Advertisement

Group A Streptococcal Serotypes Isolated from Healthy Schoolchildren In Iran

  • M. R. FazeliEmail author
  • E. Ghaemi
  • A. Tabarraei
  • E. L. Kaplan
  • D. R. Johnson
  • M. A. Vakili
  • B. Khodabakhshi
Article

Abstract

Serotypes of group A streptococci are still a major cause of pharyngitis and some post-infectious sequelae such as rheumatic fever. As part of the worldwide effort to clarify the epidemiological pattern of group A streptococci in different countries, the present study was conducted to assess the prevalence of Streptococcus pyogenes serotypes in Iran. A total of 1588 throat swabs were taken from healthy school children in the city of Gorgan during February and March 1999. Of those isolates, 175 resulted positive for group A streptococci. The distribution pattern was similar for girls and boys, with 10.8% and 11.2%, respectively. Urban school children showed a higher rate of colonization compared to those in rural areas. Serotyping was performed on 65 of the positive isolates using standard techniques, and only 21 (32%) were M-type isolates. Their profiles fell into four types with M1 predominating, which could reflect the presence of rheumatic fever in the region. However, when isolates were challenged for T-antigen types, nearly all were positive (94%). The pattern of T types was diverse (18 types), with the most common T types being T1 (26%), TB3264 (15%), TB\1-19 & B\25\1-19 (9.2%) and T2 & 2\28 (7.7%). When isolates were tested for opacity factor, only 23 (35%) were positive while 34 (52%) responded to the serum opacity reaction test. Although the number of isolates in this study was not sufficient to make any epidemiological conclusions, the scarcity of serotyping studies in Iran could render these data useful for future attempts to develop a streptococcal vaccine.

Keywords

United Arab Emirate Rheumatic Fever Necrotizing Fasciitis Rural School Throat Swab 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

This work was supported by funding from the research department of the Gorgan University of Medical Sciences (GUMS). We would like to thank the World Health Organization Collaborating Center for Reference and Research on Streptococci, Minneapolis, USA, for serotyping the GAS strains. This project could not have been achieved without the assistance of the GUMS medical students.

References

  1. 1.
    Efstratiou A, Coorge RC (1995) Invasive group A streptococcal infections. J Public Health Med 17:110–115PubMedGoogle Scholar
  2. 2.
    Adachi J, Endo K, Fkuzumi T, Tanigawa N, Aoki T (1998) Increased incidence of streptococcal impetigo in atopic dermatitis. J Dermatol Sci 17:45–53CrossRefPubMedGoogle Scholar
  3. 3.
    Sandhyna N, Chung-Tai Y, Marin S (1996) Puerperal group A beta-hemolytic streptococcal toxic shock-like syndrome. Obstet Gynecol 88:728CrossRefPubMedGoogle Scholar
  4. 4.
    Wienert P, Heib J, Rinecker H, Sing A (1999) A human bite. Lancet 354:572CrossRefPubMedGoogle Scholar
  5. 5.
    Rheumatic fever and rheumatic heart disease (1988) Report of a WHO study group. WHO Technical Report Series No. 764. World Health Organization, GenevaGoogle Scholar
  6. 6.
    Ameen AS, Nsanze H, Dawson KP, Othman S, Mustafa N, Johnson DR, Kaplan EL (1997) Serotypes of group A streptococci isolated from healthy schoolchildren in the United Arab Emirates. Bull World Health Organ 75:355–359PubMedGoogle Scholar
  7. 7.
    Colman G, Tanna A, Efstratiou A, Gaworzewska ET (1993) The serotypes of Streptococcus pyogenes present in Britain during 1980–1990 and their association with disease. J Med Microbiol 39:165–178PubMedGoogle Scholar
  8. 8.
    Kaplan EL, Johnson DR, Nanthapisud P, Sirilertpanrana S, Chumdermpadetsuk S (1992) A comparison of group A streptococcal serotypes isolated from the upper respiratory tract in the USA and Thailand: implications. Bull World Health Organ 70: 433–437PubMedGoogle Scholar
  9. 9.
    Fraser CAM, Colman G (1985) Some provisional M-types among Streptococcus pyogenes (Lancfield group A). In: Kimura Y, Kotani S, Shiokava Y (eds) Recent advances in streptococci and streptococcal diseases. Reedbooks, Bracnell, pp 35–36Google Scholar
  10. 10.
    Johnson DR, Kaplan EL (1988) Microtechnique for serum opacity factor characterization of group A streptococci adaptable to use of human sera. J Clin Microbiol 26:2025–2030PubMedGoogle Scholar
  11. 11.
    Jamal F, Pit S, Johnson DR, Kaplan EL (1995) Characterization of group A streptococcal isolates in Kuala Lumpur, Malaysia. J Trop Med Hygiene 98:343–346Google Scholar
  12. 12.
    Majeed HA, Yousof AM, Rotta J, Havlickpva H, Bahar G, Bahbahani K (1992) Group A streptococcal strains in Kuwait: a nine year prospective and association. Pediatr Infect Dis J 11:295–300PubMedGoogle Scholar
  13. 13.
    Dale JB, Simmons M, Chiang EC, Chiang EY (1996) Recombinant, octavalent group A streptococcal M protein vaccine. Vaccine 14:944–948CrossRefPubMedGoogle Scholar
  14. 14.
    Dale JB (1999) Multivalent group A streptococcal vaccine designed to optimize the immunogenicity of six tandem M protein fragments. Vaccine 17:193–200CrossRefPubMedGoogle Scholar
  15. 15.
    Hu MC, Walls MA, Stroop SD, Reddish BB, Dale J (2002) Immunogenicity of a 26-valent group A streptococcal vaccine. Infect Immun 70:2171–2177CrossRefPubMedGoogle Scholar
  16. 16.
    Johnson DR, Kaplan EL, Sramek J, Bicova R, Havlicek J, Havlickova H, Motlova J, Kriz P (1996) Laboratory diagnosis of group A streptococcal infections. World Health Organization, GenevaGoogle Scholar
  17. 17.
    Kaufhold A, Podbielski A, Johnson DR, Kaplan EL, Lutticken R (1992) M protein gene typing of Streptococcus pyogenes by nonradioactively labeled oligonucleotide probes. J Clin Microbiol 30:2391–2397PubMedGoogle Scholar
  18. 18.
    Dawson KP, Ameen AS, Nsanzeh H, Bin Othman S, Mustafa N (1996) The prevalence of group A streptococcal throat carriage in Al Ain, United Arab Emirates. Ann Trop Paediatr 16:123–127PubMedGoogle Scholar
  19. 19.
    Kaplan EL, Wotton JT, Johnson DR (2001) Dynamic epidemiology of group A streptococcal serotypes associated with pharyngitis. Lancet 358:1334–1337CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • M. R. Fazeli
    • 1
    Email author
  • E. Ghaemi
    • 2
  • A. Tabarraei
    • 2
  • E. L. Kaplan
    • 3
  • D. R. Johnson
    • 3
  • M. A. Vakili
    • 4
  • B. Khodabakhshi
    • 5
  1. 1.Department of Pharmaceutical Biotechnology, Faculty of PharmacyTehran University of Medical SciencesTehranIran
  2. 2.Department of Microbiology, Faculty of MedicineGorgan University of Medical SciencesGorganIran
  3. 3.World Health Organization Collaborating Center for Reference and Research on StreptococciUniversity of MinnesotaMinnesotaUSA
  4. 4.Department of Public HealthFaculty of MedicineGorganIran
  5. 5.Department of Infectious Diseases, Faculty of MedicineGorgan University of Medical SciencesGorganIran

Personalised recommendations