Beta-hemolytic Streptococci Group Research Articles

On the issue of the etiology of acute inflammatory pathology of the pharynx in children

To compare the microbiota of the oropharynx in healthy children and children with acute tonsillitis and pharyngitis. The study included two groups of patients (139 people) aged from 1 year to 17 years inclusive. The main group consisted of children with acute tonsillitis and acute pharyngitis (111 patients, average age 7±4 years), the control group consisted of 28 healthy children (average age 7±6 years) without signs of upper respiratory tract infection. All patients were examined and material was taken from the mucous membrane of the posterior pharyngeal wall and palatine tonsils, the samples obtained were subjected to bacteriological examination to isolate a pure culture and identify bacterial microorganisms and virological examination by polymerase chain reaction in order to isolate a number of typical respiratory viruses and herpes viruses. It was found that viral-bacterial associations predominate (66.7%) in patients with acute tonsillitis and pharyngitis (32% in healthy volunteers). The detection rates of typical respiratory viruses and herpes viruses in patients with acute tonsillitis and pharyngitis are comparable (44% and 40.5%, respectively). Streptococcus pyogenes (beta-hemolytic streptococcus group A, 6.3%), as well as Streptococcus pneumoniae, Moraxella catarrhalis, Klebsiella pneumoniae and Pseudomonas aeruginosa were detected only in patients with acute tonsillitis. Other microorganisms were isolated both in healthy patients and in children with acute tonsillitis and pharyngitis, but in the presence of inflammatory changes in the pharynx, the concentration of microorganisms was slightly higher than in a healthy state, which is especially significant for Staphylococcus aureus. In patients without signs of inflammation, typical respiratory viruses (rhinovirus, 14%) and herpes viruses (with a predominance of type 6 herpes virus - 28%) were also found in a percentage comparable to that of patients with acute tonsillitis and pharyngitis. The etiology of acute tonsillitis and pharyngitis in children is dominated by viral-bacterial associations, while rhinovirus (34%) and herpes virus type 6 (28%) are among the viruses. The detection rate of Streptococcus pyogenes in patients with acute tonsillitis was 6.3%. Typical respiratory viruses and herpes viruses can be found on the mucous membrane of the oropharynx and outside the phenomena of inflammation. This once again proves the importance of comparing the clinical manifestations observed in a patient and data on the structure of the microbiota of a particular locus, including to address the need for systemic or local antimicrobial therapy.

Associated Bacterial Coinfections in COVID-19-Positive Patients.

Background and Objectives: The aim of this study was to identify specific rhino- and oropharyngeal microbiological pathogens as well as associated comorbidities that favor SARS-CoV-2 infection and corelate them. Materials and Methods: This prospective clinical study enrolled 61 patients (28 COVID-19-positive and 33 controls) who were tested for other comorbidities and co-existence of associated oral pathogenic microbiota. Results: A total of 247 bacterial isolates were identified in the bacterial cultures in both groups. Viral hepatitis type A was more prevalent in the COVID-19-positive group (p = 0.026), as was the presence of oral candidiasis (p = 0.006). In the control group, a moderate direct relationship was observed between the Beta hemolytic streptococcus group G and dermatitis, and strong direct relationships were observed between the Beta hemolytic streptococcus group G and external otitis, Streptococcus pyogenes and dental alveolitis, and Streptococcus pyogenes and chronic lymphocytic leukemia. In the test group, strong direct relationships were observed between Hemophilus influenzae and pulmonary thromboembolism; Staphylococcus aureus and autoimmune thyroiditis; post-viral immunosuppression, chronic coronary syndrome, and hypernatremia; Beta hemolytic streptococcus group C and rheumatoid polyneuropathy; Beta hemolytic streptococcus group G and hyperkalemia, hypothyroidism, secondary anemia, and splenomegaly; and active oral candidiasis and SARS-CoV-2 viral pneumonia. The following relationships were strong, but inverse: Beta hemolytic streptococcus group G and acute respiratory failure, and active oral candidiasis and SARS-CoV-2 viral bronchopneumonia. Conclusions: Briefly, COVID-19-positive patients have the predisposition to build up associated comorbidities and coinfections, which can be the expression of the immune burden that this virus generates to the host.

