无症状儿童a组链球菌化学溶血性β的患病率

A. Silva, D. Silva, J. I. Santos, G. Le, R. D. Sousa, Ruan Carlos Gomes da Silva, Josefa Elaine Silva Germinio, S. R. Oliveira
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引用次数: 0

摘要

上呼吸道感染是临床实践中最常见的就诊原因之一,主要是儿科人群。1根据Morais等人进行的一项研究。2在日托中心或与其他人共享的环境中,儿童因β-溶血性链球菌引起的呼吸道感染的发生率可能高出18倍以上随身物品然而,在过度拥挤的条件下,所有年龄段的人都容易受到这种微生物的传播,因为这些细菌的人际传播是通过雾化微滴和/或直接接触发生的,主要是在人群聚集的环境中。在影响上呼吸道的疾病中,急性咽炎(AP)是儿童最常见的疾病之一。尽管大多数AP来源于病毒,但a组β-溶血性链球菌(EBHGA)是一种重要的细菌病原体,在约15-30%的急性咽炎中被诊断。3 EBHGA或化脓性链球菌是一种革兰氏阳性需氧菌,可引起多种感染综合征4,由于其高致病性而被认为具有极大的临床意义,通常涉及或咽部和皮肤,因此这些细菌可能导致几种炎症性疾病。这种病原体的主要实验室特征之一是能够在5%的羊血培养基中完全粉碎红细胞,导致培养基透明,这被称为β溶血性。5与B、C和G组相比,化脓性链球菌很重要,不仅因为它是链球菌性咽炎的主要病因,6还因为它会引起化脓性并发症,如宫颈腺炎、扁桃体周围脓肿、咽后脓肿或宫颈脓肿。7此外,EBHGA与其他疾病有关,如链球菌中毒性休克综合征、坏死性筋膜炎,猩红热和皮肤感染。8根据Areas等人的说法。9其主要并发症是急性风湿热、风湿性心脏病和急性链球菌病,发病率更高,尤其是在发展中国家。因此,对这种情况的早期诊断,然后进行充分的抗菌治疗,不仅对预防风湿热(RF)和其他病理,而且对减少EBHGA在患者中的传播都极为重要。3生活在日托中心和学校等受限环境中,会极大地影响这些细菌的传播,将儿童和青少年的健康置于危险之中,10考虑到儿童和青少年或咽部对EBHGA感染非常敏感,尤其是在5岁和15岁之间。11此外,他们可以携带病原微生物而不会出现症状,这是无症状携带者的特征。这种病原体的流行病学特征表明,由于其可能引起的并发症的存在及其传播的容易性,其诊断具有相关性。2因此,准确的病因诊断有助于避免滥用抗生素及其导致细菌耐药性增加的后果。12本研究旨在确定公立学校无症状儿童的a组β-溶血性链球菌的患病率,以及这些细菌对测试的主要抗生素的敏感性和耐药性。
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Prevalence of streptocochemical hemolytic beta from group a in asympletic children
Upper airway infections are one of the most common causes of medical appointment in clinical practice mainly faced by pediatric population.1 According to a study conducted by Morais et al.2 the incidence of respiratory tract infections due to β-hemolytic streptococcus can be more than 18times higher in children attending some day care center or environments where they are close to others sharing belongings. However, individuals of all ages are susceptible to propagation of this microorganism under conditions of overcrowding, because the interpersonal dissemination of these bacteria occurs through aerosolized microdroplets and/or by direct contact, mainly in environments where there are clusters of people. Among the diseases that affect the upper airways, acute pharyngitis (AP) is one of the most frequent in children. Although most of the AP is of viral origin, Group a Streptococcus Beta-hemolytic (EBHGA) presents as a significant bacterial etiological agent diagnosed in about 15-30% of acute pharyngitis.3 EBHGA or Streptococcus pyogenic is grampositive aerobic bacteria that causes a variety of infectious syndromes4 and is considered of great clinical interest due to its high pathogen city, usually involving or pharynx and skin, as a consequence these bacteria may cause several inflammatory diseases. One of the main laboratorial characteristics this pathogen presents to be identified and classified is the ability to shatter completely red blood cells in 5% sheep blood culture, causing a transparency in the culture medium, which is called Beta-hemolytic.5 Streptococcus pyogenic is important when compared to groups B, C and G, not only because it is the main etiological agent of streptococcal pharyngitis,6 but also because it causes suppurate complications such as, cervical adenitis, peritonsillar abscess, retropharyngeal or cervical abscess.7 In addition, EBHGA is related to other diseases such as streptococcal toxic shock syndrome, necrotizing fasciitis, scarlet fever and skin infections.8 According to Areas et al.9 its main complications are acute rheumatic fever, rheumatic heart disease and acute streptococcal disease, with a higher incidence especially in developing countries. Therefore, the early diagnosis of this condition, followed by adequate antimicrobial treatment, is extremely important not just for the prevention of rheumatic fever (RF) and other pathologies, but also for the reduction of EBHGA transmission among patients.3 Living in restricted settings, such as day care centers and schools, can greatly influence the dissemination of these bacteria, placing the health of children and adolescents at risk,10 considering that children and teenagers or pharynx is very sensitive to EBHGA infections, especially among 5 And 15years of age.11 Besides that, they can carry pathogenic microorganisms without presenting symptoms, characterizing the asymptomatic carriers. The epidemiological profile of this pathogen shows the relevance of it’s diagnosed due to the existence of complications it may cause and their ease of transmission.2 Therefore, a precise etiological diagnosis contributes to avoid the abusive use of antibiotics and its consequences as the increase of bacterial resistance.12 This study aimed to determine the prevalence of Group A β-hemolytic streptococcus in or pharynx of asymptomatic children who attend a public school and also the sensitivity and resistance profile of these bacteria to main antibiotics tested.
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