A Longitudinal Study of Group A Streptococcal Colonization and Pharyngitis in US Children.


Journal

The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858

Informations de publication

Date de publication:
01 12 2023
Historique:
medline: 27 11 2023
pubmed: 28 9 2023
entrez: 28 9 2023
Statut: ppublish

Résumé

Group A streptococci (GAS) are a major cause of pharyngitis in children. Recently, there were severe GAS outbreaks. The aims of this study were to assess pharyngeal colonization prevalence in healthy children, to assess different diagnostic definitions for GAS pharyngitis and to estimate incidence rates for these infections. A 2-year longitudinal study was conducted in healthy children in the United States. Pharyngeal swabs were cultured every 3 months for GAS colonization. Serum antistreptolysin O, antideoxyribonuclease B (DNaseB) and antistreptococcal C5a peptidase (SCP) antibody titers were assessed at baseline. When participants developed a sore throat, pharyngeal swabs were collected for rapid antigen detection test (RADT) and culture, and antibody titers were determined in serum samples. A range of case definitions were used for GAS pharyngitis. A total of 422 children 3-12 years old were enrolled (140, 141 and 141 were 3-5, 6-9 and 10-12 years of age, respectively). The overall prevalence of GAS colonization during the study was 48%. Baseline antistreptolysin O, anti-DNaseB and anti-SCP antibody titers were higher for children older than 5 years. The incidence of GAS pharyngitis per 100 person-years was 15.9 for RADT/culture-proven and 4.6 for serologically confirmed pharyngitis. GAS throat colonization and pharyngitis were frequent in children 3-12 years old. The case definition employed impacted the measured incidence of GAS pharyngitis, with higher rates detected using RADT/culture-based definitions. These data suggest that case definition is important and that young children are exposed to GAS, which may inform plans for vaccine development and implementation.

Sections du résumé

BACKGROUND
Group A streptococci (GAS) are a major cause of pharyngitis in children. Recently, there were severe GAS outbreaks. The aims of this study were to assess pharyngeal colonization prevalence in healthy children, to assess different diagnostic definitions for GAS pharyngitis and to estimate incidence rates for these infections.
METHODS
A 2-year longitudinal study was conducted in healthy children in the United States. Pharyngeal swabs were cultured every 3 months for GAS colonization. Serum antistreptolysin O, antideoxyribonuclease B (DNaseB) and antistreptococcal C5a peptidase (SCP) antibody titers were assessed at baseline. When participants developed a sore throat, pharyngeal swabs were collected for rapid antigen detection test (RADT) and culture, and antibody titers were determined in serum samples. A range of case definitions were used for GAS pharyngitis.
RESULTS
A total of 422 children 3-12 years old were enrolled (140, 141 and 141 were 3-5, 6-9 and 10-12 years of age, respectively). The overall prevalence of GAS colonization during the study was 48%. Baseline antistreptolysin O, anti-DNaseB and anti-SCP antibody titers were higher for children older than 5 years. The incidence of GAS pharyngitis per 100 person-years was 15.9 for RADT/culture-proven and 4.6 for serologically confirmed pharyngitis.
CONCLUSIONS
GAS throat colonization and pharyngitis were frequent in children 3-12 years old. The case definition employed impacted the measured incidence of GAS pharyngitis, with higher rates detected using RADT/culture-based definitions. These data suggest that case definition is important and that young children are exposed to GAS, which may inform plans for vaccine development and implementation.

Identifiants

pubmed: 37768176
doi: 10.1097/INF.0000000000004111
pii: 00006454-202312000-00004
pmc: PMC10629608
doi:

Substances chimiques

Antistreptolysin 9006-92-2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1045-1050

Informations de copyright

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Auteurs

Robert W Frenck (RW)

From the Cincinnati Children's Hospital Medical Center and the Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.

France Laudat (F)

Vaccine Research and Development, Pfizer Inc., Pearl River, New York.

John Liang (J)

Vaccine Research and Development, Pfizer Inc., Pearl River, New York.

Donna Giordano-Schmidt (D)

Vaccine Research and Development, Pfizer Inc., Pearl River, New York.

Kathrin U Jansen (KU)

Vaccine Research and Development, Pfizer Inc., Pearl River, New York.

William Gruber (W)

Vaccine Research and Development, Pfizer Inc., Pearl River, New York.

Annaliesa S Anderson (AS)

Vaccine Research and Development, Pfizer Inc., Pearl River, New York.

Ingrid L Scully (IL)

Vaccine Research and Development, Pfizer Inc., Pearl River, New York.

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