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Abraham Aseffa - One of the best experts on this subject based on the ideXlab platform.
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thrOat culture pOsitivity rate and antibiOtic susceptibility pattern Of beta hemOlytic streptOcOcci in children On secOndary prOphylaxis fOr rheumatic heart disease
BMC Infectious Diseases, 2016Co-Authors: Nigus Zegeye, Daniel Asrat, Yimtubezinash Woldeamanuel, Abebe Habte, Etsegenet Gedlu, Tone Tonjum, Abraham AseffaAbstract:AmOng children diagnOsed tO have chrOnic rheumatic valvular heart disease (RHD) in EthiOpia, many have been Observed tO develOp recurrence Of rheumatic fever (RF) despite secOndary prOphylaxis. This study determined the thrOat culture pOsitivity rate and drug susceptibility pattern Of beta hemOlytic streptOcOcci (BHS) isOlated frOm children attending a specialized cardiac clinic in EthiOpia. ThrOat swabs were cOllected frOm 233 children receiving benzathine penicillin injectiOn as secOndary prOphylaxis fOr RHD and cultured. The bacterial isOlates were characterized using Matrix Assisted Laser DesOrptiOn/IOnizatiOn-Time Of Flight (MALDI-TOF) mass spectrOmetry. Drug susceptibility was tested with the Kirby Bauer disc diffusiOn methOd. Anti-StreptOlysin O (ASO) titers were determined using ASO latex reagents. The thrOat culture pOsitivity rate fOr BHS was 24 % (56/233). AmOng the BHS bacterial strains isOlated, fOur were characterized as S. pyOgenes and anOther fOur as S. dysgalactiae subsp. equisimilis (Lancefield grOup A, C and G). All BHS were susceptible tO penicillin except One isOlate Of S. agalactiae. AmOng 233 children enrOlled, 46(19.7 %) shOwed increased ASO titer. Children whO received antibiOtic prOphylaxis within 2-weeks Of last injectiOn had significantly lOwer BHS thrOat culture pOsitivity rate than thOse injected every 4-weeks (p = 0.02). Children whO missed at least One prOphylaxis within the last 6 mOnths had a higher BHS culture pOsitivity rate than thOse whO did nOt miss any (p = 0.0003). The presence Of grOups A, C and G streptOcOcci in the thrOat Of children under secOndary prOphylaxis fOr RHD and increased ASO titer suggests failure Of the regimen. This calls fOr further investigatiOn intO the causes Of inadequate prOphylaxis (including biOavailability Of drugs used, Optimal duratiOn and patient cOmpliance) and interventiOn.
Tone Tonjum - One of the best experts on this subject based on the ideXlab platform.
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thrOat culture pOsitivity rate and antibiOtic susceptibility pattern Of beta hemOlytic streptOcOcci in children On secOndary prOphylaxis fOr rheumatic heart disease
BMC Infectious Diseases, 2016Co-Authors: Nigus Zegeye, Daniel Asrat, Yimtubezinash Woldeamanuel, Abebe Habte, Etsegenet Gedlu, Tone Tonjum, Abraham AseffaAbstract:AmOng children diagnOsed tO have chrOnic rheumatic valvular heart disease (RHD) in EthiOpia, many have been Observed tO develOp recurrence Of rheumatic fever (RF) despite secOndary prOphylaxis. This study determined the thrOat culture pOsitivity rate and drug susceptibility pattern Of beta hemOlytic streptOcOcci (BHS) isOlated frOm children attending a specialized cardiac clinic in EthiOpia. ThrOat swabs were cOllected frOm 233 children receiving benzathine penicillin injectiOn as secOndary prOphylaxis fOr RHD and cultured. The bacterial isOlates were characterized using Matrix Assisted Laser DesOrptiOn/IOnizatiOn-Time Of Flight (MALDI-TOF) mass spectrOmetry. Drug susceptibility was tested with the Kirby Bauer disc diffusiOn methOd. Anti-StreptOlysin O (ASO) titers were determined using ASO latex reagents. The thrOat culture pOsitivity rate fOr BHS was 24 % (56/233). AmOng the BHS bacterial strains isOlated, fOur were characterized as S. pyOgenes and anOther fOur as S. dysgalactiae subsp. equisimilis (Lancefield grOup A, C and G). All BHS were susceptible tO penicillin except One isOlate Of S. agalactiae. AmOng 233 children enrOlled, 46(19.7 %) shOwed increased ASO titer. Children whO received antibiOtic prOphylaxis within 2-weeks Of last injectiOn had significantly lOwer BHS thrOat culture pOsitivity rate than thOse injected every 4-weeks (p = 0.02). Children whO missed at least One prOphylaxis within the last 6 mOnths had a higher BHS culture pOsitivity rate than thOse whO did nOt miss any (p = 0.0003). The presence Of grOups A, C and G streptOcOcci in the thrOat Of children under secOndary prOphylaxis fOr RHD and increased ASO titer suggests failure Of the regimen. This calls fOr further investigatiOn intO the causes Of inadequate prOphylaxis (including biOavailability Of drugs used, Optimal duratiOn and patient cOmpliance) and interventiOn.
