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Streptococcus pyogenes as the cause of vulvovaginitis and balanitis in children
Author(s) -
Randjelovic Gordana,
Otasevic Suzana,
MladenovicAntic Snezana,
Mladenovic Vesna,
RadovanovicVelickovic Radmila,
Randjelovic Marina,
Bogdanovic Dragan
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13169
Subject(s) - balanitis , medicine , streptococcus pyogenes , bacitracin , penicillin , etiology , vulvitis , dermatology , antibiotics , microbiology and biotechnology , vaginitis , gynecology , biology , staphylococcus aureus , bacteria , genetics
Background Streptococcus pyogenes (group A Streptococcus ) is the etiological agent of perineal infection in children, consisting of perianal infection, vulvovaginitis and balanitis. If it is not properly diagnosed and treated, it can persist for many months and can cause severe complications. Furthermore, treatment with penicillin can be followed by failures and recurrences. Methods We report here the prevalence of S. pyogenes isolates in genital tract specimens from girls ( n = 1692) with symptoms of vulvovaginitis and from boys ( n = 52) with balanitis in the municipality of Nis, Southeast‐Serbia (the Western Balkans) in a 10 year period, and the seasonal distribution, patient age and sensitivity to bacitracin and antimicrobial drugs used in the treatment of streptococcal infection. Results Streptococcal vulvovaginitis was diagnosed in 2.30% of examinees. Of those cases, 64.10% were detected from April to September, and it was most common (71.79%) in girls aged 3–7 years. Streptococcal balanitis was diagnosed in two instances: in a 4‐year‐old boy and in a 7‐year‐old boy. S. pyogenes strains resistant to bacitracin were identified in five girls. Two isolates with M phenotype and five isolates with cMLS B phenotype were identified. Conclusions Streptococcal vulvovaginitis was diagnosed less often in the present study, but it was still far more common than streptococcal balanitis in childhood. Bacitracin resistance of S. pyogenes strains should be taken into account in routine microbiological identification, and the detection of S. pyogenes isolates resistant to erythromycin requires surveillance in the present geographical territory.