Background: Treating S. pyogenes pharyngitis with antibiotics is recommended after confirming its presence using culture or rapid antigen tests. Limiting unnecessary antibiotics use is important in attempt to avoid rising resistance to drugs such as macrolides. Not all individuals carrying S. pyogenes are infected.
Objective: To evaluate the carriage rate of S. pyogenes and methicillin resistant S. aureus (MRSA) among healthy children in the Reykjavík capital area.
Subjects and methods: Cross-sectional study for the carriage of S. pyogenes and MRSA among healthy children in the town of Gardabaer. The study took place in March and April 2005. Throat cultures were collected from 270 asymptomatic healthy primary school students and cultured selectively for S. pyogenes and MRSA and tested for antimicrobial susceptibilities.
Results: Prevalence of S. pyogenes was found to be 22%. The proportion of carriers in 1st to 6th grade was 28%, compared with 11% in 7th to 10th grade students. The highest proportion was in 1st grade, 45%. The proportion S. pyogenes resistant to erythromycin was 17%, to tetracycline 13% and clindamycin 2%. All strains were susceptible to penicillin. No MRSA strains were found.
Conclusions: The study reveals a high S. pyogenes carriage rate in primary school children in Garethabaer. Physicians should consider the prevalence of streptococcal carriage when diagnosing streptococcal pharyngitis in children, and only perform culture and/or antigen tests when clinically indicated.