A study of hemolytic streptococcal infections in relation to antistreptolysin O titer changes in orphanage children

UTHSC Affiliation

College of Medicine

Document Type

Article

Publication Date

1-1-1956

Publication Title

The Journal of Pediatrics

Volume

48

Issue

5

Abstract

Observations are reported on a one-yearorphanage study of hemolytic streptococcal infections, during which weekly throat cultures and monthly antistreptolysin O determinations were made. When these data were analyzed in relation to clinical and subclinical illness in the study group and the influence of limited specific therapy, the following observations were made:1.The high prevalence of infectionwith hemolytic streptococci during the early months of the study was considered to represent a convalescent carrier state, due to the low prevalence of clinical illness and the downward trend of antistreptolysin O titers.2.During this early period, widespreadinfection with Group C hemolytic streptococci was encountered, without associated clinical illness or significant increases in antistreptolysin O titer. However, the latter occurred during the subsequent months of the study in nine children following infection with this organism. The potential significance of Group C infections, in relation to rheumatic fever, is discussed.3.Clinical illness and significant increasesin antistreptolysin O titer were noted most frequently in the youngest age group and less frequently in the older age groups of the study, following the acquisition of Group A hemolytic streptococci.4.Significant increases in antistreptolysin O titer were preceded most frequently by upper respiratory illness in the youngest age group and less frequently in the older age groups, in whom subclinical infections were more common.5.Nontypable Group A hemolyticstreptococci encountered during our study appeared to be as capable of producing clinical illness and immunologic responses as typable organisms.6.Failure of prophylactic penicillinproducing adequate blood levels (0.03 to 0.125 unit per milliliter) to eradicate Group C hemolytic streptococci was observed in a few instances. While tetracycline hydrochloride achieved the eradication of these organisms, its administration was followed by the emergence of large numbers of staphylococci. The latter produced no adverse effects even during an epidemic of measles.7.The failure of short courses of penicillin and tetracycline antibiotics to eradicate hemolytic streptococci was repeatedly observed, and the implications of this, and of the observations made above, in the prevention of rheumatic fever are discussed. © 1956 The C. V. Mosby Company.

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