ОСОБЕННОСТИ ТЕЧЕНИЯ ОСТРЫХ ОДОНТОГЕННЫХ ВОСПАЛИТЕЛЬНЫХ ПРОЦЕССОВ ЧЕЛЮСТЕЙ ВДЕТСКОМ ВОЗРАСТЕ

The goal.Studying the clinical course’s features of acute odontogenic inflammatory processes of the jaws in children, describing species composition of pathogens, determination sensitivity to antibiotics of various groups in acute odontogenic inflammatory processes of the jaws in childhood. Materials and methods.The case histories of 900 patients were analyzed, microbiological research methods were carried out (microscopic examination of clinical samples with Gram staining, culture method, determination of the sensitivity of theisolated pathogen to antimicrobial drugs).Results.The most common odontogenic inflammatory processes of the jaws were observed in children aged 4–5 years. In48,85 % of cases in a milk bite and in 67,92 % of cases in a permanent bite, the cause of the development of an odontogenic inflammatory process was complicated caries of the mandibular molars. 56% of children had a general condition. The leading causative agent of the inflammatory process of the jaws was in 65,6 % of cases hemolytic streptococcus. In other cases, Streptococcus Viridans(6,1 %), pneumococci (4,3 %), candida (3 %), Staphylococcus aureus(2,8 %), Moraxella cataralis(1,2 %), etc. were detected in the mixed microflora of purulent exudate. The drugs of choice for empirical antibiotic therapy for odontogenic inflammatory process caused by beta-hemolytic streptococcus group A are vancomycin (antibiotic sensitivity –99 %), fluoroquinolones (antibiotic sensitivity –98 %), beta-lactams (antibiotic sensitivity –91 %). The highest percentage of resistance of this microflora was noted to macrolides (41 %), and to clindamycin (33 %). The rapid spread of the purulent-inflammatory process in the maxillofacial region in acute odontogenic processes in children, the resistant microflora of the odontogenic purulent focus require a competent approach when providing emergency care.Conclusions.The obtained has great practical importance for the choice of rational antibiotic therapy.

CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME: A VICIOUS CIRCLE OF CLOTTING AND BLEEDING

CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME: A VICIOUS CIRCLE OF CLOTTING AND BLEEDING

Antibiotic resistance and modern strategy of antibacterial therapy

Antibiotic resistance is a serious health problem. The use of new dosage forms of antibiotics should comply with the strategy of rational use of antimicrobials, which includes a set of measures for hospitals and outpatient network aimed at preserving the effectiveness of existing antibiotics. The principles of the strategy for the use of antimicrobial/antibacterial drugs: the exclusion of unjustified prescribing of antibiotics, the priority of prescribing drugs based on the identification of the bacterial agent and its sensitivity to the antibiotic in comparison with empirical prescribing, taking into account data on regional antibiotic resistance, the application of the principle of minimum sufficiency in relation to the choice of the drug – its dose, the choice of route of administration, safety and duration of treatment. The article uses the example of healthcare systems in different countries to assess the effectiveness of the strategy of rational use of antimicrobials. The problem of unjustified use of antibiotics in the treatment of COVID-19 is discussed. New innovative forms of antibiotics are dispersible tablets. Amoxicillin EXPRESS and Amoxicillin + Clavulanic Acid EXPRESS are antibiotics with improved pharmacokinetic properties in the form of dispersible tablets that have proven their safety and effectiveness against many gram-positive and gram-negative microorganisms. The analysis of the effectiveness of therapy of diseases caused by beta-hemolytic streptococcus group A, with the use of two forms: Amoxicillin and Amoxicillin + Clavulanic acid. A clinical case of the use of Amoxicillin + Clavulanic acid EXPRESS in the form of dispersible tablets is presented, which confirms the effectiveness of this drug in the treatment of acute streptococcal tonsillitis.

