Abstract
Objective: To detect group A b hemolytic streptococci (GAbHS) in the throat of rheumatic patients receiving long acting penicillin (LAP) for 2ry prophylaxis using different schedules and to compare the results of ordinary throat culture versus latex agglutination for the rapid detection of streptococci.
Patients and methods: Setting. Pediatric cardiology and general pediatrics clinics, Ain Shams University Cairo, Egypt. A prospective study on 200 rheumatic children and 100 controls: all cases complained of sore throat. Rheumatic groups were: GI(n = 60) receiving LAP (Benzathine penicillin) every 3 weeks, GII (n=60) receiving LAP every 4 weeks, GIII (n=40) on oral penicillin (Phenoxymethyl penicillin), GIV (n=40) in rheumatic activity. Two throat swabs were taken from each case one for ordinary culture and the other for latex agglutination.
Results: Latex agglutination test for rapid detection of group A streptocacci had a 100% sensitivity and specificity. The biweekly LAP regimen significantly (P<0.01) eradicated throat streptococci than the 4 weeks and oral regimens A highly significant difference (P<0.001) was found between the biweekly regimen and the control group as regard the presence of GAbHS. Streptococci were the cause of pharyngitis in 20% of controls.
Conclusion: The latex agglutination test is a rapid, sensitive and specific tool for the detection of GAbHS, LAP is still the corner stone for 2ry prophylaxis in rheumatic fever. The biweekly schedule is superior to both the 4 weeks and the oral regimens in eradicating GAbHS.