• Korean Journal of Clinical Laboratory Science
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• v.38 no.1
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• pp.34-37
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• 2006

Beta-hemolytic streptococci (BHS) are frequently isolated pathogens in clinical microbiology laboratories. Among them, Group C, G and F streptococci infrequently cause respiratory infections, but they often invade other sites. Patients with underlying diseases are prone to be infected by the organisms and some of them can be fatal. Therefore, combination tests of serological and biochemical tests are needed to correct the identification of non-A, B streptococci because to various species belong to this species. The aim of this study was to investigate the isolation rates of strains and distribution of serogroup C, G and F streptococci at Wonju Hospital during the period of 2003-2004. 133 clinical isolates of group C, G and F streptococci were examined. Of them, 13 (9.8%) were group C, 41 (31.8%) were group F, 79 (59.4%) were group G. The prevalent isolation of the strains by serogroup were: group C, Streptococcus constellatus (38.5%); group F, Streptococcus anginosus (56.1%), Streptococcus constellatus (26.9%); group G, Streptococcus anginosus (54.4%), Streptococcus dysgalatiae subsp. equisimilis (26.5%). Overall, the most frequently isolated BHS was Streptococcus anginosus (51.2%).

• Pediatric Infection and Vaccine
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• v.13 no.1
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• pp.85-88
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• 2006

Perianal streptococcal dermatitis is a bright red, sharply demarcated, perianal rash that is caused by group A beta-hemolytic streptococci. It primarily occurs in children between six months and 10 years of age and is often misdiagnosed and treated inappropriately. We report a case of Perianal streptococcal dermatitis in a 13-months-old female patient. A culture of the perianal area grew group A beta-hemolytic streptococcus. The patient was given systemic antibiotics and topical applications of mupirocin, and a dramatic improvement was noted.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.149-156
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• 2001

After the fact that obsessive-compulsive symptoms or tic symptoms are common in Sydenham's chorea which is a sequale of rheumatic fever produced by group A beta-hemolytic streptococcus was reported, the association between group A beta-hemolytic streptococcus and a subgroup of obsessivecompulsive disorder(OCD) or tic disorder has been attentioned. This subgroup shared a unique clinical course, characterized by an abrupt onset of symptoms and/or dramatic exacerbations. And this subgroup was distinguished by pre-pubertal onset of symptoms, neurological abnormalities(choreiform movements and a unique pattern of motoric hyperactivity), as well as by relapsing and remitting symptom course. Acronym PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) was used to denote a subgroup of OCD or tic disorder patients with these clinical characteristics. Then, there was a report suggesting that PANDAS category include some of attention-deficit/hyperactivity disorder(ADHD) and were two case reports of anorexia nervosa and body dysmorphic disorder with characteristics of PANDAS. This case is a patient who developed normally until age of 7, but after pharyngeal inflammation with high fever, he showed disturbance of cognition, social relationship, and language and communication, as well as tic symtoms and abnormal movement on face, hand, and foot. We report this case with review of literatures, because we think that this case belongs to the PANDAS category. Based on this observation, we suggest that PANDAS category include some of childhood disintegrative disorder as well as OCD, tic disorder, and ADHD.

• Pediatric Infection and Vaccine
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• v.2 no.2
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• pp.180-185
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• 1995

1. Purpose The accurate diagnosis and proper treatment of group A streptococcus should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. We would like to know the recover rate of beta-hemolytic streptococci by throat swab culture at the in-patient 2. Methods The throat swab cultures and filled up flow-sheets were undertaken on 619 children who had admitted to hospital, KyungHee university hospital from may 1994 to april 1995 prospectively. At the same time on admission, throat culture was performed. 3. Results The highest recover rate of BHS(Beta-Hemolytic Streptococci)and GAS(Group A Streptococci) were seen in above 10 years old, as 9.1% and 1.9%. BHS were obtained in 39 cases(6.3%) among 619 children while GAS was obtained in 3 cases (0.4%). Among 39 specimens of BHS, 33 specimens were classified as non-grouping streptococcus. 4. Conclusion The poor recovery rate of GAS inpatient compared with normal carrier rate is likely due to possible antibiotic abuse, errors in processing samples, and epidemiologic factors such as seasons and geographic areas. It is necessary to evaluate the clinical significance of non-A,B,C,G streptococcal infections and carriers.

• Korean Journal of Veterinary Research
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• v.47 no.3
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• pp.291-298
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• 2007

Olive flounder, Paralichthys olivaceus is one of the most important cultured fish in Korea, its farming has been negatively impacted by viral, bacterial and parasitic diseases. Streptococcal infection was considered as a serious problem because of significant economic losses in olive flounder farm industry. The development and evaluation of vaccine for protection against infection by this agent were required. We evaluated the safety and efficacy of ${\beta}$-hemolytic Streptococcus (S.) iniae vaccine on olive flounder Three hundreds of flounders (weight $119.8{\pm}20.7g$, body length $22.6{\pm}1.4cm$) were reared in 0.5 tons aquaria in land-marine tank system. Seawater was provided from the sea of Inchon in Korea, and water temperature was set to $22^{\circ}C$ and $25^{\circ}C$ in the vaccination and challenge test, respectively. We used the formalin-inactivated ${\beta}$-hemolytic S. iniae (F2K) vaccine (M VAC INIAE; Kyoritsu seiyaku, Japan) originated in Japan. The vaccine was intraperitoneally administered to fish. Both of vaccinated group and control group were challenged with intraperitoneally injection by virulent S. iniae SI-36 isolates with $1.0{\times}10^7CFU/fish$ at 3 weeks after vaccination. Difference on mortality of control and vaccinated group (90.0 and 15.0%, 76.5 and 8.0% respectively) at two trials were found significant (p<0.05), and relative percent survival were 83.4% and 89.5%, respectively. The dead fishes were showed dark pigmentation of skin, abdominal extension, hemorrhagic ascites, and liver necrosis, and isolated the S. iniae strain from ascites, liver and kidney. We confirmed the safety and efficacy of ${\beta}$-hemolytic S. iniae vaccine by determinations of the optimal management condition and artificial challenge test in olive flounder.

