Abstract
SummaryThirty percent of acute pharyngotonsillitis is caused by Streptococcus pyogenes, which increased the risk of glomerulonephritis and rheumatic fever. Children attending daycare centers have a higher incidence of these infections.Aimto identify and compare the prevalence of Streptococcus pyogenes in the oropharynx of children who are enrolled and who are not enrolled in daycare centers in different regions of Brazil.Materials and MethodsA prospective study of two hundred children from Sao Paulo/SP and Porto Velho/RO. Children from each city were divided into two groups: those attending, and those not attending daycare centers. Swabs of the oropharynx were taken for bacteriological culture and identification.ResultsThe prevalence of Streptococcus pyogenes in the São Paulo groups were 8% and 2% for daycare and control groups, which was statistically significant (p=0.02). The prevalence in children from Porto Velho/RO was 24% and 16% for daycare and control groups, which was statistically significant (p=0.015). Statistical analysis also showed a significant difference between the corresponding groups in the two locations (p<0.01).ConclusionThese results show that daycare attendance is a risk factor for oropharyngeal streptococcal colonization; this was seen in different populations, but was statistically significance in only one of the two samples.
Highlights
Acute tonsillitis is extremely frequent in the pediatric population, and palatine tonsils show bacterial colonization by polymicrobial flora, including anaerobius and aerobius (e.g. S. mutans and S. pyogenes, Staphylococcus aureus, Moraxella catarrhalis, Haemophilus influenzae, Prevotella sp, Bacteróides fragilis and Fusobacterium sp1,2,3) the main concern among children’s healthcare professionals still is Streptococcus pyogenes - a Lancefield Group A beta- hemolytic microorganism (SBHGA)
About 30% to 40% of acute pharyngotonsillitis are of streptococci etiology[4,5,6], and the importance of this fact is due to the possibility of late non-suppurative complications caused by this pathogenic agent, such as for example, acute diffuse glomerulonephritis and rheumatic fever, which represents 90% of surgery indications for heart valve replacement in children in Brasil.[7]
Streptococcus pyogenes was present in 8% of cultures in children from the nursery school group and in 2% in the control group in the city of São Paulo, showing a significant statistical difference between both groups (p=0.02)
Summary
Acute tonsillitis is extremely frequent in the pediatric population, and palatine tonsils show bacterial colonization by polymicrobial flora, including anaerobius and aerobius (e.g. S. mutans and S. pyogenes, Staphylococcus aureus, Moraxella catarrhalis, Haemophilus influenzae, Prevotella sp, Bacteróides fragilis and Fusobacterium sp1,2,3) the main concern among children’s healthcare professionals still is Streptococcus pyogenes - a Lancefield Group A beta- hemolytic microorganism (SBHGA). Specially on the pediatric population, acute tonsillitis represents a large source of social inconveniences, such as missing days of school, the need to use antimicrobial drugs repeatedly, and the potential risk of suppurative complications.[8]. Most studies have focused in searching alterations in the oropharynx flora of children with persistent tonsillitis. Most of these studies have shown a higher prevalence of organisms producing beta-lactamase and a higher variety of organisms in this population. Streptococcus pyogenes prevalence has been higher among these children, when compared to that in children who do not present persistent tonsillitis. A statistical difference was not found in the studies analyzed. 1,2,9-13
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