Asymptomatic group A Streptococcal throat carriage in Royal Marines recruits and Young Officers.
A prospective observational study was conducted in Royal Marines (RM) recruits to investigate throat carriage of group A Streptococcus (GAS) and incidence of soft tissue infections.



1012 RM recruits were followed through a 32-week training programme, with throat swabs being obtained in weeks 1, 6, 15, and 32. Alongside a separate cohort of 46 RM Young Officers (YO) undergoing training were sampled in parallel.



Carriage of group A Streptococcus was detected in only 5/1012 (0.49%) recruits at the beginning of training and remained low throughout training. There was no association between GAS carriage and development of soft tissue infection. There was no carriage of GAS in the smaller YO cohort at the start of training, (0/46). At week 6, a surge in GAS carriage was detected in 8/46 (17%) YO, that could be ascribed to a cluster of GAS genotype emm83.



Asymptomatic GAS carriage is very infrequent among young adults in England and this should be borne in mind when considering the relevance of a positive throat swab result in symptomatic patients or outbreaks. Despite low prevalence, there is however potential for GAS to rapidly and transiently disseminate among adults during outbreaks.
NIHR Health Protection Research Unit in Antimicrobial Resistance and Healthcare Associated Infections, Imperial College London, United Kingdom.
M
M
Pearson
Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire, United Kingdom.
J L
JL
Fallowfield
Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire, United Kingdom.
T
T
Davey
Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire, United Kingdom.
N M
NM
Thorpe
Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire, United Kingdom.
A J
AJ
Allsopp
Institute of Naval Medicine, Crescent Road, Alverstoke, Hampshire, United Kingdom.
A
A
Shaw
Academic Department of Military Medicine, Royal Centre for Defence Medicine (Research and Academia), Birmingham, United Kingdom.
D R
DR
Wilson
Department of Medicine, Imperial College London, United Kingdom; NIHR Health Protection Research Unit in Antimicrobial Resistance and Healthcare Associated Infections, Imperial College London, United Kingdom. Electronic address: s.sriskandan@imperial.ac.uk.
S
S
Sriskandan
Department of Medicine, Imperial College London, United Kingdom; Academic Department of Military Medicine, Royal Centre for Defence Medicine (Research and Academia), Birmingham, United Kingdom; Royal Free London NHS Foundation Trust, London, United Kingdom. Electronic address: drlucylamb@gmail.com.
L E
LE
Lamb
D000293:Adolescent; D000328:Adult; D058345:Asymptomatic Infections / Q000453:epidemiology*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D010614:Pharynx / Q000382:microbiology*; D011446:Prospective Studies; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000235:genetics / Q000302:isolation & purification*; D055815:Young Adult
Group A Streptococcus; Infection control; Military; Outbreak; Soft tissue infection; Training