Antibiotics such as cephalosporins, macrolides, and clindamycin are also used clinically. In some regions of the world, GAS resistance to antibiotics such as clindamycin and macrolides has become an increasing worry and epidemiological wakefulness is required to ensure that treatment matches the antibiotic sensitivity of GAS strains. Resistance among streptococci to macrolides (erythromycin and clarithromycin) is widely reported. Our study showed the resistance of Clarithromycin was 33.3% similar to showing resistance of 33.9% and the resistance to Erythromycin was 7.8% agreeing with 9.7% of study and 6.9% of study. And also shows 52.9% resistance to amoxicillin whereas the study of from Egypt showed 81% sensitivity to amoxicillin.
The Spy 1258 is the most widely common primer used for molecular detection of S. pyogenes, this study detects 82.4% of bacterial isolates, in a study from Iraq the percentage of detection by Spy 1258 was 61%. In a comparative study (Identification of Streptococcus pyogenes—Phenotypic Tests vs Molecular Assay (Spy 1258 PCR)) showed the percentage Streptococcus pyogenes contain Spy 1258 gene was 85.9%. This study showed 100% Specifity of Spy 1258 agreeing with study which also showed 100% Specifity and 87% sensitivity and showed that Spy 1258 gene was specific for S. pyogenes only, but not from other species of the genus Streptococcus and common bacteria. This result disagrees with study showed all S. pyogenes isolates contain Spy 1258 genes and study’s conclusion was to use Spy 1258 for the best results of identification. study from Sudan showed that the low sensitivity of Spy 1258 primer and the variability in S. pyogenes genome sequence necessitate developing new primers according to the environmental and geographical distribution of S. pyogenes isolates.
Author(s) Details:
Minas Mohamed Balla Yousif
Department of Microbiology, Faculty of Science, University of Gezira, Wad Medani, Sudan.
Adil Mergani
Department of Molecular and Immunogenetics, NCI, University of Gezira, Wad Medani, Sudan.
Mohamed Elamin A. M. E. Medani
Pediatric Cardiologist, Faculty of Medicine, University of Gezira, Wad Medani, Sudan.
Adam Dawoud Abakar
Department of Medical Parasitology, Faculty of Medical Laboratory Science, University of Gezira, Wad Medani, Sudan.
Recent Global Research Developments in Group A Streptococcus Pharyngitis: Advances in Diagnosis and Treatment
Vaccine Development: Recent studies have highlighted significant progress towards developing a vaccine against GAS. Researchers have identified key pathogenic proteins and are working on peptide-based subunit vaccines. Preclinical and clinical studies are ongoing to evaluate potential vaccine candidates1.
Global Burden and Incidence: A systematic review and meta-analysis have provided contemporary data on the global burden of sore throat and GAS pharyngitis. The study emphasizes the need for standardized methodologies to accurately quantify the disease burden and evaluate the impact of future vaccines2.
Diagnosis Techniques: Advances in diagnostic methods, such as nucleic acid amplification testing (NAAT), have improved the accuracy and speed of diagnosing GAS pharyngitis. Multivariate models have been used to identify significant predictors of NAAT use and antibiotic prescription3.
Rheumatic Fever and Heart Disease: Research has also focused on the relationship between GAS infections, acute rheumatic fever (ARF), and rheumatic heart disease (RHD). New hypotheses regarding the pathogenesis of ARF and revised diagnostic criteria have emerged, providing better insights into these conditions4.
Antibiotic Resistance: The increasing resistance of GAS to antibiotics, particularly macrolides, has been a growing concern. Studies are exploring alternative treatment options and the development of new antibiotics to combat resistant strains1.
References
- Fan J, Toth I, Stephenson RJ. Recent Scientific Advancements towards a Vaccine against Group A Streptococcus. Vaccines. 2024; 12(3):272. https://doi.org/10.3390/vaccines12030272
- Miller, K. M., Carapetis, J. R., Van Beneden, C. A., Cadarette, D., Daw, J. N., Moore, H. C., … & Cannon, J. W. (2022). The global burden of sore throat and group A Streptococcus pharyngitis: A systematic review and meta-analysis. EClinicalMedicine, 48.
- Luo, R., Sickler, J., Vahidnia, F., Lee, Y. C., Frogner, B., & Thompson, M. (2019). Diagnosis and management of group A streptococcal pharyngitis in the United States, 2011–2015. BMC infectious diseases, 19, 1-9.
- Zühlke, L.J., Beaton, A., Engel, M.E. et al. Group A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations. Curr Treat Options Cardio Med 19, 15 (2017). https://doi.org/10.1007/s11936-017-0513-y
