DOCSLIB.ORG

KRISTINA TRELL FACULTY of MEDICINE | LUND UNIVERSITY Department of Clinical Sciences Division of Infection Medicine

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
KRISTINA TRELL FACULTY of MEDICINE | LUND UNIVERSITY Department of Clinical Sciences Division of Infection Medicine Clinical and molecular studies of -haemolytic streptococci Trell, Kristina 2019 Document Version: Publisher's PDF, also known as Version of record Link to publication Citation for published version (APA): Trell, K. (2019). Clinical and molecular studies of β-haemolytic streptococci. Lund University: Faculty of Medicine. Total number of authors: 1 General rights Unless other specific re-use rights are stated the following general rights apply: Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Read more about Creative commons licenses: https://creativecommons.org/licenses/ Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. LUND UNIVERSITY PO Box 117 221 00 Lund +46 46-222 00 00 Clinical and molecular studies of β-haemolytic streptococci Trell, Kristina 2019 Document Version: Publisher's PDF, also known as Version of record Link to publication Citation for published version (APA): Trell, K. (2019). Clinical and molecular studies of β-haemolytic streptococci. Lund: Lund University, Faculty of Medicine. General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. LUND UNIVERSITY PO Box 117 221 00 Lund +46 46-222 00 00 Clinical and molecular studies of ß-haemolytic streptococci KRISTINA TRELL FACULTY OF MEDICINE | LUND UNIVERSITY Department of Clinical Sciences Division of Infection Medicine Lund University, Faculty of Medicine 198407 Doctoral Dissertation Series 2019:111 ISBN 978-91-7619-840-7 789176 ISSN 1652-8220 9 Clinical and molecular studies of β-haemolytic streptococci Kristina Trell DOCTORAL DISSERTATION With due permission of the Faculty of Medicine, Lund University, Sweden. To be defended in Belfragesalen, BMC D15, on November 15th 2019 at 09:00. Faculty opponent Steinar Skrede University of Bergen, Norway Organization Document name LUND UNIVERSITY Doctoral dissertation Department of Clinical Sciences Date of issue Division of Infection Medicine November 15th 2019 Author(s) Kristina Trell Sponsoring organization Title and subtitle Clinical and molecular studies of β-haemolytic streptococci Abstract Beta-haemolytic streptococci (BHS) are important causes of human infections and they have traditionally been grouped according to Lancefield antigens. The spectrum of infections caused by BHS includes pharyngitis, skin infections, bacteraemia/sepsis, endocarditis, septic arthritis and meningitis. The most studied BHS is the group A Streptococcus (GAS), which concurs with the species Streptococcus pyogenes (SP). In the last decades, several studies have shown an increase of invasive infections caused by beta-haemolytic streptococci group C (GCS) and group G (GGS). GCS and GGS cause clinical disease similar to GAS. The vast majority of clinical isolates associated with human infections, that are identified as GCS and GGS belong to the species Streptococcus dysgalactiae (SD). With the introduction of Matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) in routine diagnostics, it became possible to determine species of GGS and GCS. GCS and GGS exhibit the M-protein, a known virulence factor in GAS infections. The M-protein is encoded by the emm-gene and sequencing of this gene can be used for typing purposes. In the first study, isolates of GCS and GGS from different sites of isolation (throat, wound, and blood) were species determined and emm-typed to investigate if certain types have a predilection to cause particular infections. We found that GCS and GGS express different emm-types and that GCS and GGS from different sites of isolation were similar, suggesting that emm-types are not associated to certain disease presentations. In the second study, subjects with recurrent bacteraemia with GCS and GGS were identified and compared to controls with only one episode of bacteraemia to detect risk factors for recurrence. In the 23 patients with recurrent episodes of SD bacteraemia, most recurrences were caused by the same emm-type suggesting a host-specific