole resistivity and catalase negativity. Antibiotic susceptibility test was performed on Muller-Hinton agar containing 5% sheep blood by modifi ed Kirby-Bauer disc diffusion method. Results were interpreted as per National Committee for the Clinical Standards Guidelines. Results: Of total 106 throat swabs Group A Streptococcus pyogens was isolated in 15 (14.15%) cases. Among the isolates seven (46.7%) were from male children whereas eight (53.3%) were from female children. Out of the 15 isolates 100% were sensitive to penicillin and its derivatives whereas 13.2%, 6.7% and 6.7% of the isolates were resistant to Erythromycin, Chloramphenicol and Ciprofl oxacin respectively. Similarly Azithromycin was found to be 100% sensitive. Conclusion: Regular screening is needed to keep the GAS infection and carrier state in check as well as to prevent from further development of complications. DOI: http://dx.doi.org/10.3126/jkmc.v2i1.10537 Journal of Kathmandu Medical College, Vol. 2, No. 1, Issue 3, Jan.-Mar., 2013: 18-20
Investigation of Streptococcus pyogenes Carriage in Population Vulnerable to Scarlet Fever during 2015-2017 in Shanghai, China  [PDF]
Mingliang Chen, Chi Zhang, Dechuan Kong, Hao Pan, Xi Zhang, Min Chen
Journal of Biosciences and Medicines (JBM) , 2018, DOI: 10.4236/jbm.2018.611009
Abstract:
This study aimed to investigate the carriage of Streptococcus pyogenes in population vulnerable to scarlet fever and to compare their genotypic characterization between different age groups. Pharyngeal swabs were collected from 120 - 150 students in each of the three districts in Shanghai in May and December during 2015 to 2017, while emm typing and detection of 12 superantigen genes were performed to characterize the isolates. During 2015-2017, the average carriage rate in students was 5.7% (135/2,371), without significant difference between different years or districts. The carriage rate was significantly different between children from the three age groups, with 2.4% in 3 - 4 years, 5.4% in 5 - 9 years, and 9.1% in 10 - 14 years. Eight emm types were found, including emm 1, emm 4, emm 12, emm 22, emm 75, emm 89, emm 70 and emm 241, among which emm 12 accounted for 60%, and emm 1 27.5%. The predominance of emm 12 was found in each year, but the proportion of emm 12 was lower in 10 - 14 years (43.3%) than in 3 - 4 years (86.7%) and in 5 - 9 years (73.3%) (P = 0.002 and 0.003). Superantigen genes of speB, speC, speG, ssa and smeZ were found in almost all the isolates. The average carriage of S. pyogenes in population vulnerable to scarlet fever was 5.7% in Shanghai, highest in 10 - 14 years (9.1%), while emm 12 was the predominant type.
Mutation at the position 2058 of the 23S rRNA as a cause of macrolide resistance in Streptococcus pyogenes
Jari Jalava, Martti Vaara, Pentti Huovinen
Annals of Clinical Microbiology and Antimicrobials , 2004, DOI: 10.1186/1476-0711-3-5
Abstract: Antibiotic resistance determinations for the clinical S. pyogenes strain ni4277 were done using the agar dilution technique. Macrolide resistance mechanisms were studied by PCR and sequencing. All six rRNA operons were amplified using operon-specific PCR. The PCR products were partially sequenced in order to resolve the sequences of different 23S rRNA genes.One clinical isolate of S. pyogenes carrying an adenine to guanine mutation at the position 2058 of the 23S rRNA in five of the six possible rRNA genes but having no other known macrolide resistance determinants is described. The strain was highly resistant to macrolides and azalides, having erythromycin and azithromycin MICs > 256 microgram/ml. It was resistant to lincosamides (clindamycin MIC 16 microgram/ml) and also MIC values for ketolides were clearly elevated. The MIC for telithromycin was 16 microgram/ml.In this clinical S. pyogenes strain, a mutation at the position 2058 was detected. No other macrolide resistance-causing determinants were detected. This mutation is known to cause macrolide resistance in other bacteria. We can conclude that this mutation was the most probable cause of macrolide, lincosamide and ketolide resistance in this strain.Streptococcus pyogenes (group A streptococcus) is an important pathogen causing pharyngitis, scarlet fever, impetigo, erysipelas, cellulitis and necrotizing fasciitis. S. pyogenes throat infection can lead to suppurative complications like peritonsillar cellulitis and abscesses [1]. Nonsuppurative complications of streptococcal pharyngitis, acute rheumatic fever and glomerulonephritis are rare [2]. S. pyogenes can also colonize the throats of asymptomatic persons [1]. The treatment of S. pyogenes infections relies on penicillin [3], which has retained its antimicrobial activity and is the drug of choice [4]. Macrolide antibiotics are used to treat patients with allergies to penicillin. In contrast to penicillin, resistance to macrolides among S. pyogenes strains
Detection of group A Streptococcus in tonsils from pediatric patients reveals high rate of asymptomatic streptococcal carriage
