Pendru Raghunath

Abstract

Introduction: Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Materials and Methods: Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. Results: BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes. Conclusion: This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.   Keywords: Prevalence, Risk factors, Beta-haemolytic streptococci, GAS, GBS.

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Abstract

Introduction: Pyoderma is a common acute superficial bacterial skin infection which is highly contagious. In the great majority of cases, pyoderma is caused by Streptococcus pyogenes, Staphylococcus aureus, or both. The present study was carried out to determine the prevalence and antibiotic susceptibility of S.pyogenes isolated from pyoderma in Dr. VRK Women’s Teaching hospital. Materials and Methods: Swabs or pus samples were collected from 250 patients attending Dermatology, outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Samples were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37?C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Presumptive identification of a strain as a Group A Streptococcus (GAS) was also made by PYRase test. Presumptively identified GAS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. S. pyogenes isolates were subjected to antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method. Results: BHS were isolated from 30% of samples. Prevalence of BHS was more among 0-10 years age group (38%). BHS were isolated more frequently from males (38.8%). S. pyogenes were isolated from 52 (20.8%) samples. All 52 S. pyogenes isolates were found to be susceptible to Penicillin G, amoxicillin, ceftriaxone, azithromycin and vancomycin. Erythromycin and clindamycin showed good activity with sensitivity rates of 92.3% & 96.1%, respectively. Resistance to tetracycline (59.6%) and chloramphenicol (23.1%) was commonly seen in S. pyogenes. Conclusion: This study reports the prevalence and antibiotic susceptibility of S. pyogenes isolated from pyoderma in Dr. VRK Women’s Teaching hospital. Results of this study suggests the peak incidence of pyoderma in children aged 0 to 10 years and male preponderance. Our study also reports high prevalence of tetracycline and chloramphenicol resistance in S. pyogenes. Keywords: Pyoderma, GAS, Prevalence, Antibiotic susceptibility.

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