title: Throat Carriage Rate and Antimicrobial Resistance ofStreptococcus pyogenesIn Rural Children in Argentina.
abstract: OBJECTIVE
  The aim of this study was to determine the prevalence of asymptomatic carriers of group A β-hemolytic streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status.
  
  
  METHODS
  Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin.
  
  
  RESULTS
  The carriage of β-hemolytic streptococci was detected in 18.1% of participants, withStreptococcus pyogenesin 18 participants followed byS. dysgalactiaessp.equisimilisin 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate.
  
  
  CONCLUSIONS
  The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiaessp.equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.
authors.affiliation: School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina.
authors.forename: Gastón
authors.identifier: 0000-0002-9109-7615
authors.initials: G
authors.lastname: Delpech
authors.affiliation: School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina.|Hospital Ramón Santamarina, Tandil, Argentina.
authors.forename: Mónica
authors.identifier: 0000-0002-0768-894X
authors.initials: M
authors.lastname: Sparo
authors.affiliation: School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina.
authors.forename: Beatriz
authors.identifier: 0000-0002-1539-6947
authors.initials: B
authors.lastname: Baldaccini
authors.affiliation: School of Medicine, Universidad Nacional del Centro de la Provincia de Buenos Aires, Olavarría, Argentina.
authors.forename: Gisela
authors.identifier: 0000-0002-5095-2160
authors.initials: G
authors.lastname: Pourcel
authors.affiliation: Hospital Ramón Santamarina, Tandil, Argentina.
authors.forename: Sabina
authors.identifier: 0000-0002-4041-0931
authors.initials: S
authors.lastname: Lissarrague
authors.affiliation: Center of Biochemical Studies, Tandil, Argentina.
authors.forename: Leonardo
authors.identifier: 0000-0001-5237-2840
authors.initials: L
authors.lastname: García Allende
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001118:Argentina; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D018942:Macrolides / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D010612:Pharyngitis / Q000175:diagnosis* / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology*; D010641:Phenotype; D012424:Rural Population; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000187:drug effects / Q000302:isolation & purification*; D013752:Tetracycline / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D013752:Tetracycline
keywords: Argentina; Pharyngitis; Prevalence; Rural population; Streptococcus pyogenes