Клініко-параклінічні маркери активності запального процесу при гострих тонзилофарингітах у дітей

Purpose — to study clinical and paraclinical markers of inflammatory activity in acute non-streptococcal and streptococcal tonsillopharyngitis in children to address rational treatment tactics. Materials and methods. To achieve this goal, a comprehensive examination of 102 children with acute tonsillopharyngitis, which was divided into two clinical groups depending on the isolation of beta-hemolytic streptococcus group A during a culture of smears from the mucosa of the tonsils/pharynx. The first (I) clinical group included 68 patients in whom bacteriological examination did not reveal BGSA — GTP of non-streptococcal etiology (nGTP). And 34 children in whom the streptococcal etiology of the disease was determined formed the second (II) clinical group — streptococcal acute tonsillopharyngitis (cGTP). Results. The presence of a subfebrile body temperature in the child increased its post-test probability by 27.4%, and higher fever figures reduced the probability of non-streptococcal GTP by only 4.3%. The absence of symptoms of intoxication syndrome in children with a high degree of specificity — 91.4% confirms the non-streptococcal nature of the disease. Expressive layers on the tonsils are more characteristic of streptococcal GTP, and the assessment of their severity <3 points was much more common in patients with non-streptococcal disease. When using the determination of the content of C-reactive protein <50.0 mg/l in the venous blood of children as a test, allows you to verify the non-streptococcal nature of acute tonsillopharyngitis with a fairly high sensitivity — 73.5% (95% CI 63.7–81.8), however, low specificity — 35.3% (95% CI 26.0–45.5). Conclusions. Indicators of local inflammation and clinical manifestations of the general inflammatory reaction were less pronounced in patients with non-streptococcal GTP. Indicators of C-reactive protein <50.0 mg/l in venous blood with high sensitivity (73.5%; 95% CI 63.7–81.8) and relative risk 1.2 (95% CI 1.0–1.5) probably testified in favor of the nonstreptococcal nature of acute tonsillopharyngitis. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: acute tonsillopharyngitis, children, clinic, C-reactive protein.

Çanakkale’de Tonsillofarenjitli Hastaların Boğaz Kültürlerinden İzole Edilen Beta Hemolitik Streptokokların Grup Dağılımlarının ve Antibiyotik Direnç Profillerinin Belirlenmesi§

Objective: Group A, C and G beta- hemolytic streptococci (BHS) are bacterial agents of tonsillopharyngitis, and cause various diseases and increase morbidity and mortality. In this study, we aimed to determine the percentage of group distribution and the rate of antibiotic resistance of BHS identified from the throat cultures of patients with acute tonsillopharyngitis. Method: The throat swabs were collected from 200 patients with tonsillopharyngitis aged 1-80 years between October 2017 and May 2018. Bacterial isolates were identified by conventional methods such as Gram staining, bacitracin-trimethoprim sulfamethoxazole, catalase, and L-pyrrolidonyl β-naphthylamide. Latex agglutination test was used for serogrouping BHS. The antibiotic susceptibility profiles of BHS were determined by Kirby Bauer disc diffusion method. Streptococcus pyogenes ATCC 19615 strain was used as a control. Inhibition zone diameters were evaluated according to the Clinical Laboratory Standards Institute (CLSI) criteria. Results: Thirty-four (17%) BHS were isolated from 200 throat swap specimens.Distribution percentages of BHS group were determined as 44.1% (15) for A, 29.4% (10) C, 23.5% (8) G and 2.9% (1) F. All isolates were 100 % susceptible to penicillin, vancomycin and levofloxacin. The highest resistance (29.4%) was found against ampicillin followed by clindamycin (26.5%), erythromycin (23.5%), amoxycillin-clavulanic acid and tetracycline (14.7%), cefotaxime and ceftriaxone (11.8%), clarithromycin (8.8%) and chloramphenicol (2.9%). Conclusion: This study revealed that Group C, and Group G Streptococci had lower resistance to some antibiotics than Group A Streptococci. Based on the findings, the BHS group distributions and antibiotic resistance profiles should be repeated at certain intervals and precautions should be taken with public health surveillance studies

