title: Higher rates of streptococcal colonization among children in the Pacific Rim Region correlates with higher rates of group A streptococcal disease and sequelae.
abstract: Group A streptococcal (GAS) pharyngeal colonization rates were determined among 1061 asymptomatic students in Hawaii and American Samoa where acute rheumatic fever rates are high. All GAS isolates were emm sequence typed. Although pharyngeal colonization rates were low in Hawaii (3.4%), Pacific Islander children had significantly higher colonization rates (5.7% vs. 1.2% in other ethnic groups, p <0.05). The colonization rate was higher in American Samoa (13%). Few emm types that were infrequently observed in symptomatic infections in Hawaii were repeatedly identified in both sites. These emm types were previously described among asymptomatic children suggesting a type-specific association with pharyngeal colonization.
authors.affiliation: Department of Pediatrics, University of Hawaii at Manoa, Honolulu, 96813, USA. guliz@hawaii.edu <guliz@hawaii.edu>
authors.forename: G
authors.initials: G
authors.lastname: Erdem
authors.forename: S
authors.initials: S
authors.lastname: Sinclair
authors.forename: J R
authors.initials: JR
authors.lastname: Marrone
authors.forename: T F
authors.initials: TF
authors.lastname: I'atala
authors.forename: A
authors.initials: A
authors.lastname: Tuua
authors.forename: B
authors.initials: B
authors.lastname: Tuua
authors.forename: F
authors.initials: F
authors.lastname: Tuumua
authors.forename: A
authors.initials: A
authors.lastname: Dodd
authors.forename: C
authors.initials: C
authors.lastname: Mizumoto
authors.forename: L
authors.initials: L
authors.lastname: Medina
mesh_terms: D000293:Adolescent; D018948:American Samoa / Q000453:epidemiology; D000942:Antigens, Bacterial / Q000235:genetics; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010614:Pharynx / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D002352:Carrier Proteins; C014689:streptococcal M protein
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