colonization. In addition, no specific emm-types or other clinical factors were significantly associated with recurrences. Among GCS causing human infections, isolates of Streptococcus equi (SE) have been found. In the third study, the clinical course of patients with bacteraemia with SE was described and the isolates were typed through sequencing of the gene encoding the M-like protein SzP. Eighteen cases of SE were found during a thirteen-year period, which confirms that SE is a rare cause of infection in humans. No temporal or geographical clustering was found in our material. Our study also indicated that sporadic cases of SE bacteraemia have a favourable prognosis. In the fourth work, we investigated the possibility of using cultures for diagnostic purposes by determining the perianal colonization with BHS in patients with erysipelas compared with a control group. In the group with erysipelas, 44% of the patients were colonized with BHS compared with 4 % of the patients in the control group. The BHS found were most commonly GGS and when subjected to MALDI-TOF MS, these were found to be SD. We concluded that SD colonizes the perianal area in a substantial proportion of patients with erysipelas. SP is a well-known cause of postpartum infections and is still causing significant morbidity and mortality worldwide. In the final study, we described the use of whole genome sequencing (WGS) to investigate an outbreak of postpartum SP emm75 infections related to an asymptomatic carrier working in a maternity ward. Source identification and WGS proved to be vital for outbreak control. Key words Beta-haemolytic streptococci, Streptococcus dysgalactiae, MALDI-TOF MS, Streptococcus equi, Streptococcus pyogenes, Erysipelas, Endometritis Classification system and/or index terms (if any) Supplementary bibliographical information Language English ISSN 1652-8220 Lund University, Faculty of Medicine Doctoral ISBN 978-91-7619-840-7 Dissertation Series 2019:111 Recipient’s notes Number of pages 76 Price Security classification I, the undersigned, being the copyright owner of the abstract of the above-mentioned dissertation, hereby grant to all reference sources permission to publish and disseminate the abstract of the above-mentioned dissertation. Signature Date 2019-10-18 Clinical and molecular studies of β-haemolytic streptococci Kristina Trell Kristina Trell Division of Infection Medicine Department of Clinical Sciences Faculty of Medicine Lund University Biomedical Center, B14 Tornavägen 10 221 84 Lund Sweden Email: [email protected] The cover photo is a modified version of a pus specimen with Streptococcus pyogenes from the CDC photo bank Copyright Kristina Trell Paper 1 © Publisher Paper 2 © Publisher Paper 3 © Publisher Paper 4 © Publisher Paper 5 © by the Authors (Manuscript unpublished) Faculty of Medicine Department of Clinical Sciences, Lund ISBN 78-91-7619-840-7 ISSN 1652-8220 Lund University, Faculty of Medicine Doctoral Dissertation Series 2019:111 Printed in Sweden by Media-Tryck, Lund University, 2019 To my family Table of Contents List of papers ............................................................................................................ 9 Abbreviations ......................................................................................................... 11 Abstract .................................................................................................................. 13 Introduction ............................................................................................................ 15 Brief history of β-haemolytic streptococci ........................................................ 15 Methods for identification and typing of β-haemolytic streptococci ............... 16 Phenotypic methods for identification ..................................................................... 16 16S rRNA ................................................................................................................ 17 MALDI-TOF MS .................................................................................................... 17 Emm- and SzP-typing .............................................................................................
