Throat culture positivity rate and antibiotic susceptibility pattern of beta-hemolytic streptococci in children on secondary prophylaxis for rheumatic heart disease

BMC Infectious Diseases

Research Article

Abraham Aseffa¹  Abebe Habte¹  Nigus Zegeye²  Yimtubezinash Woldeamanuel³  Daniel Asrat³  Tone Tønjum⁴  Etsegenet Gedlu⁵ 

[1] Armauer Hansen Research Institute, PO Box 1005, Jimma Road, Addis Ababa, Ethiopia;Department of Medicine, DebreBerhan University, P. O. Box: 445, DebreBerhan, Ethiopia;Armauer Hansen Research Institute, PO Box 1005, Jimma Road, Addis Ababa, Ethiopia;Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Department of Microbiology, Oslo University Hospital, Oslo, Norway;Department of Microbiology, University of Oslo, Oslo, Norway;Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;

关键词: Beta;    Rheumatic heart disease (RHD);    Rheumatic fever (RF);    Antibiotic prophylaxis;    Streptococcus pyogenes;    Streptococcus dysgalactiae subsp. equisimilis;    Antibiotic resistance;    Ethiopia;   

DOI  :  10.1186/s12879-016-1841-3

 received in 2016-02-01, accepted in 2016-09-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAmong children diagnosed to have chronic rheumatic valvular heart disease (RHD) in Ethiopia, many have been observed to develop recurrence of rheumatic fever (RF) despite secondary prophylaxis. This study determined the throat culture positivity rate and drug susceptibility pattern of beta hemolytic streptococci (BHS) isolated from children attending a specialized cardiac clinic in Ethiopia.MethodsThroat swabs were collected from 233 children receiving benzathine penicillin injection as secondary prophylaxis for RHD and cultured. The bacterial isolates were characterized using Matrix Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) mass spectrometry. Drug susceptibility was tested with the Kirby Bauer disc diffusion method. Anti-streptolysin O (ASO) titers were determined using ASO latex reagents.ResultsThe throat culture positivity rate for BHS was 24 % (56/233). Among the BHS bacterial strains isolated, four were characterized as S. pyogenes and another four as S. dysgalactiae subsp. equisimilis (Lancefield group A, C and G). All BHS were susceptible to penicillin except one isolate of S. agalactiae. Among 233 children enrolled, 46(19.7 %) showed increased ASO titer. Children who received antibiotic prophylaxis within 2-weeks of last injection had significantly lower BHS throat culture positivity rate than those injected every 4-weeks (p = 0.02). Children who missed at least one prophylaxis within the last 6 months had a higher BHS culture positivity rate than those who did not miss any (p = 0.0003).ConclusionsThe presence of groups A, C and G streptococci in the throat of children under secondary prophylaxis for RHD and increased ASO titer suggests failure of the regimen. This calls for further investigation into the causes of inadequate prophylaxis (including bioavailability of drugs used, optimal duration and patient compliance) and intervention.

【 授权许可】

CC BY   
© The Author(s). 2016