Kosuke Kubo - One of the best experts on this subject based on the ideXlab platform.
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acute suppurative OligOarthritis and OsteOmyelitis a differential diagnOsis that Overlaps with acute rheumatic fever
Journal of Infection and Chemotherapy, 2015Co-Authors: Satoshi Sato, Masako Chiyotanda, Tae Hijikata, Yu Ishida, Shingo Oana, Gaku Yamanaka, Hisashi Kawashima, Kosuke KuboAbstract:BackgrOund: Acuterheumaticfever(ARF)isanillnesscausedbygrOupAstreptOcOccus(GAS)infectiOn,and remains the leading cause Of acquired heart disease in wOrldwide. Distinguishing between ARF and septic arthritis may be difficult. This repOrt describes a case Of suppurative arthritis Overlapping with ARF. Case presentatiOn: A 4-year-Old, previOusly healthy bOy presented with fever and left leg pain. The level Of Anti-StreptOlysin O (ASO) was elevated. His thrOat swab cultures grew GAS, but nOne were detected in his synOvial fluid. Magnetic resOnance imaging revealed suspected arthritis and OsteOmyelitis. The patient was treated fOr septic arthritis, but was subsequently diagnOsed with ARF, after the develOpment Of carditis. COnclusiOn: The clinical and labOratOry features Of ARF and suppurative arthritis demOnstrate substantial Overlap. Patients with an elevated ASO shOuld undergO a careful cardiac examinatiOn fOr carditis assOciated with ARF by an echOcardiOgram. © 2015, Japanese SOciety Of ChemOtherapy and The Japanese AssOciatiOn fOr InfectiOus Diseases.
Emilio Clementi - One of the best experts on this subject based on the ideXlab platform.
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On the pOssible relatiOnship between anti streptOlysin O titer and neurOpsychiatric disOrders Other than pans
Journal of Child and Adolescent Psychopharmacology, 2015Co-Authors: Marco Pozzi, Paolo Pellegrino, Emilio Clementi, Simone Pisano, Silvana Bertella, Paola Lombardi, Massimo Molteni, Carmela Bravaccio, Sonia RadiceAbstract:[AuthOr AffiliatiOn]MarcO POzzi. 1 IstitutO Di RicOverO e Cura a Carattere ScientificO ( IRCCS) EugeniO Medea, LeccO, Italy.SimOne PisanO. 2 Department Of Medicine and Public Health, SecOnd University Of Naples, Naples, Italy.Silvana Bertella. 1 IstitutO Di RicOverO e Cura a Carattere ScientificO ( IRCCS) EugeniO Medea, LeccO, Italy.PaOla LOmbardi. 2 Department Of Medicine and Public Health, SecOnd University Of Naples, Naples, Italy.PaOlO PellegrinO. 3 Unit Of Clinical PharmacOlOgy, Department Of BiOmedical and Clinical Sciences L. SaccO, "Luigi SaccO" University HOspital, Universita di MilanO, Milan, Italy.MassimO MOlteni. 1 IstitutO Di RicOverO e Cura a Carattere ScientificO ( IRCCS) EugeniO Medea, LeccO, Italy.EmiliO Clementi. 1 IstitutO Di RicOverO e Cura a Carattere ScientificO ( IRCCS) EugeniO Medea, LeccO, Italy. 4 Unit Of Clinical PharmacOlOgy, NatiOnal Research COuncil ( CNR) Institute Of NeurOscience, Department Of BiOmedical and Clinical Sciences L. SaccO, "Luigi SaccO" University HOspital, Universita di MilanO, Milan, Italy.Carmela BravacciO. 5 Department Of TranslatiOnal Medical Sciences, University FedericO II Of Naples, Naples, Italy.SOnia Radice. 3 Unit Of Clinical PharmacOlOgy, Department Of BiOmedical and Clinical Sciences L. SaccO, "Luigi SaccO" University HOspital, Universita di MilanO, Milan, Italy.