Load more

Recommended publications
  • Streptococcus Agalactiae Using Strand Invasion Based Amplification (SIBA®) Method
    Sanna Hirvonen Rapid detection of Streptococcus agalactiae using Strand Invasion Based Amplification (SIBA®) Method Helsinki Metropolia University of Applied Sciences Bachelor of Engineering Biotechnology and Food Engineering Bachelor’s Thesis 01.06.2017 Abstract Author(s) Sanna Hirvonen Title Rapid detection of Streptococcus agalactiae using Strand In- vasion Based Amplification (SIBA®) Method Number of Pages 41 pages + 1 appendix Date 1. June 2017 Degree Bachelor of Engineering Degree Programme Biotechnology and Food Engineering Specialisation option Kevin Eboigbodin, Senior Development Manager Instructor(s) Kirsi Moilanen, Project Manager Tiina Soininen, Senior Lecturer The aim of this Bachelor’s thesis was to develop a new and rapid method for the detection of Streptococcus agalactiae by using the isothermal SIBA®-method. S. agalactiae, i.e. group B streptococcus (GBS), is the leading cause of severe neonatal infections. In addi- tion, it causes infections for pregnant women, the elderly and people, who have some chronic disease. The experimental part of this thesis was executed at Orion Diagnostica’s Research and Development laboratory. The thesis was started by conducting oligoscreening to find the most suitable primer combinations. Along with the screening, GBS was grown on blood agar plate and LB broth. The genomic DNA was extracted from LB broth and quantified with qPCR. Primer combinations that passed the oligoscreening were tested with the ge- nomic DNA. Suitable assays were optimized, the sensitivity and specificity of the assays were tested, and the best assay was freeze-dried. In addition, the effect of different lytic enzymes to SIBA® reaction and GBS cells was tested. Lastly, the developed SIBA GBS assay was tested with clinical samples by using freeze-dried reagents.
    [Show full text]
  • Beta-Haemolytic Streptococci (BHS)
    technical sheet Beta-Haemolytic Streptococci (BHS) Classification Transmission Gram-positive cocci, often found in chains Transmission is generally via direct contact with nasopharyngeal secretions from ill or carrier animals. Family Animals may also be infected by exposure to ill or Streptococcaceae carrier caretakers. β-haemolytic streptococci are characterized by Lancefield grouping (a characterization based on Clinical Signs and Lesions carbohydrates in the cell walls). Only some Lancefield In mice and rats, generally none. Occasional groups are of clinical importance in laboratory rodents. outbreaks of disease associated with BHS are Streptococci are generally referred to by their Lancefield reported anecdotally and in the literature. In most grouping but genus and species are occasionally used. cases described, animals became systemically ill after experimental manipulation, and other animals Group A: Streptococcus pyogenes in the colony were found to be asymptomatic Group B: Streptococcus agalactiae carriers. In a case report not involving experimental Group C: Streptococcus equi subsp. zooepidemicus manipulation, DBA/2NTac mice and their hybrids were Group G: Streptococcus canis more susceptible to an ascending pyelonephritis and subsequent systemic disease induced by Group B Affected species streptococci than other strains housed in the same β-haemolytic streptococci are generally considered barrier. opportunists that can colonize most species. Mice and guinea pigs are reported most frequently with clinical In guinea pigs, infection with Group C streptococci signs, although many rodent colonies are colonized leads to swelling and infection of the lymph nodes. with no morbidity, suggesting disease occurs only with Guinea pigs can be inapparent carriers of the organism severe stress or in other exceptional circumstances.
    [Show full text]
  • Pathodxtra Strep Grouping
    of extracted streptococci antigens of prepared (as described in test procedure on solid media) representative strains of Lancefield Groups A Colonies On Solid Media: with an uninoculated mixing stick or inoculating loop. The A, B, C, D, F and G. The solution contains 1 Label one 12 × 75 mm test tube for each specimen. latex suspension should not show significant agglutination 0.098% sodium azide as preservative. Store 2 Add 1 free flowing drop of Reagent 1 to each specimen and the result serves as a control for direct comparison of at 2 to 8°C; stable until the expiration date tube by squeezing the bottle gently in a vertical the test performed with bacterial extract. Key Code TSMX7733B position. marked on the label. c) Carry out the complete test procedure on stock cultures www.oxoid.com/ifu 3 Pick 1 to 4 isolated ß-haemolytic colonies with a Reagent 1 (DR0709A) disposable applicator stick or with an inoculating loop of known groups. Europe + 800 135 79 135 US 1 855 236 0910 One bottle containing 4.0 ml of a blue and resuspend them in Reagent 1. (If colonies are 10 RESULTS CA 1 855 805 8539 ROW +31 20 794 7071 coloured sodium nitrite solution with minute sufficient colonies should be resuspended in 0.098% sodium azide as preservative. Store Reagent 1 to ensure it becomes turbid.) Do not use INTERPRETATION upright and tightly capped; stable at 2 to a swab, since it will absorb too much of the liquid 10.1 POSITIVE RESULT: A positive reaction occurs when there volume.
