Prevalence of Group A b-Hemolytic Streptococcus Among XXXX with Tonsillopharyngitis in Kyrgyzstan: The Difficulty of Diagnostics and Therapy.

@entity4789 @entity1 @entity2756 @entity6331 @entity115 @entity114 @entity2929 @entity102 @entity14698 @entity869
OBJECTIVE: @entity4789 ( @entity4789 ) is well known disease as a result of frequent complication of the group A b-hemolytic streptococcal (GABHS) tonsillopharyngitis, have noticeably grown for the last 15 years among young generation in the Kyrgyz Republic. It is important to hold a study about the prevalence of @entity4789 and GABHS and their susceptibility to antibiotics in the Kyrgyz Republic. MATERIALS AND METHODS: We have studied 200 @entity1 with @entity102 at the National Center of Pediatrics and @entity1 Surgery in Bishkek (the Kyrgyz Republic) from August till September 2008. 188 (48 out of them are with @entity4789 ) out of total 200 @entity1 are Kyrgyz and 12 are Russian (2 out of them are with @entity4789 ). 111 out of total are female (34 out of them are with @entity4789 ) and 89 are male (17 out of them are with @entity4789 ). The average age of the subjects is 10.9  6.0 (from 3 to 17 years old). The presence of GABHS was assessed using two ways: by the rapid antigen detection test (RADT) for outcrop of streptococcus antigen in smear from mucosal surface of tonsils, and by bacterial culture analysis (BA). RADT was used to determine its specificity and sensitivity in order to recommend practitioners its further wide use. Furthermore, the discovered culture of GABHS have been investigated on susceptibility to antibiotics by disc-diffusion method. RESEARCH RESULTS: GABHS antigen was positive in 72 (36.0 %) subjects from RADT and in 80 (40.0%) subjects from BA out of 200 total subjects. In the @entity1 with @entity4789 (n=51), GABHS was positive in 18 (35.2%) subjects by RADT and in 24 (47.0%) subjects by BA. In the subjects without @entity4789 (n=149), GABHS was positive in 54 (36.2%) subjects by RADT and in 56 (37.5%) by BA. Among 80 GABHS positive results sensitive to antibiotics were: to @entity114 only 10 (12.5%), to @entity869 -29 (36.2%), to @entity115 -36 (45.0%), to @entity2756 - 31 (38.7%), to @entity14698 - 21 (26.2%), to @entity2929 - 19 (23.7%). It is noted that 21 (26.2%) GABHS positive results were absolutely resistant for all these tested antibiotics. RADT showed that its specificity is 85% as well as its sensitivity is equal to 67.5%. CONCLUSION: In this study the sensitivity of RADT was low; therefore, the negative results of RADT don't exclude presence of GABHS. High prevalence of GABHS antigen demonstrates not only in @entity1 with @entity4789 , but also among healthy @entity1 (without @entity4789 ) of the Kyrgyz Republic. The high prevalence of GABHS at @entity1 with @entity4789 (47.0%), probably, presents a low sensitivity to antibiotics and irregular secondary prophylaxis. Significant presence of GABHS among healthy @entity1 (37.5%) requires improvement of primary prevention to prevent further spread of @entity4789 and @entity6331 ( @entity6331 ) in the country.