Group C beta hemolytic Streptococci as a potential pathogen in patients presenting with an uncomplicated acute sore throat – a systematic literature review and meta-analysis

Objective: The pathogenicity of beta-hemolytic Streptococcus group C (GCS) in patients attending for an uncomplicated acute sore throat is unknown and it was the objective to clarify this.Design: Systematic literature review with meta-analysis. Setting Medline and Scopus were searched from inception to February 2019, with searches of reference lists, Subjects case-control studies stating prevalence of GCS in patients as well as healthy controls presented for children and adults separately. Studies including patients already treated with antibiotics and studies focused on patients with HIV, malignancy or immunosuppression were not included. Main outcome measures Pooled prevalence of GCS was compared between patients and controls using chi-square and was further explored by calculating the positive etiologic predictive value (P-EPV) showing the post-test probability of a link between a sore throat and the bacterial finding. P-EPV for GCS was compared with that for group A Streptococci (GAS) using figures from the same publications and patients.Results: Eleven studies were included. The prevalence of GCS among patients versus controls was similar in children (3.15 versus 2.87%, p = .44) but for adults higher in patients (11%) than in controls (5.6%) (p < .0001). The P-EPV for finding GCS in children with a sore throat was 9.3% (0.0–41%). The corresponding P-EPV for GCS in adults with a sore throat was 53% (36–67%) while the corresponding P-EPV for GAS in adults was 94% (90–96%).Conclusions: GCS do not seem associated with the uncomplicated acute sore throat in children but there is support for an association in adults being weaker than for GAS. A possible consequence is to ignore GCS in otherwise healthy patients at their first visit for an uncomplicated sore throat. This would enable a stronger focus on the use of modern point of care tests (POCTs) to detect GAS.Key pointsThere is no current consensus on the pathogenicity of group C beta-hemolytic Streptococcus (GCS) in patients attending for an uncomplicated acute sore throat.This systematic literature review concludes it is unlikely that GCS is involved in the uncomplicated sore throat in otherwise healthy children.This meta-analysis found a moderate link between GCS and the uncomplicated sore throat in adults.The link in adults between GCS and the sore throat is much weaker than the corresponding link for group A beta-hemolytic Streptococcus.

Virulence of beta-hemolytic streptococci in infective endocarditis.

Streptococci involved in infective endocarditis (IE) primarily comprise alpha- or non-hemolytic streptococci (ANHS). Moreover, beta-hemolytic streptococci (BHS) can be involved, and guidelines recommend the addition of gentamicin for the first 2weeks of treatment and the consideration of early surgery in such cases. This study compared the morbidity and mortality associated with IE depending on the microorganisms involved (BHS, ANHS, staphylococci, and enterococci). We conducted a retrospective observational study between 2012 and 2017 in a single hospital in France. The endpoints were overall in-hospital mortality, 1-year mortality and the occurrence of complications. We analyzed 316 episodes of definite IE including 150 (38%), 96 (25%), 46 (12%), and 24 cases (6%) of staphylococcal, ANHS, enterococcal, and BHS IE, respectively. In-hospital mortality was significantly higher in the staphylococcal (n = 40; 26.7%) and BHS groups (n = 6; 25.0%) than in the ANHS (n = 9; 9.4%) and enterococcal groups (n = 5; 10.9%) (all p < 0.01). The rates of septic shock and cerebral emboli were also higher in the BHS group than in the ANHS group [n = 7 (29.2%) vs. n = 3 (3.1%), p < 0.001; n = 7 (29.2%) vs. n = 12 (12.5%); p = 0.05, respectively]. This study confirmed that BHS IE has a more severe prognosis than ANHS IE. The virulence of BHS may be similar to that of staphylococci, justifying increased monitoring of these patients and more 'aggressive' treatments such as early surgery.