    [Show full text]
  • BD™ Enterococcosel™ Agar
    INSTRUCTIONS FOR USE – READY-TO-USE PLATED MEDIA PA-254019.06 Rev.: Mar 2013 BD Enterococcosel Agar INTENDED USE BD Enterococcosel Agar is a selective medium for the isolation and enumeration of fecal streptococci (group D) from clinical specimens. PRINCIPLES AND EXPLANATION OF THE PROCEDURE Microbiological method. This medium is based on the Bile Esculin Agar formulation of Rochaix which was later modified by Isenberg et al. by reducing the bile concentration and by adding sodium azide.1,2 This modification is supplied as BD Enterococcosel Agar. The medium is a standard formulation for the isolation of enterococci.3-5 Two peptones provide nutrients. Group D streptococci (including enterococci) hydrolyze esculin to esculetin and glucose. Esculetin reacts with an iron salt to form a dark brown or black complex. Ferric citrate is included as an indicator and reacts with esculetin to produce a brown to black complex. Oxgall is used to inhibit gram-positive bacteria other than enterococci. Sodium azide is inhibitory to gram-negative micro-organisms.5-7 REAGENTS BD Enterococcosel Agar Formula* Per Liter Purified Water Pancreatic Digest of Casein 17.0 g Peptic Digest of Animal Tissue 3.0 Yeast Extract 5.0 Oxgall 10.0 Sodium Chloride 5.0 Esculin 1.0 Ferric Ammonium Citrate 0.5 Sodium Azide 0.25 Sodium Citrate 1.0 Agar 13.5 pH 7.1+/- 0.2 *Adjusted and/or supplemented as required to meet performance criteria. PRECAUTIONS . For professional use only. Do not use plates if they show evidence of microbial contamination, discoloration, drying, cracking or other signs of deterioration.
    [Show full text]
  • Streptex Rapid Contains Sufficient Material for 50 Tests, See Kit Contents
    Latex Suspensions 2. In accordance with the principles of Good Laboratory Practice it is strongly PROCEDURE Five plastic dropper bottles, one specific for each of the recommended that extracts at any stage of testing should be treated as MATERIALS PROVIDED groups A, B, C, F and G, each containing sufficient for 50 potentially infectious and handled with all necessary precautions. Streptex Rapid contains sufficient material for 50 tests, see Kit Contents. tests. The polystyrene latex particles, which are coated 3. Non-disposable apparatus should be sterilised by any appropriate with purified rabbit antibody to the appropriate group procedure after use, although the preferred method is to autoclave for TEST PROCEDURE antigen, are suspended at a concentration of 0.5% in Key Code TSMX7797B 15 minutes at 121°C; disposables should be autoclaved or incinerated. CAUTION: Precautions appropriate to the handling of live cultures should phosphate buffer pH 7.4 containing 0.1% sodium azide. Spillage of potentially infectious materials should be removed be taken while performing the tests. immediately with absorbent paper tissue and the contaminated area www.oxoid.com/ifu The Latex Suspensions are supplied ready for A suggested outline scheme for grouping organisms from primary plates or swabbed with a standard bacterial disinfectant or 70% alcohol. Do NOT Europe + 800 135 79 135 US 1 855 236 0910 use and should be stored upright at 2 to subculture is shown in Figure 3. 8°C where they will retain activity at least until use sodium hypochlorite. Materials used to clean spills, including gloves, For each culture: CA 1 855 805 8539 ROW +31 20 794 7071 the date shown on the bottle labels.