• Pediatric Infection and Vaccine
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• v.7 no.1
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• pp.143-151
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• 2000

Purpose : The accuracy of bacteriologic diagnosis of beta-hemolytic streptococcal pharyngotonsillitis depends on the degree of carrier rate in that area where the throat swabs are obtained and the evaluation of serological T typing as an epidemiologic marker is important to understand epidemiology of streptococcal infection. The purpose of this study is to know the carrier rates of group A streptococcus in normal children form four different areas and to find out the epidemiologic characteristic in distribution of the serotypes for 3 years. Method : Throat swabs were obtained from the tonsillar fossa of normal school children in four different areas(Uljin, Seoul, Osan, Kunsan) from March to May 1996, in Uljin in April 1997, and in Uljin in April 1998. The samples were plated on a 5% sheep blood agar plate and incubated overnight at $37^{\circ}C$ before examination for the presence of beta-hemolytic colonies. All isolated beta-hemolytic streptococcus were grouped and serotyped by T agglutination. Results : The carrier rate of beta-hemolytic streptococci and group A streptococci in 1996 were 27.6%, 18.6% at Uljin; 16.4%, 2.7% at Seoul; 33.0%, 26.0% at Osan; 20.0%, 12.3% at Kunsan, respectively. Among 1,192 normal school children from 4 different areas, we obtained 179 strains of group A streptococci. Fifty two percent of the strains were typable by T agglutination in 1996. Common T-type in 1996 were NT, T1, T3, T2 at Uljin; T12, T25 at Seoul; NT, T6, T28 at Osan; T25, T4, NT, T5 at Kunsan, in decreasing order, respectively. At Uljin, T1, T3, T25 accounted for 69% of strains in 1996, T1, T12, T25 accounted for 70% in 1997, and T12, T4 accounted for 88% in 1998. Conclusion : Higher carrier rates were found in Uljin and Osan, where there are a lower population density with scanty of medical facilities compared with another areas. We supposed that low carrier rates is likely to be related to antibiotic abuse or some epidemiologic factor. The periodic and seasonal serotyping analysis is important in monitoring and understanding the epidemiologic patterns of group A streptococci.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.127-132
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• 2017

Objectives: The aim of this study was to determine the prevalence of asymptomatic carriers of group A ${\beta}-hemolytic$ streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status. Methods: Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin. Results: The carriage of ${\beta}-hemolytic$ streptococci was detected in 18.1% of participants, with Streptococcus pyogenes in 18 participants followed by S. dysgalactiae ssp. equisimilis in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate. Conclusions: The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiae ssp. equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.210-214
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• 2009

Group A streptococcus (GAS) rarely causes meningoencephalitis in children without risk factors. A previously healthy 8 year-old child presented with lethargy, high fever, and vomiting. The clinical course was unusual including intractable seizures, disseminated intravascular coagulation (DIC), and left hemiparesis in spite of the appropriate and timely administration of antibiotics and corticosteroids. The microbiologic studies revealed that the pathogen was susceptible to penicillin and GAS M18 strains. This case showed the importance of the GAS vaccine in addition to appropriate antibiotics.

• Journal of Korean Neurosurgical Society
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• v.48 no.1
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• pp.73-78
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• 2010

Objective : Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods : The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as $40^{\circ}C$. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results : Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion : Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.95-101
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• 2003

Objective : To determine the clinical and bacteriologic efficacy and safety of Cefdinir in acute pharyngitis and pharyngotonsillitis caused by group A beta hemolytic streptococci in pediatric patients. Methods : Children aged 3 through 12 years who visited the hospitals enrolled in this study with signs and symptoms of pharyngitis or pharyngotonsillitis since May to December 2002, were taken throat culture and given Cefdinir(12 mg/kg/day, in three divided doses) for 7 days. Two hundred thirty five patients were enrolled and 90 patients who showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Follow-up culture were done at the end of the study and bacteriologic efficacy was determined Results : Ninety out of 235 patients who visited the hospitals with the signs and symptoms of pharyngitis showed positive growth on throat culture. Seventy nine patients were clinically and microbiologically assessable. The bacteriologic eradication rates of S. pyogenes were 100% in all the children treated with Cefdinir. Clinical cure rates were not different between less than 7 days-treated group(75%) and just 7 days-treated group(98.6%)(P=0.077). Two patients reported adverse reaction during Cefdinir treatment. Antimicrobial sensitivity of Cefdinir against S. pyogenes was 100% with range of MIC being less than 0.5 ${\mu}g/mL$. Conclusion : It seems that Cefdinir is one of reliable and well-tolerated drugs for the treatment of group A beta hemolytic streptococcal pharyngotonsillitis in children. It needs to be investigated short term efficacy in terms of improving drug compliance and impact of economic point of view. We can recognized that still high rate of the erythromycin resistant group A streptococci in our community should be monitored every year.