Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studies

Introduction: This study examined group A streptococcus(GAS) carriage, emm types, and antibiotic susceptibility in children (6–13 years) in Aral, China, during the post-COVID-19 scarlet fever resurgence, providing regional insights. Methods: The prevalence of GAS carriage was assessed in 1,835 child...

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Main Authors: Mengyang Guo, Xiangping Hou, Wei Shi, Qian Huang, Wei Gao, Limin Dong, Yun Lai, Siyu Chen, Jianghong Deng, Kaihu Yao
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716525000906
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author Mengyang Guo
Xiangping Hou
Wei Shi
Qian Huang
Wei Gao
Limin Dong
Yun Lai
Siyu Chen
Jianghong Deng
Kaihu Yao
author_facet Mengyang Guo
Xiangping Hou
Wei Shi
Qian Huang
Wei Gao
Limin Dong
Yun Lai
Siyu Chen
Jianghong Deng
Kaihu Yao
author_sort Mengyang Guo
collection DOAJ
description Introduction: This study examined group A streptococcus(GAS) carriage, emm types, and antibiotic susceptibility in children (6–13 years) in Aral, China, during the post-COVID-19 scarlet fever resurgence, providing regional insights. Methods: The prevalence of GAS carriage was assessed in 1,835 children aged 6–13 years across two surveys at an Aral school in China during the post-COVID-19 resurgence of scarlet fever. GAS isolates were analyzed for emm types, M1UK lineage, and antimicrobial susceptibility using culture, PCR, sequencing, and automated methods. Results: The first survey (885 children) showed a 1.9% isolation rate, highest in 9-year-olds (4.8%) and slightly higher in boys (2.3% vs. 1.5%, P > 0.05). The second survey (950 children) reported a 3.1% rate, peaking at 10 years (6.7%) and also higher in boys (3.5% vs. 2.6%, P > 0.05). Colonization rates were similar overall (P > 0.05), but increased significantly in children aged ≥10 years (1.1% to 3.3%, P = 0.038). No children tested positive for GAS in both sampling rounds, which meant that the two surveys identified distinct host populations colonized by the bacteria. Emm12 prevalence decreased from 76.5% to 55.2% (P > 0.05), while emm1 increased from 11.8% to 31.0% (P > 0.05), with no M1UK lineage detected. All isolates were sensitive to penicillin, linezolid, vancomycin, and levofloxacin. Among 33 co-resistant isolates, emm12 accounted for 84.8% and emm1 for 15.2%. Conclusion: Despite low GAS carriage rates, variations in age distribution and emm types suggest increased bacterial activity, warranting ongoing monitoring for GAS-related diseases.
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spelling doaj-art-bf7df24541ef456aba66f7f9a59ca77c2025-08-20T02:35:06ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-06-014318318710.1016/j.jgar.2025.04.012Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studiesMengyang Guo0Xiangping Hou1Wei Shi2Qian Huang3Wei Gao4Limin Dong5Yun Lai6Siyu Chen7Jianghong Deng8Kaihu Yao9National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, ChinaClinical Laboratory, Sir Run Shaw Alaer Hospital, Zhejiang University School of Medicine, Aral, ChinaNational Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, ChinaDepartment of Pediatrics, Sir Run Shaw Alaer Hospital, Zhejiang University School of Medicine, Aral, ChinaNational Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, ChinaNational Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, ChinaDepartment of Pediatrics, Sir Run Shaw Alaer Hospital, Zhejiang University School of Medicine, Aral, ChinaNational Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, ChinaDepartment of Rheumatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, ChinaNational Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China; Corresponding author. Mailing address: National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute, National Clinical Research Center for Respiratory Disease, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.Introduction: This study examined group A streptococcus(GAS) carriage, emm types, and antibiotic susceptibility in children (6–13 years) in Aral, China, during the post-COVID-19 scarlet fever resurgence, providing regional insights. Methods: The prevalence of GAS carriage was assessed in 1,835 children aged 6–13 years across two surveys at an Aral school in China during the post-COVID-19 resurgence of scarlet fever. GAS isolates were analyzed for emm types, M1UK lineage, and antimicrobial susceptibility using culture, PCR, sequencing, and automated methods. Results: The first survey (885 children) showed a 1.9% isolation rate, highest in 9-year-olds (4.8%) and slightly higher in boys (2.3% vs. 1.5%, P > 0.05). The second survey (950 children) reported a 3.1% rate, peaking at 10 years (6.7%) and also higher in boys (3.5% vs. 2.6%, P > 0.05). Colonization rates were similar overall (P > 0.05), but increased significantly in children aged ≥10 years (1.1% to 3.3%, P = 0.038). No children tested positive for GAS in both sampling rounds, which meant that the two surveys identified distinct host populations colonized by the bacteria. Emm12 prevalence decreased from 76.5% to 55.2% (P > 0.05), while emm1 increased from 11.8% to 31.0% (P > 0.05), with no M1UK lineage detected. All isolates were sensitive to penicillin, linezolid, vancomycin, and levofloxacin. Among 33 co-resistant isolates, emm12 accounted for 84.8% and emm1 for 15.2%. Conclusion: Despite low GAS carriage rates, variations in age distribution and emm types suggest increased bacterial activity, warranting ongoing monitoring for GAS-related diseases.http://www.sciencedirect.com/science/article/pii/S2213716525000906Group A streptococcusStreptococcus pyogenesCarriagePrevalenceChildren
spellingShingle Mengyang Guo
Xiangping Hou
Wei Shi
Qian Huang
Wei Gao
Limin Dong
Yun Lai
Siyu Chen
Jianghong Deng
Kaihu Yao
Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studies
Journal of Global Antimicrobial Resistance
Group A streptococcus
Streptococcus pyogenes
Carriage
Prevalence
Children
title Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studies
title_full Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studies
title_fullStr Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studies
title_full_unstemmed Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studies
title_short Low GAS carriage in school-aged children in western China during the national atypical scarlet fever resurgence: Insights from two cross-sectional studies
title_sort low gas carriage in school aged children in western china during the national atypical scarlet fever resurgence insights from two cross sectional studies
topic Group A streptococcus
Streptococcus pyogenes
Carriage
Prevalence
Children
url http://www.sciencedirect.com/science/article/pii/S2213716525000906
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