Journal
EUROPEAN JOURNAL OF PEDIATRICS
Volume 181, Issue 12, Pages 4059-4065Publisher
SPRINGER
DOI: 10.1007/s00431-022-04633-2
Keywords
GAS; Group A streptococcus; MxA; Myxovirus resistance protein A; Pharyngitis; Streptococcus pyogenes
Categories
Funding
- University of Turku (UTU)
- Academy of Finland [277535]
- Sohlberg Foundation
- Paulo Foundation
- Finnish Medical Foundation
- Outpatient Research Foundation
- Foundation for Paediatric Reaserch
- Turku University Central Hospital
- Academy of Finland (AKA) [277535, 277535] Funding Source: Academy of Finland (AKA)
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The aim of this study was to investigate the detection of group A streptococcus (GAS) in pediatric pharyngitis patients using different diagnostic methods. The study found that GAS was frequently detected even in pediatric pharyngitis patients with a confirmed viral infection. This suggests that viral infections may lead to incidental carriage of GAS in the throat.
Our aim was to study the detection of group A streptococcus (GAS) with different diagnostic methods in paediatric pharyngitis patients with and without a confirmed viral infection. In this prospective observational study, throat swabs and blood samples were collected from children (age 1-16 years) presenting to the emergency department with febrile pharyngitis. A confirmed viral infection was defined as a positive virus diagnostic test (nucleic acid amplification test [NAAT] and/or serology) together with an antiviral immune response of the host demonstrated by elevated (>= 175 mu g/L) myxovirus resistance protein A (MxA) blood concentration. Testing for GAS was performed by a throat culture, by 2 rapid antigen detection tests (StrepTop and mariPOC) and by 2 NAATs (Simplexa and Illumigene). Altogether, 83 children were recruited of whom 48 had samples available for GAS testing. Confirmed viral infection was diagnosed in 30/48 (63%) children with febrile pharyngitis. Enteroviruses 11/30 (37%), adenoviruses 9/30 (30%) and rhinoviruses 9/30 (30%) were the most common viruses detected. GAS was detected by throat culture in 5/30 (17%) with and in 6/18 (33%) patients without a confirmed viral infection. Respectively, GAS was detected in 4/30 (13%) and 6/18 (33%) by StrepTop, 13/30 (43%) and 10/18 (56%) by mariPOC, 6/30 (20%) and 9/18 (50%) by Simplexa, and 5/30 (17%) and 6/18 (30%) patients by Illumigene. Conclusion: GAS was frequently detected also in paediatric pharyngitis patients with a confirmed viral infection. The presence of antiviral host response and increased GAS detection by sensitive methods suggest incidental throat carriage of GAS in viral pharyngitis.
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