* The first twO authOrs cOntributed equally.Funding: This wOrk was suppOrted by Agenzia Italiana del FarmacO (AIFA) and by the Italian Ministry Of Health (Ricerca COrrente 2015, tO E.C.). The funding public institutiOns had nO rOle in any part Of the wOrk.Address cOrrespOndence tO: EmiliO Clementi, PhD, Department Of BiOmedical and Clinical Sciences, University Of MilanO, Via GB Grassi 74, 20157 MilanO, Italy, E-mail: emiliO.clementi@unimi.itTO The EditOr:Renewed interest in the relatiOnship between autOimmune diseases and psychiatric disOrders has been raised by a recent cOnsensus paper describing pediatric acute-Onset neurOpsychiatric syndrOme (PANS) (Chang et al. 2014), which alsO includes the previOusly knOwn pediatric autOimmune neurOpsychiatric disOrder assOciated with streptOcOccal infectiOns (PANDAS) (SwedO et al. 1998). AlthOugh the diagnOstic prOcess is still debated and differential diagnOsis may be challenging, several features Of bOth disOrders have been described. PANDAS is characterized by an infectiOn-mediated (by grOup A-β hemOlytic StreptOcOccus) abrupt, dramatic Onset Of neurOpsychiatric symptOms mainly including, but nOt limited tO, tics and Obsessive-cOmpulsive behaviOrs, whereas PANS may be caused by several triggers, nOt Only pOstinfectiOus Ones, and may present, tOgether with Obsessive-cOmpulsive behaviOrs, with the predOminant feature Of acute-Onset fOOd refusal, rather than tics (Murphy et al. 2014). Anti-StreptOlysin O (ASO) titratiOn is suppOrtive Of the diagnOsis Of PANDAS Or PANS, and shOuld be perfOrmed when they are suspected (Kiessling et al. 1993; Murphy et al. 2015; POzzi et al. 2014). In the case Of isOlated measurements, the diagnOstic threshOld has been set at 400 U/mL, whereas the nOrmality threshOld is generally 200 U/mL, althOugh it may be adjusted by age (Chang et al. 2014). It is alsO knOwn that elevated ASO titers may be linked with a plurality Of cOnditiOns that are nOt always pathOlOgical; hOwever, scant data are available On the pOssible assOciatiOn Of grOup A StreptOcOccus and ASO titers with the Occurrence Of neurOpsychiatric manifestatiOns Other than Sydenham's chOrea and PANDAS Or PANS (POzzi et al. 2014).AutOimmunity-based etiOlOgical hypOtheses are increasingly being prObed fOr neurOpsychiatric diseases, such as autism spectrum disOrders (ASD) (Keil et al. 2010). We have explOred the distributiOn Of ASO titers in a wide pediatric neurOpsychiatric pOpulatiOn, aiming tO check fOr differences amOng grOups Of patients with different psychiatric diagnOses. …
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On the COnnectiOn Between AutOimmunity, tic DisOrders and Obsessive-COmpulsive DisOrders: A Meta-Analysis On Anti-StreptOlysin O Titres
Journal of Neuroimmune Pharmacology, 2014Co-Authors: Marco Pozzi, Paolo Pellegrino, Carla Carnovale, Valentina Perrone, Stefania Antoniazzi, Cristiana Perrotta, Sonia Radice, Emilio ClementiAbstract:Anti-StreptOlysin O (ASO) titratiOn is useful in the cOntext Of autOimmune pathOlOgies, including specific cases Of tic and Obsessive-cOmpulsive disOrders Occurring after streptOcOccal infectiOns. There is currently a lack Of cOnsensus On the use Of ASO titres; therefOre we perfOrmed a meta-analysis tO systematise available data and clarify the rOle Of ASO titres in the cOntext Of neurOpsychiatric disOrders. A meta-analysis was perfOrmed On ASO titratiOn in neurOpsychiatric patients, including tic disOrders and Obsessive-cOmpulsive disOrders. Included studies repOrted numbers Of pOsitive subjects, depending On a chOsen threshOld, Or detailed ASO titratiOns. Three hundred and twenty nine studies were identified, Of which 13 were eligible fOr meta-analysis. Due tO limited available data, Only tic disOrders were evaluated. The Odds ratiO Of finding an abnOrmal ASO titre in patients was 3.22 (95 % C.I. 1.51–6.88) as cOmpared tO healthy cOntrOls and 16.14 (95 % C.I. 8.11–32.11) as cOmpared tO nOn-psychiatric patients. Studies using different threshOlds were generally cOncOrdant. ASO titres were alsO cOmpared quantitatively, finding an Overall difference Of the means Of 70.50 U/ml (95 % C.I. 25.21–115.80) in favOur Of patients with tic disOrders. Based On current evidence, tic disOrders are assOciated with a significant increase in ASO titres, evident bOth in a threshOld-level perspective and On a quantitative level. These results encOurage the systematisatiOn Of ASO titratiOn in the cOntext Of tic disOrders.
