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Algengi Streptococcus pyogenes og methisillín ónæmra Staphylococcus aureus í hálsi heilbrigðra barna í Garðabæ

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Authors
Björg Þuríður Magnúsdóttir
Jón Steinar Jónsson
Karl G Kristinsson
Issue Date
2008-06-01

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Other Titles
Prevalence of Streptococcus pyogenes and methisillin-resistant Staphylococcus aureus in the pharynx of healthy children in the town of Gardabaer
Citation
Læknablaðið 2008, 94(6):447-51
Abstract
BACKGROUND: Treating S. pyogenes pharyngitis with antibiotics is recommended after confirming its presence using culture or rapid antigen tests. Limiting unnecessary antibiotics use is important in attempt to avoid rising resistance to drugs such as macrolides. Not all individuals carrying S. pyogenes are infected. OBJECTIVE: To evaluate the carriage rate of S. pyogenes and methicillin resistant S. aureus (MRSA) among healthy children in the Reykjavík capital area. SUBJECTS AND METHODS: Cross-sectional study for the carriage of S. pyogenes and MRSA among healthy children in the town of Gardabaer. The study took place in March and April 2005. Throat cultures were collected from 270 asymptomatic healthy primary school students and cultured selectively for S. pyogenes and MRSA and tested for antimicrobial susceptibilities. RESULTS: Prevalence of S. pyogenes was found to be 22%. The proportion of carriers in 1st to 6th grade was 28%, compared with 11% in 7th to 10th grade students. The highest proportion was in 1st grade, 45%. The proportion S. pyogenes resistant to erythromycin was 17%, to tetracycline 13% and clindamycin 2%. All strains were susceptible to penicillin. No MRSA strains were found. CONCLUSIONS: The study reveals a high S. pyogenes carriage rate in primary school children in Garethabaer. Physicians should consider the prevalence of streptococcal carriage when diagnosing streptococcal pharyngitis in children, and only perform culture and/or antigen tests when clinically indicated.
Inngangur: Hálsbólgur skal meðhöndla með sýklalyfjum ef S. pyogenes (hemólýtískir streptókokkar af flokki A) er talin orsök þeirra. Mikilvægt er að staðfesta tilvist S. pyogenes í hálsi til að forðast óþarfa sýklalyfjanotkun en vaxandi ónæmi til dæmis gegn makrólíðum er orðið algengt. Ekki er þó fullvíst að um streptókokkahálsbólgu sé að ræða þó S. pyogenes finnist í hálsi því viðkomandi gæti verið beri og haft veiruhálsbólgu. Tilgangur: Kanna beratíðni og sýklalyfjanæmi S. pyogenes meðal heilbrigðra barna á höfuðborgarsvæðinu og hvort eitthvert barnanna beri methisillín ónæma Staphylococcus aureus (MÓSA) í hálsi. Efniviður og aðferðir: Þversniðsrannsókn á algengi S. pyogenes og MÓSA hjá heilbrigðum börnum. Rannsóknin var gerð í mars og apríl 2005. Hálsstrok voru tekin úr 270 einkennalausum heilbrigðum grunnskólabörnum í Garðabæ og ræktuð fyrir S. pyogenes og MÓSA. Sýklalyfjanæmi bakteríanna var kannað. Niðurstöður: Algengi S. pyogenes reyndist vera 22%. Beratíðnin í 1.-6. bekk var 28% en 11% í 7.-10. bekk. Hæst var tíðnin í 1. bekk eða 45%. Sýklalyfjaónæmi S. pyogenes fyrir erýtrómýcíni reyndist 17% og fyrir tetracýklíni 13%, 0% fyrir penicillíni og 2% fyrir klindamýcíni. Engir MÓSA stofnar ræktuðust úr hálsstrokum barnanna. Ályktun: Niðurstöðurnar sýna háa beratíðni hjá grunnskólabörnum í Garðabæ. Læknar ættu að hafa beratíðnina í huga við greiningu streptókokkahálsbólgu hjá börnum og ekki gera hraðgreiningarpróf og/eða hálsræktun nema einkenni gefi tilefni til.
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