Group A Beta Hemolytic Streptococcus Infections in Children; Change According to Age and Years

Çocuklarda A Grubu Beta Hemolitik Streptokok Enfeksiyonları; Yıllara ve Yaş Gruplarına Göre Değişimi

Abstract

Objective: Group A streptococcus (GAS) is the most common bacterial reason of tonsillopharyngitis cultured rarely in children under three years old and above 15 years old of age. We aimed to determine the changing pattern in Streptococcus pyogenes isolates according to cultured site, years, age of the patient, and invasive disease between 2010 and 2019. Material and Methods: Children with cultured Streptococcus pyogenes isolates in Keciören Research and Training Hospital between January 2009 and July 2019 were included. Primary symptoms, sociodemographic characteristics, site of culturing, year and month of culturing were recorded. Results: Totally, 3899 patients with a mean age of 83 ± 34.5 months, inluding1880 (48.2%) females and 2019 (51.8%) males, were included in the study. Streptococcus pyogenes were cultured from throat culture in 3703 (90%) patients, wound culture in 66 (1.7%) patients, otorrhea/middle ear aspiration fluid in 30 (0.8%) patients, blood culture in 12 (0.3%) patients, sputum culture in three (0.1%) patients. Sixty-six (1.7%) patients were hospitalised, 3748 (98.3%) patients were outpatients. In patients with invasive S. pyogenes infections, 66 (61.1%) samples were isolated from wound culture, 30 (27.8%) from middle ear aspiration culture, 12 (11.1%) from blood culture. Invasive S. pyogenes infection was present in 53 (49.1%) of children under three years old of age, nine (8.3%) of children between the ages of 3-5 years of age, 46 (42.6%) of children over five years old of age. Incidence of invasive S. pyogenes infections was found to increase during years (p< 0.001).Objective: Group A streptococcus (GAS) is the most common bacterial reason of tonsillopharyngitis cultured rarely in children under three years old and above 15 years old of age. We aimed to determine the changing pattern in Streptococcus pyogenes isolates according to cultured site, years, age of the patient, and invasive disease between 2010 and 2019. Material and Methods: Children with cultured Streptococcus pyogenes isolates in Keciören Research and Training Hospital between January 2009 and July 2019 were included. Primary symptoms, sociodemographic characteristics, site of culturing, year and month of culturing were recorded. Results: Totally, 3899 patients with a mean age of 83 ± 34.5 months, inluding1880 (48.2%) females and 2019 (51.8%) males, were included in the study. Streptococcus pyogenes were cultured from throat culture in 3703 (90%) patients, wound culture in 66 (1.7%) patients, otorrhea/middle ear aspiration fluid in 30 (0.8%) patients, blood culture in 12 (0.3%) patients, sputum culture in three (0.1%) patients. Sixty-six (1.7%) patients were hospitalised, 3748 (98.3%) patients were outpatients. In patients with invasive S. pyogenes infections, 66 (61.1%) samples were isolated from wound culture, 30 (27.8%) from middle ear aspiration culture, 12 (11.1%) from blood culture. Invasive S. pyogenes infection was present in 53 (49.1%) of children under three years old of age, nine (8.3%) of children between the ages of 3-5 years of age, 46 (42.6%) of children over five years old of age. Incidence of invasive S. pyogenes infections was found to increase during years (p< 0.001).

Özet

(S. pyogenes) tonsillofarenjitin en yaygın bakteriyel etkenidir. Üç yaşından küçük ve 15 yaşından büyüklerde daha az rastlanır. Bu çalışmada 2010- 2019 yılları arasında üreyen S. pyogenes izolatlarının retrospektif olarak incelenmesi, üreme yerleri, üreme yıllarının yaş grupları ve mevsimlere göre değişiminin araştırılması planlanmıştır. Gereç ve Yöntemler: Çalışmaya Keçiören Eğitim ve Araştırma Hastanesi’ne başvuran Ocak 2009-Temmuz 2019 tarihleri arasında alınan kültürlerde grup A beta hemolitik streptokok üremesi olan hastalar dahil edilmiştir. Hastaların primer başvuru şikayetleri, üreme yerleri, üreme zamanı yaş grubu, cinsiyet gibi sosyodemografik özellikleri kaydedilmiştir. Bulgular: Çalışmaya ortalama yaşı 83 ay ± 34.5 ay olan, 1880 (%48.2)’i kız, 2019 (%51.8)‘u erkek toplam 3899 hasta dahil edilmiştir. Altmış altı (%1.7) üreme yatan hastalardan, 3748 (%98.3) üreme ayaktan başvuran hastalardan izole edilmiştir. Çalışmaya en sık boğaz kültüründen (%90) olmak üzere, yara yeri kültürü (%1.7), kulak akıntısından/aspirasyon sıvısından (%0.8), kan kültüründen (%0.3), balgam kültüründen (%0.1) olmak üzere Streptococcus pyogenes üremesi ve semptomu olan toplam 3899 hasta dahil edilmiştir. İnvaziv S. pyogenes enfeksiyonu saptanan hastaların 66 (%61.1)’sında etken yara yeri kültüründen, 30 (%27.8) ‘unda kulak aspirasyon sıvısından, 12 (%11.1)’sinde kan kültüründen izole edilmiştir. İnvaziv S. pyogenes enfeksiyonu saptanan 108 hastanın 53 (%49.1)’ü üç yaş altında, 9 (%8.3)‘u 3-5 yaş aralığında, 46 (%42.6)’sı beş yaş üstü çocuk hastalarda saptanmıştır . Yıllara göre invaziv hastalık görülme sıklığının istatistiksel anlamlı olarak arttığı saptanmıştır (p< 0.001).