Throat carriage rate, associated factors, and antimicrobial susceptibility pattern of group A Streptococcus among healthy school children in Jigjiga City, Eastern Ethiopia

Abstract

Background Group A Streptococcus has been recognized as an important human pathogen and it remains among the top ten causes of mortality from an infectious disease. Group A Streptococcus throat carriage plays an important role in the development of infection and transmission to contacts. In Ethiopia, there is little information about screening of children for group A Streptococcus carriage. Objective This study was aimed to assess the magnitude of throat carriage, associated factors, and antimicrobial susceptibility pattern of group A Streptococcus among healthy school children in Jigjiga city, Eastern Ethiopia from 12 April to 27 May 2021. Method A cross-sectional study was conducted enrolled by simple random sampling. Data on socio-demographic and related characteristics were gathered using pretested structured questionnaire. The throat sample was collected from 462 healthy school children and immediately transported to Jigjiga University Sultan Sheik Hassan referral hospital laboratory for investigation. Identification of group A Streptococcus was done by colony characterstics, gram staining, catalase negativity, bacitracin sensitivity, and Pyrrolidonyl arylamidase tests. Antibiotic susceptibility test was done on Muller-Hinton agar containing 5% sheep blood by modified Kirby-Bauer disc diffusion method. The data were coded, cleaned, and entered onto EpiData Version 3.1 then exported to SPSS version 26.0 for analysis. Bivariate and multivariable logistic regression through adjusted odds ratio (AOR) was used to determine the relationship between culture-positivity rates of GAS and predictor variables. A p-value < 0.05 was taken as statistically significant on multivariable analysis. Results The overall prevalence of group A Streptococcus throat culture rate was 10.6% (95%CI; 8.1%—13.7%). Previous family member who had a sore throat, children living with larger families (more than 11 members), and children living with non-immediate families were significantly associated with culture-positivity rates of GAS. Children who live with a family member with a sore throat compared with those who lived with in a family with no history of sore throat (AOR = 2.51; 95%CI 1.09–5.73), children who live with a large family comared to children living in families with less members (AOR = 4.64; 95% CI 1.53–14.1), and children who live with non-immediate families compared to children living with their mothers (AOR = 3.65; 95% CI 1.39 – 9.61), showed significant association with group A Streptococcus carriage rate. Resistance to all other antibiotics tested was low (< 5%). Multidrug resistance was found in 4.1% of isolates. Conclusion The present study showed 10.6% throat carriage of group A Streptococcus. Family member with a sore throat, having a large family, and living with non-immediate families have all been identified as independent predictors of carriage prevalence.

The Rate of Asymptomatic Throat Carriage of Streptococcus Pyogenes and Its Associated Risk Factors Among Medical Students of Queen Arwa University in Sana’a City, Yemen

“…The existing result recorded that the prevalence rate of S. pyogenes carriage was detected among medical students who lived in a single house (2.9%), less than 5 individuals lived per room (1.5%), and less than 5 children lived in a household (2.3%). It was found that children from families with more than eleven members had a four-fold greater chance of carrying GAS than children from families with fewer members [27].…”

Prevalence, Antibiotic Susceptibility Profile and Associated Factors of Group A Streptococcal pharyngitis Among Pediatric Patients with Acute Pharyngitis in Gondar, Northwest Ethiopia

“… 14 , 62 In our study, all the GAS isolates were susceptible to penicillin, which is also reported by several studies worldwide. 30 , 31 , 41 , 45 , 46 Hence, given its narrow spectrum, low cost, and efficacy in preventing strep throat complications such as RHD and PSGN, penicillin remains the drug of choice for treating GAS pharyngitis. 17 Our findings reveal that vancomycin 4.3% and ceftriaxone 13% have reduced susceptibility against GAS causing pharyngitis.…”

“…The isolates also showed 95.7% susceptibility to chloramphenicol, which is consistent with reports from other studies in Ethiopia. 30 , 71 The acquisition of chloramphenicol O-acetyltransferase (CAT) enzymes or the presence of active efflux mediated by specific transporters is highly associated with chloramphenicol resistance. Target modifications are also possible through point mutations or cfr (chloramphenicol–florfenicol-resistance)-mediated methylation in 23S rRNA (ribosomal ribonucleic acid).…”

“… 29 Furthermore, there are only a few reports on the epidemiology and clinical aspects of acute bacterial pharyngitis in susceptible populations in Ethiopia. 30 , 31 Therefore, determining the prevalence, antimicrobial susceptibility pattern (ASP), and associated factors of GAS among pediatric patients with acute pharyngitis is needed.…”

The Rate of Asymptomatic Throat Carriage of Streptococcus pyogenes and its Associated Risk Factors among Medical Students of Queen Arwa University in Sana’a City, Yemen

“…Also, a study by Barsenga et al [27] revealed a high rate of GAS among those who had a history of hospitalization (13.5%). Also, children who lived with a family member who had a sore throat were twice as likely to colonize group A Streptococcus (GAS) than children who did not have a primary case or sore throat in their household [27].…”