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Lancet. 2001 Oct 20;358(9290):1334-7.

Dynamic epidemiology of group A streptococcal serotypes associated with pharyngitis.

Author information

1
Department of Pediatrics, WHO Collaborating Center for Reference and Research on Streptococci, University of Minnesota Medical School, Minneapolis, MN 55455, USA. kapla001@umn.edu

Abstract

BACKGROUND:

Despite the past 15 years of heightened awareness of the disease-causing potential of group A streptococci, the possible epidemiological influence of rapid changes in prevalent serotypes has not been fully appreciated.

METHODS:

We analysed throat cultures collected as part of routine medical care in a semi-closed community of nearly 500 children and adults between January, 1999, and April, 2000. beta-haemolytic streptococci from all positive cultures were characterised by serological grouping, T-agglutination pattern, and serotyping for M protein or opacity factor.

FINDINGS:

We saw an increase in the number of symptomatic individuals with pharyngitis beginning in mid-1999. Between July 1 and Dec 31, 1999, 111 (29%) of 378 throat cultures yielded group A streptococci, 102 (92%) of which were serotype M1. Between Jan 1 and Mar 31, 2000, 126 (45%) of 277 throat cultures yielded group A streptococci. Unexpectedly, 106 (84%) of these throat isolates were serotype M6, and only 16 (13%) were M1. 20 (28%) of the 71 individuals with M1 infection subsequently acquired infection with M6.

INTERPRETATION:

This rapid and almost complete shift in predominance of group A streptococcal serotype in this community draws attention to the dynamic epidemiology of these organisms. This change has important implications for further understanding the epidemiology of group A streptococcal infections, and for the development and use of a vaccine.

PMID:
11684215
DOI:
10.1016/S0140-6736(01)06415-7
[Indexed for MEDLINE]

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