Infection and Drug Resistance (Dec 2020)
Beta-Haemolytic Group A, C and G Streptococcal Infections in Southern Hungary: A 10-Year Population-Based Retrospective Survey (2008–2017) and a Review of the Literature
Abstract
Márió Gajdács,1 Marianna Ábrók,2 Andrea Lázár,2 Katalin Burián2,3 1Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Szeged 6720, Hungary; 2Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Szeged, Hungary; 3Department of Medical Microbiology, Faculty of Medicine, University of Szeged, Szeged 6720, HungaryCorrespondence: Márió GajdácsDepartment of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös Utca 6, Szeged 6720, HungaryTel +36-63-341-330Email [email protected]: Pyogenic β-hemolytic streptococci (including Group A, C and G Streptococcus) are some of the most important Gram-positive bacterial pathogens in human medicine. Although effective therapy is available, invasive streptococcal infections are associated with a significant disease burden.Methods: In this retrospective study, the epidemiological characteristics of invasive Group A (iGAS) and Group C and G (iGCGS) streptococci, along with tonsillo-pharyngitis-causing pGAS and pGCGS infections, were assessed in Southern Hungary. A total of 1554 cases of streptococcal tonsillo-pharyngitis infections (26.5– 44.1/100,000 persons, pGAS: 95.5%; n=1484) and 1104 cases of invasive streptococcal infections were detected (12.5– 31.4/100,000 persons, iGAS: 77.9%; n=861).Results: The average age of the affected patients in the various groups were the following: pGAS: 13.2± 13.1 years, pGCGS: 21.0± 15.0 years (p=0.039), iGAS: 49.1± 12.8 years, iGCGS: 58.7± 18.5 years (p> 0.05). iGAS isolates originated from abscesses (47.1%), blood culture samples (24.1%), surgical samples (16.7%), biopsies (4.6%), pleural fluid (3.5%), pus (2.0%), synovial fluid (1.3%) and cerebrospinal fluid samples (0.7%). In contrast, iGCGS isolates mainly originated from blood culture samples (53.8%), abscesses (22.9%), surgical samples (12.3%), synovial fluid (5.1%), pleural fluid (3.7%), pus (1.8%) and cerebrospinal fluid samples (0.4%). All respective isolates were susceptible to benzyl-penicillin; overall resistance levels for erythromycin (10.5% for GAS, 21.4% for GCGS) and clindamycin (9.2% for GAS, 17.2% for GCGS) were significantly higher in GCGS isolates, while resistance levels for norfloxacin were higher in GAS isolates (13.5% for GAS, 6.9% for GCGS).Conclusion: The rates of resistance to macrolides and clindamycin are a cause for concern (especially among GCGS isolates); however, resistance levels are still relatively low, compared to Southern European countries.Keywords: epidemiology, antibiotics, group A Streptococcus, group C Streptococcus, group G Streptococcus, Hungary, Streptococcus pyogenes, Streptococcus dysgalactiae subspecies equisimilis