    [Show full text]
  • Streptococcosis Humans and Animals
    Zoonotic Importance Members of the genus Streptococcus cause mild to severe bacterial illnesses in Streptococcosis humans and animals. These organisms typically colonize one or more species as commensals, and can cause opportunistic infections in those hosts. However, they are not completely host-specific, and some animal-associated streptococci can be found occasionally in humans. Many zoonotic cases are sporadic, but organisms such as S. Last Updated: September 2020 equi subsp. zooepidemicus or a fish-associated strain of S. agalactiae have caused outbreaks, and S. suis, which is normally carried in pigs, has emerged as a significant agent of streptoccoccal meningitis, septicemia, toxic shock-like syndrome and other human illnesses, especially in parts of Asia. Streptococci with human reservoirs, such as S. pyogenes or S. pneumoniae, can likewise be transmitted occasionally to animals. These reverse zoonoses may cause human illness if an infected animal, such as a cow with an udder colonized by S. pyogenes, transmits the organism back to people. Occasionally, their presence in an animal may interfere with control efforts directed at humans. For instance, recurrent streptococcal pharyngitis in one family was cured only when the family dog, which was also colonized asymptomatically with S. pyogenes, was treated concurrently with all family members. Etiology There are several dozen recognized species in the genus Streptococcus, Gram positive cocci in the family Streptococcaceae. Almost all species of mammals and birds, as well as many poikilotherms, carry one or more species as commensals on skin or mucosa. These organisms can act as facultative pathogens, often in the carrier. Nomenclature and identification of streptococci Hemolytic reactions on blood agar and Lancefield groups are useful in distinguishing members of the genus Streptococcus.
    [Show full text]
  • JOURNAL of CLINICAL MICROBIOLOGY VOLUME 20 * DECEMBER 1984 * NUMBER 6 Henry D
    JOURNAL OF CLINICAL MICROBIOLOGY VOLUME 20 * DECEMBER 1984 * NUMBER 6 Henry D. Isenberg, Editor in Chief (1989) Herman Friedman, Editor (1985) Peter B. Smith, Editor (1989) Long Island Jewish-Hillside College ofMedicine Centers for Disease Control Medical Center University of South Florida Atlanta, Ga. New Hyde Park, N. Y. Tampa, Fla. Richard C. Tilton, Editor (1989) Steven D. Douglas, Editor (1988) Michael R. McGinnis, Editor (1985) University of Connecticut School of Children's Hospital ofPhiladelphia North Carolina Memorial Hospital Medicine Philadelphia, Pa. Chapel Hill, N.C. Farmington, Conn. Nathalie J. Schmidt, Editor (1985) California Department ofHealth, Berkeley, Calif. EDITORIAL BOARD Libero Ajello (1985) J. J. Farmer (1986) Walter J. Loesche (1985) Joseph D. Schwartzman (1985) William L. Albritton (1984) Mary Jane Ferraro (1984) Victor Lorian (1984) Alexis Shelokov (1985) Stephen D. Allen (1984) Patricia Ferrieri (1986) James D. MacLowry (1986) Maurice C. Shepard (1985) Daniel Amsterdam (1986) Sydney M. Finegold (1985) Laurence R. McCarthy (1986) Patricia L. Shipley (1985) Ann M. Arvin (1984) James Folds (1984) Kenneth McClatchy (1986) David M. Shlaes (1985) Lawrence Ash (1986) Marianne Forsgren (1984) Joseph E. McDade (1985) Marcelino F. Sierra (1984) Arthur L. Barry (1984) Earl H. Freimer (1984) Jerry R. McGhee (1985) Robert M. Smibert II (1984) Barry Beaty (1984) Lynn S. Garcia (1986) Joseph L. Melnick (1985) James W. Smith (1986) John E. Bennett (1985) W. Lance George (1984) Thomas Mitchell (1984) Steven Specter (1986) Merlin S. Bergdoll (1985) Gerald L. Gilardi (1986) Josephine A. Morello (1984) Leslie Spence (1985) Jennifer M. Best (1984) Robert C. Good (1985) Stephen A. Morse (1986) Roy W.
