Children less than three-years-old with pharyngitis. Are group A streptococci really that uncommon?
Related Experiment Videos
Insights
Group A beta-hemolytic streptococci (BHS) were frequently isolated from symptomatic children under three years old. Further research is needed to determine if these BHS isolations indicate infection or asymptomatic carriage.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pharyngitis is a common condition in infants and young children.
- Group A beta-hemolytic streptococci (BHS) are a significant bacterial cause of pharyngitis.
Purpose of the Study:
- To investigate the prevalence of Group A BHS in children under three years old presenting with pharyngitis symptoms.
- To compare isolation rates based on age and culture techniques.
Main Methods:
- A 15-month observational study monitored 148 infants and children (<3 years) with pharyngitis symptoms.
- Throat swabs were cultured using both conventional aerobic and overnight anaerobic methods.
- Clinical signs such as fever, tonsillar exudate, and cervical adenopathy were recorded.
Main Results:
- Group A BHS were isolated in 25% of cases.
- Isolation rates were higher in children aged 25-35 months compared to those under 2 years (35% vs. 19%).
- Overnight anaerobic culture techniques yielded significantly more BHS isolations than aerobic methods (23% vs. 11%).
Conclusions:
- Group A BHS can be frequently isolated from symptomatic children under three years old.
- Age and specific culture techniques influence isolation rates.
- The clinical significance of these isolations (infection vs. carriage) requires further investigation.
Abstract:
During a 15-month period, 148 infants and children less than 3-years-old who presented with signs and/or symptoms of pharyngitis were monitored in a private pediatric practice. Clinical signs included fever (95 or 64%), tonsillar exudate (16 or 11%), and cervical adenopathy (5 or 3%). Beta-hemolytic streptococci (BHS) from group A were isolated from throat swabs in 37 (25%) instances. These isolations were more common among children 25-35 months old than among children less than 2 years old (35% vs. 19%, p less than 0.05), and were significantly more likely when overnight anaerobic culture techniques were used rather than conventional aerobic methods (23% vs. 11%, p less than 0.01). Group A BHS may be isolated relatively frequently from symptomatic children under 3-years-old. Whether these isolations reflect invasive infection or asymptomatic carriage is uncertain.