Prevalence, Antibiotic Susceptibility Profile and Associated Factors of Group A Streptococcal pharyngitis Among Pediatric Patients with Acute Pharyngitis in Gondar, Northwest Ethiopia

Molla Tadesse; Yohanes Hailu; Sirak Biset; Getachew Ferede; Baye Gelaw

doi:10.2147/IDR.S402292

Prevalence, Antibiotic Susceptibility Profile and Associated Factors of Group A Streptococcal pharyngitis Among Pediatric Patients with Acute Pharyngitis in Gondar, Northwest Ethiopia

Infect Drug Resist. 2023 Mar 22:16:1637-1648. doi: 10.2147/IDR.S402292. eCollection 2023.

Authors

Molla Tadesse¹, Yohanes Hailu², Sirak Biset³, Getachew Ferede³, Baye Gelaw³

Affiliations

¹ Department of Medical Microbiology, Jigjiga University, Jigjiga, Ethiopia.
² Department of Pediatrics and Child Health, School of Medicine, University of Gondar, Gondar, Ethiopia.
³ Department of Medical Microbiology, School of BioMedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia.

Abstract

Background: Streptococcus pyogenes (S. pyogenes) or group A streptococcus is a common cause of bacterial pharyngitis in children. Since it is difficult to distinguish between viral and bacterial pharyngitis using solely signs and symptoms, culture-based diagnosis and treatment are critical for avoiding serious complications. Therefore, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of S. pyogenes among pediatric patients with acute pharyngitis.

Methods: A hospital-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital from April to June 2021. Standard microbiological procedures were used to collect and process throat swabs and to isolate and identify S. pyogenes. The disc diffusion method was used for antimicrobial susceptibility testing (AST).

Results: A total of 215 children with acute pharyngitis were included in this study. Of these, 23 (10.7%) were culture positive for S. pyogenes. The presence of an inflamed tonsil, tonsillar exudate, scalariform rash, and dysphagia were associated with streptococcal pharyngitis. Children aged 5 to 15 were more susceptible to streptococcal throat infection than younger children. Penicillin, vancomycin, chloramphenicol, clindamycin, and ceftriaxone were effective against 100%, 95.7%, 95.7%, 91%, and 87% of isolates, respectively. In contrast, 56.5%, 39.1%, and 30.4% of isolates showed at least reduced susceptibility to tetracycline, erythromycin, and azithromycin, respectively.

Conclusion: Streptococcus pyogenes is responsible for 10.7% of acute pharyngitis cases among pediatric patients in the study area. Although all isolates remain sensitive to penicillin, many showed reduced susceptibility to tetracycline and macrolides. Therefore, prior to antibiotic prescription, screening children with acute pharyngitis for S. pyogenes and testing the antibiotic susceptibility of isolates is recommended.

Keywords: Ethiopia; S. pyogenes; antibiotic resistance; bacterial pharyngitis; group A streptococcus.