Infect Chemother.  2015 Dec;47(4):225-230. 10.3947/ic.2015.47.4.225.

Antibiotic Susceptibility Evaluation of Group A Streptococcus Isolated from Children with Pharyngitis: A Study from Iran

• Sayyahfar
• Fahimzad A
• Naddaf A
• Tavassoli

• KMID: 2170499
• DOI: http://doi.org/10.3947/ic.2015.47.4.225

Abstract

BACKGROUND
The aim of this study was to evaluate the antibiotic susceptibility of Group A streptococcus (GAS) to antibiotics usually used in Iran for treatment of GAS pharyngitis in children.
MATERIALS AND METHODS
From 2011 to 2013, children 3-15 years of age with acute tonsillopharyngitis who attended Mofid Children's Hospital clinics and emergency ward and did not meet the exclusion criteria were enrolled in a prospective study in a sequential manner. The isolates strains from throat culture were identified as GAS by colony morphology, gram staining, beta hemolysis on blood agar, sensitivity to bacitracin, a positive pyrrolidonyl aminopeptidase (PYR) test result, and the presence of Lancefield A antigen determined by agglutination test. Antimicrobial susceptibility was identified by both disk diffusion and broth dilution methods.
RESULTS
From 200 children enrolled in this study, 59 (30%) cases were culture positive for GAS. All isolates were sensitive to penicillin G. The prevalence of erythromycin, azithromycin, and clarithromycin resistance by broth dilution method was 33.9%, 57.6%, and 33.9%, respectively. Surprisingly, 8.4% of GAS strains were resistant to rifampin. In this study, 13.5% and 32.2% of the strains were resistant to clindamycin and ofloxacin, respectively.
CONCLUSION
The high rate of resistance of GAS to some antibiotics in this study should warn physicians, especially in Iran, to use antibiotics restrictedly and logically to prevent the rising of resistance rates in future. It also seems that continuous local surveillance is necessary to achieve the best therapeutic option for GAS treatment.

Keyword

Antibiotic resistance; Group A streptococci; Pharyngitis; Streptococcus pyogenes; Tonsillitis

MeSH Terms

Agar
Agglutination Tests
Anti-Bacterial Agents
Azithromycin
Bacitracin
Child*
Clarithromycin
Clindamycin
Diffusion
Drug Resistance, Microbial
Emergency Service, Hospital
Erythromycin
Hemolysis
Humans
Iran*
Logic
Ofloxacin
Penicillin G
Pharyngitis*
Pharynx
Prevalence
Prospective Studies
Rifampin
Streptococcus pyogenes
Streptococcus*
Tonsillitis
Agar
Anti-Bacterial Agents
Azithromycin
Bacitracin
Clarithromycin
Clindamycin
Erythromycin
Ofloxacin
Penicillin G
Rifampin

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