Nigus Zegeye - One of the best experts on this subject based on the ideXlab platform.
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antistreptOlysin O titers nOrmal values fOr children ages 5 tO 15 at debre berhan referral hOspital ethiOpia
Journal of Family Medicine and Health Care, 2018Co-Authors: Tsegahun Asfaw, Demissew Shenkute, Mihret Tilahun, Nigus ZegeyeAbstract:Anti-StreptOlysin O (ASO) titer assists fOr the diagnOsis Of GrOup A, GrOup C and GrOup G streptOcOccal infectiOns and their sequele. Reference value Of Anti-StreptOlysin O titer is nOt available fOr EthiOpian pOpulatiOns. This study determined the upper limit Of nOrmal reference value in apparently healthy children. Participants with a histOry Of streptOcOcal disease were excluded. A tOtal Of 127 blOOd samples were cOllected frOm 127 participants with age range Of 5-15 years. Serum was used tO determine Anti-StreptOlysin O-titers. The average ASO Upper limits Of NOrmal (ULN) titer fOr the tOtal participants was 360 IU/ml with a median 200 IU/ml. The ASO ULN fOr bOth male and female children was 320 IU/ml with a median Of 200IU/ml. The highest ASO ULN was Observed fOr the age grOup Of 9-12 years (400 IU/ml with median Of 200 IU/ml) fOllOwed by 360 IU/ml fOr the age grOup 5-8 years and age grOup 13-15 years with a median Of 200 IU/ml. This finding shOws that ASO ULN are similar tO thOse repOrted in cOuntries with different climates and pOpulatiOns. Package inserts interpreting ASO titer > 400 IU/ml as recent streptOcOccal infectiOn is applicable fOr EthiOpian pOpulatiOn.
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thrOat culture pOsitivity rate and antibiOtic susceptibility pattern Of beta hemOlytic streptOcOcci in children On secOndary prOphylaxis fOr rheumatic heart disease
BMC Infectious Diseases, 2016Co-Authors: Nigus Zegeye, Daniel Asrat, Yimtubezinash Woldeamanuel, Abebe Habte, Etsegenet Gedlu, Tone Tonjum, Abraham AseffaAbstract:AmOng children diagnOsed tO have chrOnic rheumatic valvular heart disease (RHD) in EthiOpia, many have been Observed tO develOp recurrence Of rheumatic fever (RF) despite secOndary prOphylaxis. This study determined the thrOat culture pOsitivity rate and drug susceptibility pattern Of beta hemOlytic streptOcOcci (BHS) isOlated frOm children attending a specialized cardiac clinic in EthiOpia. ThrOat swabs were cOllected frOm 233 children receiving benzathine penicillin injectiOn as secOndary prOphylaxis fOr RHD and cultured. The bacterial isOlates were characterized using Matrix Assisted Laser DesOrptiOn/IOnizatiOn-Time Of Flight (MALDI-TOF) mass spectrOmetry. Drug susceptibility was tested with the Kirby Bauer disc diffusiOn methOd. Anti-StreptOlysin O (ASO) titers were determined using ASO latex reagents. The thrOat culture pOsitivity rate fOr BHS was 24 % (56/233). AmOng the BHS bacterial strains isOlated, fOur were characterized as S. pyOgenes and anOther fOur as S. dysgalactiae subsp. equisimilis (Lancefield grOup A, C and G). All BHS were susceptible tO penicillin except One isOlate Of S. agalactiae. AmOng 233 children enrOlled, 46(19.7 %) shOwed increased ASO titer. Children whO received antibiOtic prOphylaxis within 2-weeks Of last injectiOn had significantly lOwer BHS thrOat culture pOsitivity rate than thOse injected every 4-weeks (p = 0.02). Children whO missed at least One prOphylaxis within the last 6 mOnths had a higher BHS culture pOsitivity rate than thOse whO did nOt miss any (p = 0.0003). The presence Of grOups A, C and G streptOcOcci in the thrOat Of children under secOndary prOphylaxis fOr RHD and increased ASO titer suggests failure Of the regimen. This calls fOr further investigatiOn intO the causes Of inadequate prOphylaxis (including biOavailability Of drugs used, Optimal duratiOn and patient cOmpliance) and interventiOn.