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Community-wide outbreak of group G streptococcal pharyngitis
M A Gerber1, M F Randolph, N J Martin
1Department of Pediatrics, University of Connecticut School of Medicine, Farmington.
Abstract:
Although several outbreaks of group G beta-hemolytic streptococcal (GGBHS) pharyngitis have been described, doubt still remains regarding the etiologic role of GGBHS in acute pharyngitis beyond a limited number of situations. In the winter/spring of 1986/87, throat cultures were obtained from 222 consecutive children seen at a private pediatric office with acute pharyngitis and group A beta-hemolytic streptococci (GABHS) were recovered from 91 children (41%) and GGBHS from 56 children (25%). One patient had both GABHS and GGBHS isolated. This isolation rate of GGBHS was dramatically greater than in previous and subsequent years, and 67% of the GGBHS isolates occurred during an 8-week period. Results of DNA fingerprinting of the 57 isolates of GGBHS demonstrated that 43 (75%) appeared to be the same strain. The patients with GGBHS were comparable to those with GABHS with respect to clinical findings, antistreptolysin-O titer response, and clinical response to antibiotic therapy. However, patients with GGBHS were significantly older (P less than .05). This is the first well-documented, community-wide outbreak of GGBHS pharyngitis and the first respiratory outbreak of GGBHS pharyngitis in a pediatric population. GGBHS may be a more important cause of acute, treatable pharyngitis than had been previously recognized.
Insights
Group G beta-hemolytic streptococcal (GGBHS) pharyngitis outbreaks are uncommon, but a 1986/87 study found GGBHS caused 25% of pediatric pharyngitis cases. This suggests GGBHS may be a more significant cause of treatable pharyngitis than previously thought.
Area of Science:
- Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Group G beta-hemolytic streptococci (GGBHS) pharyngitis outbreaks are infrequently documented.
- The etiological role of GGBHS in acute pharyngitis remains uncertain in many contexts.
Purpose of the Study:
- To investigate the incidence and characteristics of GGBHS pharyngitis during a specific outbreak period.
- To compare GGBHS pharyngitis with group A beta-hemolytic streptococci (GABHS) pharyngitis in a pediatric population.
Main Methods:
- Throat cultures were performed on 222 children with acute pharyngitis during winter/spring 1986/87.
- DNA fingerprinting was used to analyze GGBHS isolates.
- Clinical findings, serological responses, and treatment outcomes were compared between GGBHS and GABHS groups.
Main Results:
- GGBHS was isolated from 25% of children, a rate significantly higher than in other years.
- A single strain of GGBHS accounted for 75% of isolates during an 8-week period.
- Patients with GGBHS pharyngitis were comparable to those with GABHS pharyngitis, but were significantly older.
Conclusions:
- This study documents the first community-wide outbreak of GGBHS pharyngitis in a pediatric population.
- GGBHS may represent a more substantial cause of acute, treatable pharyngitis than previously recognized.