Amity L Roberts, Kristie L Connolly, Daniel J Kirse, Adele K Evans, Katherine A Poehling, Timothy R Peters, Sean D Reid
BMC Pediatrics , 2012, DOI: 10.1186/1471-2431-12-3
Abstract: Blinded immunofluorescent and histological methods were employed to evaluate palatine tonsils from children undergoing routine tonsillectomy for adenotonsillar hypertrophy or recurrent GAS tonsillopharyngitis.Immunofluorescence analysis using anti-GAS antibody was positive in 11/30 (37%) children who had tonsillectomy for adenotonsillar hypertrophy and in 10/30 (33%) children who had tonsillectomy for recurrent GAS pharyngitis. Fluorescent microscopy with anti-GAS and anti-cytokeratin 8 & 18 antibodies revealed GAS was localized to the tonsillar reticulated crypts. Scanning electron microscopy identified 3-dimensional communities of cocci similar in size and morphology to GAS. The characteristics of these communities are similar to GAS biofilms from in vivo animal models.Our study revealed the presence of GAS within the tonsillar reticulated crypts of approximately one-third of children who underwent tonsillectomy for either adenotonsillar hypertrophy or recurrent GAS tonsillopharyngitis at the Wake Forest School of Medicine.The tissue collected was normally discarded tissue and no patient identifiers were collected. Thus, no subjects were formally enrolled.Group A Streptococcus (GAS) is a β-hemolytic, Gram-positive human pathogen capable of causing a wide variety of human disease. GAS is one of the predominant causes of acute bacterial tonsillopharyngitis [1-6]. Tonsillopharyngitis is an acute infection of the palatine tonsils and pharynx often presenting symptomatically with a sore throat, fever and cervical lymphadenopathy [7]. Patients diagnosed with GAS tonsillopharyngitis are prescribed antibiotic therapy to avoid the potential development of post-infectious sequelae such as acute rheumatic fever and acute rheumatic heart disease [1-6].Prevention of rheumatic fever with antibacterial therapy can be life-saving, so it is important to identify patients with GAS pharyngitis. Because accurate clinical differentiation between viral and GAS pharyngitis is not possib
Portadores assintomáticos de infec??es por Streptococcus pyogenes em duas escolas públicas na cidade do Recife, Pernambuco
Maciel, Amelia;Aca, Ivanize da Silva;Lopes, Ana Catarina de Souza;Malague?o, Elizabeth;Sekiguchi, Tsuneari;Andrade, Gildete Patriota de;
Revista Brasileira de Saúde Materno Infantil , 2003, DOI: 10.1590/S1519-38292003000200007
Abstract: objectives: assess the prevalence of streptococcus pyogenes in throat secretions of students from two public elementary schools in recife. methods: an epidemiological and clinical-microbiological study was performed. from two schools, 753 individuals were examined. throat secretion cultures were performed in blood sheep ágar 5% and sbga strains identified by bacitracin, pyr and latex agglutination tests. results: the school children were aged from five to 19 years old, 54,3% of the sample were male and 45,7% female. six asymptomatic sbga carriers were identified. following treatment with penicillin, aslo sera titration was performed. all carriers had antibody titers below 200ut. conclusions: sbga prevalence rate of 0,8% was estimated in asymptomatic carriers, this percentage was low when compared with other results from similar studies. the authors suggest that epidemiological studies be accomplished to estimate sbga prevalence in children with pharyngitis and correlation with acute rheumatic fever.
Production of bacteriocin-like inhibitory substances (BLIS) by Streptococcus salivarius strains isolated from the tongue and throat of children with and without sore throat
Fantinato, Vera;Jorge, A. O. C.;Shimizu, Mário. T.;
Revista de Microbiologia , 1999, DOI: 10.1590/S0001-37141999000400007
Abstract: streptococcus salivarius strains, isolated from children with and without sore throat, were tested for bacteriocin production against streptococcus pyogenes. s. salivarius strains producing bacteriocin-like inhibitory substances (blis) against s. pyogenes were more frequently found in children without sore throat. these results suggest that these children may be protected against sore throat by the presence of blis-positive s. salivarius strains.
Production of bacteriocin-like inhibitory substances (BLIS) by Streptococcus salivarius strains isolated from the tongue and throat of children with and without sore throat  [cached]
Fantinato Vera,Jorge A. O. C.,Shimizu Mário. T.
Revista de Microbiologia , 1999,
Abstract: Streptococcus salivarius strains, isolated from children with and without sore throat, were tested for bacteriocin production against Streptococcus pyogenes. S. salivarius strains producing bacteriocin-like inhibitory substances (BLIS) against S. pyogenes were more frequently found in children without sore throat. These results suggest that these children may be protected against sore throat by the presence of BLIS-positive S. salivarius strains.
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