PEDIATRICS Vol. 83 No. 3 March 1989, pp. 380-384
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Group A Streptococcus-Associated Upper Respiratory Tract Infections in a Day-Care Center

Thomas D. Smith MD1, Virginia Wilkinson RN1, and Edward L. Kaplan MD1

1 The Department of Pediatrics, University of Minnesota Medical School, Minneapolis, and Washington County Health Department, Stillwater, Minnesota

Little information is available about the epidemiology of group A streptococcal upper respiratory tract infections in child day-care centers. During an initial 3-month period, symptomatic upper respiratory tract infections associated with throat cultures or rapid antigen detection tests positive for group A streptococci developed in 55 of 214 (26%) children and adult staff in one day-care center. When the entire day-care center population (except for those receiving antibiotics at the time) was then surveyed, 52 of 146 (36%) children and two of 24 (8%) adult staff had throat cultures positive for group A streptococci. Of the 54 group A streptococcal isolates found during the survey, the three most frequently encountered serotypes were M2, T2/28 (35%), M3,T3/13 (30%), and M-NT, T25 (20%). Rapid antigen detection was performed at the same time as the throat culture in the first 98 individuals examined during the culture survey but was positive in only 11 (35%) of 31 individuals with positive throat cultures. Sensitivity of the rapid antigen test was related to degree of positivity of the throat culture but not to age. The overall group A streptococcal positivity rate was 49% for 187 children and 33% for 27 adult staff; 18 of 66 (27%) children younger than 3frac12 years of age were found to have group A streptococci in their upper respiratory tracts. This is the first report of high prevalence rates of group A streptococci associated with upper respiratory tract infections in a day-care center. The group A Streptococcus may represent a significant upper respiratory tract pathogen in the day-care setting.

Key Words: group A Streptococcus • upper respiratory tract infection • day care • serotype • rapid antigen detection • throat culture

Submitted on January 11, 1988
Accepted on March 23, 1988




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