Group A streptococci in children with acute pharyngitis in Sousse, Tunisia

A 1-year prospective study in 2 paediatric outpatient clinics in Sousse, Tunisia, aimed to determine the presence of group A streptococci in acute pharyngitis cases and carriers, and the distribution of the serotypes and biotypes. Group A streptococci were found in 9.0% of throat swabs from 155 controls and 17.7% from 474 patients [P < 0.05]. Of 43 strains isolated from patients and submitted for typing, 15 different types were identified, the most common being M75 [14 strains; 32.5%], M9 [6 strains; 14.0%], M76 [5 strains; 11.6%] and M12 [4 strains; 9.3%]. Three strains were non-typeable [7.0%]. Biotyping of the strains showed 3 predominant biotypes: biotype 3 [n = 14], biotype 2 [n = 11], and biotype 1 [n = 7]

Beta-haemolytic streptococci in acute pharyngitis

To determine the role and importance of beta-haemolytic streptococci in acute pharyngitis and its relative susceptibility to antibiotics, we cultured samples from 143 patients [age range: 3-72 years] who presented over a 5-month period in 2001 at three primary health care centres in Sousse, Tunisia. The cultures yielded 80 beta-haemolytic streptococci [59 group A streptococci and 21 non-group A streptococci]. All strains were susceptible to benzylpenicillin, amoxicillin, chloramphenicol, rifampicin and pristinamycin. Susceptibility was variable in erythromycin, tetracycline, fosfomycin, telithromycin and levofloxacin. Minimum inhibitory concentrations were determined by E-test for penicillin, erythromycin and levofloxacin. Our results confirm that penicillin is still the reference treatment for acute pharyngitis. However, to minimize the potential for complications arising from its use, continued vigilance is required