title: Group A streptococcus-associated upper respiratory tract infections in a day-care center.
abstract: Little information is available about the epidemiology of group A streptococcal upper respiratory tract infections in child day-care centers. During an initial 3-month period, symptomatic upper respiratory tract infections associated with throat cultures or rapid antigen detection tests positive for group A streptococci developed in 55 of 214 (26%) children and adult staff in one day-care center. When the entire day-care center population (except for those receiving antibiotics at the time) was then surveyed, 52 of 146 (36%) children and two of 24 (8%) adult staff had throat cultures positive for group A streptococci. Of the 54 group A streptococcal isolates found during the survey, the three most frequently encountered serotypes were M2,T2/28 (35%), M3,T3/13 (30%), and M-NT, T25 (20%). Rapid antigen detection was performed at the same time as the throat culture in the first 98 individuals examined during the culture survey but was positive in only 11 (35%) of 31 individuals with positive throat cultures. Sensitivity of the rapid antigen test was related to degree of positivity of the throat culture but not to age. The overall group A streptococcal positivity rate was 49% for 187 children and 33% for 27 adult staff; 18 of 66 (27%) children younger than 31/2 years of age were found to have group A streptococci in their upper respiratory tracts. This is the first report of high prevalence rates of group A streptococci associated with upper respiratory tract infections in a day-care center. The group A Streptococcus may represent a significant upper respiratory tract pathogen in the day-care setting.
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455.
authors.forename: T D
authors.initials: TD
authors.lastname: Smith
authors.forename: V
authors.initials: V
authors.lastname: Wilkinson
authors.forename: E L
authors.initials: EL
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial / Q000032:analysis; D001431:Bacteriological Techniques; D002353:Carrier State / Q000382:microbiology; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D004196:Disease Outbreaks; D006801:Humans; D007223:Infant; D010612:Pharyngitis / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D012703:Serotyping; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000276:immunology / Q000302:isolation & purification
chemical_list: D000942:Antigens, Bacterial