Community-wide outbreak of group G streptococcal pharyngitis.
Community-wide outbreak of group G streptococcal pharyngitis.
复制标题
社区范围内爆发 G 族链球菌性咽炎。
作者：
M. Gerber;M. Randolph;N. Martin;Munir F. Rizkallah;P. Cleary;E. L. Kaplan;E. Ayoub
虽然已经报道了几次G群β溶血性链球菌（GGBHS）咽炎的暴发，但除了有限的几种情况外，关于GGBHS在急性咽炎中的病因作用仍然存在疑问。1986/87年冬/春，对在私立儿科诊所连续就诊的222例急性咽炎患儿进行了咽喉培养，其中91例（41%）患儿检出a组β溶血性链球菌（GABHS）， 56例（25%）患儿检出GGBHS。1例患者同时分离了GABHS和GGBHS。GGBHS的分离率显著高于前几年和随后的年份，67%的GGBHS分离株发生在8周的时间内。对57株GGBHS进行DNA指纹图谱分析，其中43株（75%）为同一菌株。GGBHS患者在临床表现、抗溶血素o滴度反应和抗生素治疗的临床反应方面与GABHS患者相当。而GGBHS患者年龄明显偏大（P < 0.05）。这是首次在社区范围内充分记录的GGBHS咽炎暴发，也是首次在儿科人群中发生GGBHS咽炎呼吸道暴发。GGBHS可能是急性、可治疗咽炎的一个比以前认识到的更重要的原因。
Although several outbreaks of group G beta-hemolytic streptococcal (GGBHS) pharyngitis have been described, doubt still remains regarding the etiologic role of GGBHS in acute pharyngitis beyond a limited number of situations. In the winter/spring of 1986/87, throat cultures were obtained from 222 consecutive children seen at a private pediatric office with acute pharyngitis and group A beta-hemolytic streptococci (GABHS) were recovered from 91 children (41%) and GGBHS from 56 children (25%). One patient had both GABHS and GGBHS isolated. This isolation rate of GGBHS was dramatically greater than in previous and subsequent years, and 67% of the GGBHS isolates occurred during an 8-week period. Results of DNA fingerprinting of the 57 isolates of GGBHS demonstrated that 43 (75%) appeared to be the same strain. The patients with GGBHS were comparable to those with GABHS with respect to clinical findings, antistreptolysin-O titer response, and clinical response to antibiotic therapy. However, patients with GGBHS were significantly older (P less than .05). This is the first well-documented, community-wide outbreak of GGBHS pharyngitis and the first respiratory outbreak of GGBHS pharyngitis in a pediatric population. GGBHS may be a more important cause of acute, treatable pharyngitis than had been previously recognized.