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An epidemiologic study of perianal dermatitis among children in Egypt
W Z Mostafa1, H H Arnaout, M I el-Lawindi
1Department of Dermatology, Faculty of Medicine, Cairo University, Egypt.
Insights
Perianal dermatitis in children is often caused by streptococci. A study found a link between throat colonization of beta-hemolytic streptococci and Staphylococci and their presence in perianal dermatitis.
Area of Science:
- Pediatrics
- Dermatology
- Microbiology
Background:
- Perianal dermatitis is a frequent pediatric condition.
- Beta-hemolytic group A streptococci are significant causative agents.
- Associations between perianal and pharyngeal colonization by specific bacteria exist.
Purpose of the Study:
- To investigate the epidemiologic association between perianal dermatitis and pharyngeal colonization by beta-hemolytic streptococci and Staphylococcus aureus in children.
Main Methods:
- A hospital-based study involving 150 children with perianal dermatitis.
- Data collection included questionnaires, clinical examinations, and perianal and throat swabs.
- Bacteriologic examination of swabs was performed.
Main Results:
- Beta-hemolytic streptococci were found in 35.3% of perianal swabs and 44% of throat swabs.
- Group A beta-hemolytic streptococci were identified in 17.3% of perianal and 21.3% of throat swabs.
- A significant association (Kappa = 0.4) was observed between pharyngeal colonization and perianal dermatitis caused by these bacteria.
Conclusions:
- Pharyngeal colonization by beta-hemolytic streptococci and Staphylococcus aureus is associated with their presence in pediatric perianal dermatitis.
- This finding supports the role of these bacteria in the causation of perianal dermatitis.
Abstract:
Perianal dermatitis is a common problem occurring among infants and children. Streptococci, particularly beta-hemolytic group A organisms, play a major role in its causation. An epidemiologic association between perianal dermatitis caused by group A beta-hemolytic streptococci in some patients and pharyngeal colonization with the same organisms seems to exist. A similar relation is also true for other organisms, including non-group A beta-hemolytic streptococci and Staphylococcus aureus. This was the main conclusion of a hospital-based study performed on 150 children with perianal dermatitis. All patients were subjected to a questionnaire, clinical examination, two perianal swabs, and two throat swabs. The bacteriologic examination of the perianal swabs revealed the presence of beta-hemolytic streptococci in 35.3% of the cases, half of which were of the group A beta-hemolytic strain (17.3%) and half of which were non-group A (18%). Throat swabs revealed the presence of beta-hemolytic streptococci in 44% of cases, half of which were found to belong to group A (21.3%) and half to non-group A (22.7%). Among patients with perianal dermatitis caused by group A beta-hemolytic streptococci, 53.8% had associated pharyngeal colonization by the same organism. S. aureus was isolated from the perianal skin in five patients (3.4%); in four of whom the same organism also grew in cultures from throat swabs. A relatively good association between pharyngeal colonization by beta-hemolytic streptococci and Staphylococci and the presence of perianal dermatitis caused by the same organisms was demonstrated using the Kappa test of agreement (K = 0.4).