Epidemiological Aspects and Antibiotics Susceptibility Patterns of Streptococcus pyogenes Isolated from Subjects with Tonsillitis, Sudan

Abstract

Background: Globally, Streptococcus pharyngitis is a major public health challenge. The current study investigates the prevalence of Streptococcal pyogenes among children under 17 years old in ENT Kosti Teaching Hospital and examines the susceptibility of isolated S. pyogenes strains to commonly used antibiotics.
Methods: A total of 384 throat swabs were obtained from children under the age of 17 who attended the Kosti Teaching Hospital between 2019 and 2021. Streptococcus pyogenes was isolated by conventional microbiology procedures. Each S. pyogenes strain was subjected to antibiotic susceptibility testing according to the CLSI guidelines.
Results: Most participants of this study were females 219 (57%) and aged between 5 and 10 years 259 (67.4%). Out of the 384 participants, 134 (34.9%) and 255 (66.4%) suffered from lymphadenopathy and tonsil hyperplasia, respectively. Interestingly, lymphadenopathy and tonsil hyperplasia were more (P 0.05) in the 5–10 age group than those aged 11–16 years. Moreover, 41.4% of the participants were infected by a GAS sore throat. GAS sore throat is significantly associated with lymphadenopathy (AOR: 2.375, 95% CI: 1.479–3.815, P 0.000) and tonsil hyperplasia (AOR: 3.374, 95% CI: 1.939–5.874, P 0.000). Notably, males (AOR: 0.853, 95% CI: 0.549–1.325, P 0.479) and individuals aged 5–10 years (AOR: 0.867, 95% CI: 0.464–1.618, P 0.654) were less likely to have a GAS sore throat. In our study, all isolated strains were sensitive to penicillin. Clindamycin, azithromycin, and erythromycin resistance were observed in 7 (4.4%), 44 (27.7%), and 47 (29.6%) isolates, respectively.
Conclusion: The study displayed the current situation of GAS sore throat in the White Nile state. Penicillin was found to be the effective drug to cure S. tonsillitis but a high rate of resistance to macrolides was noticed which is an alarming sign.