Frequency of Beta-Hemolytic Streptococci Group A, C and G in The Tonsillopharyngeal Flora of Individuals of Families with a Case of Rheumatic Fever and/or Rheumatic Heart Disease

AbstractBackground: Rheumatic fever is an inflammatory reaction that can develop as a complication of a Group A streptococcal infection. The role of Group C (GCS) and Group G (GGS) in disease burden is under recognized the present study is carried out to find the prevalence of GAS, GCS and GCS in throat of rheumatic families.Aim of Study: Isto explore the frequency of beta-hemolytic streptococci Group A, C and G in the tonsillopharyngeal flora of individuals of families with a case of rheumatic fever and/ or rheumatic heart disease.Patients and Methods: This study was carried out on 20 families of children with rheumatic fever and/or rheumatic heart disease chosen from children attending to Pediatric Clinic at Tanta University Hospital and El-Menshawe General Hospital in Gharbia governorate ten families have animals (cattle and/or birds) and ten families have not. Ten healthy families enrolled as controls five families have animals (cattle and/or birds) and five families have not.Results: In our study (20%) of children in rheumatic families (cases and siblings) less than 18 years and (15.63%) of children of controls in the same age group were GAS positive and GCS was present in (1.67%) and it is absent in children of controls. As regarding GGS (5%) of children in rheumatic families and (3.13%) of children of controls in the same age group were GGS positive.Conclusion: Our study concluded that Group A beta hemolytic streptococci is the most prevalent type of beta hemolytic streptococci compared to Group C and G strepto-cocci in throat of children with ARF/RHD as well as their siblings.

Frequent colonization of betahaemolytic streptococci at various body sites including the perineum and anal canal during erysipelas and cellulitis

Background: Erysipelas and cellulitis are usually caused by betahaemolytic streptococci but the aetiology is often difficult to verify in clinical practice.Methods: Patients with erysipelas or cellulitis were analysed for betahaemolytic streptococci in samples from multiple body sites, including the perineum and the anal canal, during the acute episode and at follow up. Healthy control persons were sampled from the same sites.Results: Betahaemolytic streptococci group A, C or G were identified in 23/28 (82%) patients, most commonly group G. A wound or ulcer, present in 16/28 (57%), was colonized in 8/16 (50%). The perineum and anal canal were colonized in 11/28 (39%) and 10/28 (36%), respectively. At follow-up after about 4 weeks, only 4/28 (14%) were colonized (p<.001). In 39 healthy control persons, no betahaemolytic streptococci group A were found, groups C or G were found in 4/39 (10%). Group B streptococci were more often identified in controls, than in patients,12/39 (31%).Conclusions: Acute episodes of erysipelas or cellulitis are associated with colonization of betahaemolytic streptococci at multiple sites including the perineum and anal canal, in particular serogroup G. This may be important for choice of primary antibiotic therapy and possibilities for prevention of relapses.