    [Show full text]
  • Streptococci
    STREPTOCOCCI Streptococci are Gram-positive, nonmotile, nonsporeforming, catalase-negative cocci that occur in pairs or chains. Older cultures may lose their Gram-positive character. Most streptococci are facultative anaerobes, and some are obligate (strict) anaerobes. Most require enriched media (blood agar). Streptococci are subdivided into groups by antibodies that recognize surface antigens (Fig. 11). These groups may include one or more species. Serologic grouping is based on antigenic differences in cell wall carbohydrates (groups A to V), in cell wall pili-associated protein, and in the polysaccharide capsule in group B streptococci. Rebecca Lancefield developed the serologic classification scheme in 1933. β-hemolytic strains possess group-specific cell wall antigens, most of which are carbohydrates. These antigens can be detected by immunologic assays and have been useful for the rapid identification of some important streptococcal pathogens. The most important groupable streptococci are A, B and D. Among the groupable streptococci, infectious disease (particularly pharyngitis) is caused by group A. Group A streptococci have a hyaluronic acid capsule. Streptococcus pneumoniae (a major cause of human pneumonia) and Streptococcus mutans and other so-called viridans streptococci (among the causes of dental caries) do not possess group antigen. Streptococcus pneumoniae has a polysaccharide capsule that acts as a virulence factor for the organism; more than 90 different serotypes are known, and these types differ in virulence. Fig. 1 Streptococci - clasiffication. Group A streptococci causes: Strep throat - a sore, red throat, sometimes with white spots on the tonsils Scarlet fever - an illness that follows strep throat. It causes a red rash on the body.
    [Show full text]
  • Factors Affecting Experimental Streptococcus Agalactiae Infection in Tilapia, Oreochromis Niloticus
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Stirling Online Research Repository FACTORS AFFECTING EXPERIMENTAL STREPTOCOCCUS AGALACTIAE INFECTION IN TILAPIA, OREOCHROMIS NILOTICUS THESIS SUBMITTED TO THE UNIVERSITY OF STIRLING FOR THE DEGREE OF DOCTOR OF PHILOSOPHY BY DILOK WONGSATHEIN 27 SEPTEMBER 2012 INSTITUTE OF AQUACULTURE Declaration Declaration I declare that this thesis has been composed in its entirety by me. Except where specifically acknowledged, the work described in this thesis has been conducted by me and has not been submitted for any other degree. Signature: _________________________________________ Signature of supervisor: _________________________________________ Date: _________________________________________ II Abstract Abstract Streptococcus agalactiae infection is one of the major disease problems affecting farmed tilapia (Oreochromis niloticus) worldwide. Tilapia are highly susceptible to this disease which results in mortality of up to 70% over a period of around 7 days and significant economic losses for farmers. Affected tilapia commonly present with an irregular behaviour associated with meningoencephalitis and septicaemia. Currently, factors affecting the virulence and transmission of S. agalactiae in fish including tilapia are poorly understood. Reports from natural outbreaks of S. agalactiae infection on tilapia farms have suggested larvae and juvenile or fish smaller than 20 g are not susceptible. In addition, there is variability in individual response to experimental inflammatory challenge associated with coping styles (bold, shy) in common carp (Cyprinus carpio). The central hypotheses of this thesis were that weight, age and coping style might affect the development and progression of this bacterial disease. This study investigated these three factors with experimental S. agalactiae infection in Nile tilapia.
