Key words: group A, /3-hemolytic streptococci, serotype, pyrogenic exotoxin, antibiotic resistance

Transcription

1 Key words: group A, /3-hemolytic streptococci, serotype, pyrogenic exotoxin, antibiotic resistance

2 Table 1 Age of patients and group A streptococcal infections Table 2 Relationship between M-and T-type of group A streptococci a2166; provisional type Matsuyama 2166 UT; untypable

3 Table 3 Serotype of group A streptococcal isolates and year Table 4 Group A streptococcal infection and M-type of isolates

4 Table 5 Relapse and recurrence of streptococcal infection Ph; pharyngitis, SF ; scarlet fever Table 6 Characteristics of isolates from patients suffered twice from scarlet fever Upper; first episode, lower; second episode. Table 7 Susceptibility of group A streptococci to antibiotics MIC; minimal inhibitory concentration.

5 Table 8 Relationship between antibiotic resistance pattern and M-type Table 9 Resistant group A streptococci and year

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7 10) Sahm, D. F. & Washington, J. A. II: Antibacterial susceptibility tests; dilution methods. In Manual of Clinical Microbiology. 5th Ed.,(Balows A., Hausler, W. J. Jr., Herrmann, K.L., Isenberg, H. D. & Shadomy, H. J., ed.), p Am. Soc. Microbiol. Washington, D. C., ) Seppala, H., Nissinen, A., Jarvinen, H., Huovinen, S., Henriksson, T., Herva, E., Holm, S. E., Jahkola, M., Katila, M-L., Klaukka, T., Kontiainen, S., Liimatainen, 0., Oinonen, S., Passi-Metsomaa, L. & Huovinen, P.: Resistance to erythromycin in group A streptococci. 1) Denny, F. W. Jr.: Group A streptococcal infections Curr. Probl. Pediatr. May/June: N. Engl. J. Med., 326: , , ) Rathore, M. H. & Jenkins, S. G.: Group A 2) Shulman, S. T.: Invasive group A streptococcal infections and streptococcal toxic shock beta-hemolytic Streptococcus; issue of resistance. Pediatr. Infect. Dis. J., 12: , syndrome. Pediatr. Infect. Dis. J., 12: S21-S24, ) Betriu, C., Sanchez, A., Gomez, M., Cruceyra, A. & Picazo, J. J.: Antibiotic susceptibility of group A streptococci; a 6-year follow-up study. Antimicrob. Agents Chemother., 37: , ) El-Daher, N. T., Hijazi, S. S., Rawashdeh, N. M., Al-Khalil, I.A.-H., Abu-Ektaish, F.M. & Abdel- Latif, D.I.: Immediate vs. delayed treatment of group A beta-hemolytic streptococcal pharyngitis with penicillin V. Pediatr. Infect. Dis. J., 10: , ) Gerber, M. A., Randolph, M. F., DeMeo, K. K. & Kaplan, E. L.: Lack of impact of early antibiotic therapy for streptococcal pharyngitis on recurrence rates. J. Pediatr., 117: , ) Fischetti, V. A., Hodges, W. M. & Hruby, D. E.: Protection against streptococcal pharyngeal colonization with a vaccinia: M protein recombinant. Science, 244: , 1989.

8 Serotype and Antibiotic Susceptibility of Isolates from Children with Group A Streptococcal Infection; Observation for 10 Years Kozo FUJITA1), Michito YOSHIKAWA1, Koichi MURONO", Teiko MURAI2), Masamichi KISHISHITA3), Shinji YAMASAKI4) & Yoshifumi TAKEDA4) Department of Pediatrics, Asahikawa Medical College 1) College of Health Professions, Toho University 2) College of Medical Technology, Kyoto 3) University 4) Department of Microbiology, Faculty of Medicine, Kyoto University Six hundred and seventy isolates from children with group A streptococcal infections from 1981 through 1990 were typed serologically and their antibiotic susceptibilities were determined. Productivity of streptococcal pyrogenic exotoxins was also investigated in some isolates. Four hundred and seventy-nine strains were isolated from patients with pharyngitis, 133 from those with scarlet fever, 35 from those with suppurative infection and 23 from those with nonsuppurative disease. With immediate treatment (antibiotics were started at the same day throat swabs were taken) for 10 days, 5.3% of the patients with pharyngitis including scarlet fever had relapses and 13.4% of those patients had recurrences. Of the episodes of recurrences 15.7% were due to the same M serotype strains. Six patients had two episodes of scarlet fever. M type of isolate was different in the first and the second episode of each patient. Pyrogenic exotoxin type was unprecedented in the second episode of 4 out of 6 patients. M-typable and T-typable rates of isolates were 90.7% and 97.3%, respectively. Coincidence between M and T types was 73.3% (83.0% if including strains with the same and mixed T-type). Prevalent M-serotypes were 12 and 4, but Ml, 3, or 28 was the most prevalent type of isolates in certain years. None of the 670 strains was resistant to penicillin G and cephalexin. Resistant rate of isolates to erythromycin and linecomycin was 26.5% in 1981 and 18.4% in But a marked decrease has noted since 1983 and only one has been resistant since Nineteen of the 21 erythromycin resistant strains were M-type 12 and the others were type 4 and 28. Chloramphenicol resistance was similar to erythromycin and lincomycin, and tetracycline resistance rate decreased gradually from 61.7% to less than 20% year by year.