Acute tonsillitis in a pediatrician’s practice

Acute tonsillopharyngitis (ATP) is a common infectious disease in paediatric practice. Throat pain, as the main symptom of acute tonsillopharyngitis, is the most common cause of seeking outpatient care. ATP is a polyethyological disease and requires a clarification of the etiological factor. Viral tonsillitis is the most common in children’s practice. Among bacterial pathogens, the beta hemolytic streptococcus group A (BHSA Streptococcus pyogenes) is of particular importance. This pathogen is associated with 5 to 15% of cases of acute tonsillopharyngitis in adults and 20- 30% in children [5]. Suspicion of BHSA in ATP requires the mandatory prescription of systemic antibiotic therapy. Currently, there are no reliable criteria for differential diagnosis of viral and bacterial ATP. As a result, the choice of ATP treatment tactics is an important task. On the one hand, this pathology is most often associated with unnecessary and unjustified prescription of systemic antibiotic therapy, and on the other hand, the rejection of antibiotics can contribute to the development of serious complications. Given the high frequency of viral ATP, an important area of pediatric practice is the use of local antiseptic and anti-inflammatory drugs. Topical drugs can be used both as monotherapy and, if necessary, in combination therapy of ATP. Timely etiological diagnostics and rational therapy of ATP are an important part of the effectiveness of ATP treatment in children and prevention of antibiotic resistance of microorganisms.

Interaction between pathogens and acute glomerulonephritis in childhood: A case report and sonographic appearance

More than one trigger are known as responsible for acute glomerulonephritis in the pediatric age. The most common infective trigger is beta-hemolytic Streptococcus group A (GAS) but various infective agents, bacterial and viral, are capable of triggering the inflammatory process. We report a case of 5-year-old child who developed an acute glomerulonephritis related to a GAS and Mycoplasma pneumonia infection and Cytomegalovirus urine reactivation with ultrasound picture suggestive of important kidney involvement. The case support the hypothesis of a relationship between multiple infectious disease and immune-mediated and/or autoimmune mechanism whereas underling mechanism is still unclear and highlights the possible use of ultrasound as a tool to assess the severity of renal involvement.

GAMBARAN MIKROBIOLOGI ISPA (INFEKSI SALURAN PERNAPASAN ATAS) DI SEKELOMPOK JAMAAH HAJI SURABAYA TAHUN 2004

Upper respiratory tract infection usually has been presence on hajj pilgrims after they spent at the holy Mecca. They are known by long duration cough until they were come home. The pilgrims have been given health education how to live in Mecca and Medina before they go to Saudi Arabia and had meningitis vaccination as well. The purpose of this study is to know what the cause of the upper respiratory tract infection. If the pathogens have been found, before departure the infected pilgrims have been given antibiotics to prevent the pilgrimage ceremony to be disturbed.. Regarding the infection problems this study will be done, to give information whether the pathogenic that cause URI is from Indonesia or Saudi Arabia. About 118 people partially from Surabaya's pilgrims were divided into 1st and 2nd groups (53 and 65 persons). Each group have been examined their pharyngeal swab before the departure to Mecca and after arrival in Surabaya. The samples were kept in transport media, than sent to the Clinical Pathologic Laboratory at Dr Soetomo Hospital. The swab samples were isolated and identificated after the cultivation in the incubator at the laboratory. From the118 pilgrims, only 95 persons completed the laboratory examination before the departure to Mekah and after they arrived in Surabaya. It is found before departure 5 person (5%) contaminated by pathogenic microorganism, four from K. pneumoniae and one A betahemolytic Streptococcus group. After their arrival about 97% have normal flora, but two of them contaminated by Gamma Streptococcus regarding to these results it is concluded that URI may cause by the environment, difference of weather or viral infection origin Because in the town at Saudi Arabia the pilgrim lived together with other peoples which came from various countries of the world.

Nghiên cứu đặc điểm dịch tễ và di truyền của liên cầu khuẩn gây tan máu β lưu hành ở học sinh tiểu học một số vùng miền của Việt Nam

Beta hemolytic streptococci group A, C and G are bacteria that cause pharyngitis, lymphadenitis, pyoderma, erysipelas, toxic shock syndrome, etc which are commonly appeared in children of different ages. In order to study the epidemiological and genetical characteristics of β hemolytic steptococci in primary school pupils in some areas of Vietnam, a total of 1450 primary school pupils including 734 males (50.62%) and 716 females (49.38%) representing for six provinces of Vietnam was investigated. The results showed that the beta hemolytic streptococci infection rate in primary school pupils was 9.38%, in which group A, group C, and group G were 3.45%, 0.55%, and 5.38%, respectively. The highest and lowest rate of streptococcal infection rate was in Quang Tri (25.5%) and Tay Ninh (4.67%) respectively. Chronic pharyngitis and tonsillitis contributed to the increment of streptococcal infection. The 11 emm types of S. pyogenes strains were identified and it hypothesized that the different existence were caused by the diversity of genotypes in various geographical regions. Genetical diversity of S. anginosus strains has been detected based on toxic genes.

