University of Khartoum

Bacteriological and Serological Diagnosis of Streptococcal Pharyngitis in Eddwayim Town

Bacteriological and Serological Diagnosis of Streptococcal Pharyngitis in Eddwayim Town

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Title: Bacteriological and Serological Diagnosis of Streptococcal Pharyngitis in Eddwayim Town
Author: Ahmed, Alaa Elwaseela
Abstract: Background: Streptococcal pharyngitis is a common bacterial infection worldwide especially among children. Repeated and untreated infection can lead to serious complications. This infection is common in Eddwayim Town and the only method used for diagnosis of this condition is the titration of antibodies against streptolysin O. “ASO titer” although this test is not a good diagnostic tool in many condition and may give false result in some cases. The main objective of this study was to use different bacteriological and serological tests for diagnosis of Streptococcal pharyngitis in Eddwayim Town. Method: A cross-sectional study done in Eddwayim Teaching Hospital, ENT department during the period from March to September 2016. One hundred and twenty two participants were included in this study regardless of their age .Two throat swabs and one blood sample were collected from each participants , one for culture using standard techniquesforisolation and identification of streptococcus group Aand other Beta hemolytic streptococci groups. The other swab for antigen detection of Streptococcus group A. Theblood sample was used fortitration of Anti Streptolysin O qualitatively and quantitatively and for C-Reactive Protein titration qualitatively. Results: From the 122 samples collected from patients with tonsillitis, streptococcus pyogenes group Awas isolated from 5 samples (4.09%) group B streptococci was isolated from 8 patients (6.6%) group C streptococci was isolated from 28 of patients (22.95%) group D streptococci was isolated from 6 patients (4.9%) group F streptococci was isolated from 44 of patients (36.06%) and group G streptococci was isolated from 22 of patients (18.03%). The result of antimicrobial sensitivity test showed that all Group A Streptococci isolates were sensitive to penicillin and Ampicillin. Other groups showed resistant to penicillin and Ampicillin and varied sensitivity to the remaining antibiotics. Streptococcal group A antigen was detected in 32 (26.32%) of 122patients, included all GAS isolates. The result of ASO test showed that 43 (35.2%) patients had ASO titer more than 200 iu qualitatively, whereas number of patients showing ASO titer more than 200, 300, and 500iuwere 8 (47.06%), 7(41.17%) and 2 (11.76%) quantitatively. The quantitative result of ASO showed that 17 had significant titer ,more than 200iu/ml.The CRP titre positive for thirty six of patients (29.05%) 43 of 122 had significant rise in ASO titre, and 18 (47%) of 36 of high positive CRP correlated with positive ASO. Conclusion: Streptococcus group A may not be the only cause of streptococcal pharyngitis. Also group F and C may be included. ASO determination doesn’t discriminate between the acute infection and the previous one.ASO titer for most patients is less than 200 iu/ml. GAS remains 100% sensitive to benzyl penicillin. Rapid antigen detection test for GAS with centor criteria is very helpful. C-reactive protein determination is beneficial at time of acute visit.
URI: http://khartoumspace.uofk.edu/123456789/26593


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