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Open Access 27-09-2022 | Adenovirus | Original Article

Detection of group A streptococcus in children with confirmed viral pharyngitis and antiviral host response

Authors: Lauri Ivaska, Jussi Niemelä, Kirsi Gröndahl-Yli-Hannuksela, Niina Putkuri, Jaana Vuopio, Tytti Vuorinen, Matti Waris, Kaisu Rantakokko-Jalava, Ville Peltola

Published in: European Journal of Pediatrics | Issue 12/2022

Abstract

Our aim was to study the detection of group A streptococcus (GAS) with different diagnostic methods in paediatric pharyngitis patients with and without a confirmed viral infection. In this prospective observational study, throat swabs and blood samples were collected from children (age 1–16 years) presenting to the emergency department with febrile pharyngitis. A confirmed viral infection was defined as a positive virus diagnostic test (nucleic acid amplification test [NAAT] and/or serology) together with an antiviral immune response of the host demonstrated by elevated (≥ 175 µg/L) myxovirus resistance protein A (MxA) blood concentration. Testing for GAS was performed by a throat culture, by 2 rapid antigen detection tests (StrepTop and mariPOC) and by 2 NAATs (Simplexa and Illumigene). Altogether, 83 children were recruited of whom 48 had samples available for GAS testing. Confirmed viral infection was diagnosed in 30/48 (63%) children with febrile pharyngitis. Enteroviruses 11/30 (37%), adenoviruses 9/30 (30%) and rhinoviruses 9/30 (30%) were the most common viruses detected. GAS was detected by throat culture in 5/30 (17%) with and in 6/18 (33%) patients without a confirmed viral infection. Respectively, GAS was detected in 4/30 (13%) and 6/18 (33%) by StrepTop, 13/30 (43%) and 10/18 (56%) by mariPOC, 6/30 (20%) and 9/18 (50%) by Simplexa, and 5/30 (17%) and 6/18 (30%) patients by Illumigene.

Conclusion: GAS was frequently detected also in paediatric pharyngitis patients with a confirmed viral infection. The presence of antiviral host response and increased GAS detection by sensitive methods suggest incidental throat carriage of GAS in viral pharyngitis.

What is Known: •The frequency and significance of GAS-virus co-detection are poorly characterised in children with pharyngitis. •Detection of a virus and the antiviral host response likely indicates symptomatic infection.
What is New: •Group A streptococcus (GAS) was detected in 17–43% of the children with confirmed viral pharyngitis depending on the GAS diagnostic method. •Our results emphasize the risk of detecting and treating incidental pharyngeal carriage of GAS in children with viral pharyngitis.

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Title: Detection of group A streptococcus in children with confirmed viral pharyngitis and antiviral host response
Authors: Lauri Ivaska
Jussi Niemelä
Kirsi Gröndahl-Yli-Hannuksela
Niina Putkuri
Jaana Vuopio
Tytti Vuorinen
Matti Waris
Kaisu Rantakokko-Jalava
Ville Peltola
Publication date: 27-09-2022
Publisher: Springer Berlin Heidelberg
Keywords: Adenovirus
Rhinovirus
Pharyngitis
Streptococci
Pharyngitis
Published in: European Journal of Pediatrics / Issue 12/2022
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-022-04633-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Detection of group A streptococcus in children with confirmed viral pharyngitis and antiviral host response

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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