EPIGLOTTIS MICROFLORA OF ADULT PATIENTS WITH ACUTE EPIGLOTTITIS

Introduction. Nowadays acute infectious-inflammatory processes of upper respiratory tract, including acute epiglottitis retain a high proportion among human pathology. In the literature acute epiglottitis is allocated into an independent nosology as severe acute phlegmonous bacterial inflammation of the epiglottis and hypopharynx. There are currently no clear guidelines on how to classify an acute epiglottitis, as well as protocols for patients at various stages of the pathological process. According to common belief, Haemophilus influenzae type -B (Haemophilus influenza type b (Hib)) is the most common cause of epiglottitis. At present, the main etiological role in the genesis of acute epiglottitis in children belongs to haemophilus influenzae. In adults the causes of the disease are beta hemolytic streptococci groups A, B, pneumococcus, Klebsiella, Pseudomonas, Staphylococcus aureus, herpes simplex virus (type 1) and parainfluenza, and others.The aim of this work is to study: the mucosal microflora of the epiglottis in adult patients with acute epiglottitis and to study sensitivity of certain isolates to antimicrobial agents. Material & methods. 86 adult patients with acute epiglottitis were observed: 36 with abscess form of epiglottitis and 50 - with infiltrative. Microbiological analysis of mucosal swab samples taken from hypopharynx were conducted by the conventional technology: for seeding solid or liquid nutrient medium, followed by allocation of isolith and its microscopic, biochemical and serological identification. Microorganisms were classified according to schemes of Bergy. Antimicrobial susceptibility of each strain was determined in accordance with the guidelines. We used discs with antibacterial drugs. The availability of sensitive and resistant strains of microorganisms to antibiotics was assessed. A mucous membrane of the epiglottis was analyzed through microbiological investigation in 86 patients with acute epiglottitis. As a result, 169 strains of microorganisms were sowed from mucous membrane of epiglottis. Results & discussion. In patients with acute epiglottitis Streptococcus progenies dominated in 33 (23.7%) of cases, H. influenza was detected in 27 cases (19.4%), Streptococcus pneumonia strain was in 21 (12.4%) of cases, 4th place -. Staphylococcus aureus -9.3%. There are different types of: staphylococci strains -29, of Enterococcus spp - 11, gram-negative bacilli -41. Noteworthy fact is the high degree of microbial contamination of patients 107-109 CFU. Conclusion. Acute epiglottitis highest sensitivity was observed to the following medications as cephalosporin, namely cefotaxime while it is variable within the same group (1,2,3 cephalosporin’s generation). The isolated strains showed almost 99,4±1,2% sensitivity to fluoroquinolones, especially to levofloxacin and others (S. aureus, S. pyogenes, S. pneumoniae, H. Influenzae). There was a high sensitivity to lincosamides - clindamycin; fluoroquinolones- levofloxacin. In 50% of cases, a resistance to the antibiotic penicillin; and macrolide antibiotic, especially the last generations was observed. According to the obtained findings on the sensitivity of microflora to antibiotics cephalosporin’s II- III generation with moderate and severe degrees of severity in combination with fluoroquinolones (all administered parenterally) are used in acute epiglottitis. Use of fluoroquinolones (levofloxacin, ciprofloxacin, and others) is recommended in case of Cephalosporin intolerance, as well as lincosamides (clindamycin, dalatsin, lincomycin)