    [Show full text]
  • Comparison of Grouping Methods for Beta-Hemolytic Streptococci" (1982)
    Western Kentucky University TopSCHOLAR® Masters Theses & Specialist Projects Graduate School 5-1982 Comparison of Grouping Methods for Beta- Hemolytic Streptococci Renee Smith Western Kentucky University Follow this and additional works at: https://digitalcommons.wku.edu/theses Part of the Biology Commons Recommended Citation Smith, Renee, "Comparison of Grouping Methods for Beta-Hemolytic Streptococci" (1982). Masters Theses & Specialist Projects. Paper 2865. https://digitalcommons.wku.edu/theses/2865 This Thesis is brought to you for free and open access by TopSCHOLAR®. It has been accepted for inclusion in Masters Theses & Specialist Projects by an authorized administrator of TopSCHOLAR®. For more information, please contact [email protected]. Smith, Renee V. 1982 COMPARISON OF GROUPING METHODS FOR BETA-HEMOLYTIC STREPTOCOCCI A Thesis Presented to the Faculty of the Department of Biology Western Kentucky University Bowling Green, Kentucky In Partial Fulfillment of the Requirements for the Degree Master of Science by Renee V. Smith May, 1982 AUTHORIZATION FOR USE OF THESIS Permission is hereby 0-granted to the Western Kentucky University Library to make, or allow to be made photocopies, microfilm or other copies of this thesis for appropriate reseai-ch or scholarly purposes. reserved to the author for the making of any copies of this 11tFesis except for brief sections for research or scholarly purposes. Signed ().101.thi- Date jk._& Ki 7Q, Please place an "X" in the appropriate box. This form will be filed with the original of the thesis and will control future use of the thesis. COMPARISON OF GROUPING METHODS FOR BETA-HEMOLYTIC STREPTOCOCCI Recommended \-1/,2,5 z ate) k.V • Y`.4.4_ tor of Thesis Dean of the Gra'liege ACKNOWLEDGMENTS I wish to thank Dr.
    [Show full text]
  • Streptococcal Throat Carriage Among Primary School Children Living in Uyo, Southern Nigeria
    Published online: 2021-02-09 THIEME e28 Original Article Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria Kevin B. Edem1 Enobong E. Ikpeme1 Mkpouto U. Akpan1 1 Department of Paediatrics, University of Uyo Teaching Hospital, Address for correspondence Kevin Bassey Edem, MBBCH, FWACP, Uyo, Akwa Ibom State, Nigeria Department of Paediatrics, University of Uyo Teaching Hospital, PMB 1136, Uyo, Akwa Ibom State, Nigeria J Child Sci 2021;11:e28–e34. (e-mail: [email protected]). Abstract Surveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross- sectional studyof 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer’s exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with Keywords asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest ► β-hemolytic with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were streptococci susceptible to penicillin.
    [Show full text]
  • The Use of GMDN Codes for IVD Medical Devices in Australia
    The use of GMDN codes for IVD medical devices in Australia September 2010 Therapeutic Goods Administration About the Therapeutic Goods Administration (TGA) · The TGA is a division of the Australian Government Department of Health and Ageing, and is responsible for regulating medicines and medical devices. · TGA administers the Therapeutic Goods Act 1989 (the Act), applying a risk management approach designed to ensure therapeutic goods supplied in Australia meet acceptable standards of quality, safety and efficacy (performance), when necessary. · The work of the TGA is based on applying scientific and clinical expertise to decision-making, to ensure that the benefits to consumers outweigh any risks associated with the use of medicines and medical devices. · The TGA relies on the public, healthcare professionals and industry to report problems with medicines or medical devices. TGA investigates reports received by it to determine any necessary regulatory action. · To report a problem with a medicine or medical device, please see the information on the TGA website. Copyright © Commonwealth of Australia 2010 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Attorney General’s Department, National Circuit, Barton ACT 2600 or posted at http://www.ag.gov.au/cca The use of GMDN codes for IVD medical devices in Australia, Page i September 2010 Therapeutic Goods Administration The use of GMDN codes for IVD medical devices in Australia This section Global Medical Device Nomenclature (GMDN) ...............................................
    [Show full text]