Clinical manifestations, diagnosis, and antimicrobial resistance of group A streptococci infections

Abstract

Group A streptococci (GAS) cause diverse diseases ranging from mild to severe illnesses, and the global burden of GAS infections is enormous. Serological typing has been replaced by emm genotyping for the epidemiological study of GAS. Acute bacterial pharyngitis is a common illness, which requires either throat culture or rapid Ag test for diagnosis. Moreover, molecular point-of-care tests have been introduced owing to their higher sensitivity. Optimal diagnosis of bacterial pharyngitis is necessary for the adequate use of antibiotics. Although antimicrobial resistance (AMR) to erythromycin or clindamycin does not seem serious in Korea, it is very high in China, being reported at over 90%. Antibiotic surveillance and relevant education are necessary for primary clinical physicians and pediatricians. It is necessary to monitor AMR and develop a system for reporting the appearance of highly virulent diseases, such as necrotizing fasciitis or streptococcal toxic-shock syndrome, to the government authority.