COINFECŢIA AMIGDALIANĂ VIRALĂ ŞI BACTERIANĂ. PREZENTARE DE CAZ

Acute tonsillitis is an infection of the tonsils caused by one or more types of bacteria or viruses. We describe a case of acute tonsillitis, in a 8 year-old girl, with beta-hemolytic streptococcus group A, in pharyngeal exudate and staphylococcal methicillin-sensitive nasal swab, together with Epstein-Barr virus’ IgM antibodies. The incidence of infectious mononucleosis concomitant with angina group A beta-hemolytic streptococcal (GABHS) and methicillin sensitive Staphylococcus aureus is much lower, but not exceptional, representing complications of infectious mononucleosis. Amazing is the association of these bacteria in the infectious mononucleosis. Therefore, we face with a possible initial viral infection with secondary bacterial superinfection. In cases like this, a joint venture of the two bacterial infections, antibiotic treatment is recommended in order to prevent complications, especially those that can occur after an untreated strep infection.

Conceptul de infecţie de focar amigdalian

Tonsillar outbreak infection is an non-discharging inflammatory disease of the connective tissue, with multiple organ manifestations, with a self-timing nature, being chronologically and etiopathogenically linked to the infection with beta-hemolytic streptococcus group A. An important role for the emergence and persistence of the outbreak infection is assigned to the poor local immunity, which is translated, among others, by low levels of serum and secretory IgA in upper respiratory mucosa. Tonsil immune pathology is at the origin of various diseases, mainly cardiac and renal. We present some data regarding the concept of tonsillar infection, hoping to help the physicians in making better decisions for the amigdalectomy indication.

BIR TIP FAKÜLTESİ HASTANESİNDE GIDA ÇALIŞANLARININ PERİYODİK SAĞLIK TARAMALARININ DEĞERLENDİRİLMESİ

Objective: Food-borne diseases are a public health issue. They can be prevented by improving sanitation conditions and screening refectory staff periodically for carriage of potentially infectious organisms. This screening may include nose, throat and stool cultures. The objective of this study is to evaluate the analyses of nose, throat and stool cultures of the refectory staff in Istanbul University, Istanbul Medical Faculty. Method: This is a cross-sectional descriptive study. This study period was February 2013 through May 2013, and was carried out at the Istanbul Medical Faculty Public Health Workplace Safety Clinic. All refectory and canteen staff were included. The refectory staff was examined at the appointment time and nose, throat, and stool examinations were carried out in order to find out carriers. Qualitative data were evaluated by mean and standard deviation. Quantitative data were evaluated by frequency and percent rate. Findings: The responsibilities of the staff in the refectory were as follows: 35 (32.4%) worked in the production department, 58 (53.7%) in distribution, 10 (9.3%) were support staff and 5 (4.6%) were management. According to the nose culture results, Metisilin sensitive Staphylococcus aureus was detected in 13 people (12%), and Metisilin resistant S.aureus was detected in 4 people (3.7%). Ten of the 17 people were working in distribution. According to the throat culture results, beta-hemolytic streptococcus group A was detected in 1 person (1%). According to the stool culture and direct parasite examination (in stool) results, Salmonella Enteridis was detected in 1 person (1%), Blastocyctis Hominis was detected in 3 people (2.8%) who were working in distribution. Results: Intestinal parasites were detected in 4 members of staff (3.7%). To prevent communicable diseases, rest, treatment and education was given to the affected staff

Рациональная антибиотикотерапия БГСА-инфекции как фактор профилактики первичной и вторичной острой ревматической лихорадки

В статье рассматривается вопрос выбора антибиотика для лечения инфекций, вызванных бета-гемолитическим стрептококком группы А (БГСА). Приведены режимы антибиотикотерапии при различных вариантах — носительстве БГСА, БГСА-фарингите у пациентов без аллергии и с ней на пенициллин, при острой ревматической лихорадке.