# Throat Swab Culture Positivity Rate, Antibiotic Susceptibility Profile, and Associated Risk Factors of Streptococcus pyogenes Among Children With Acute Pharyngitis Attending Jigjiga University Sheik Hassan Yebere Referral Hospital, Jigjiga, Ethiopia

## TL;DR

This study found that about 14% of children with sore throats in Ethiopia had a bacterial infection caused by Streptococcus pyogenes, with household smoking and swollen tonsils as risk factors.

## Contribution

The study provides new data on the prevalence and risk factors of S. pyogenes in children with pharyngitis in a specific Ethiopian hospital setting.

## Key findings

- The prevalence of S. pyogenes infection was 14.3% among children with acute pharyngitis.
- Household smoking and tonsillar swelling were significantly associated with S. pyogenes infection.
- The bacteria showed resistance to tetracycline, azithromycin, chloramphenicol, and clindamycin.

## Abstract

Pharyngitis is inflammation of the oropharynx primarily caused by Streptococcus pyogenes. S. pyogenes is a Gram‐positive, catalase‐negative, β‐hemolytic, bacitracin‐sensitive bacterium. Group A streptococci (GAS) pharyngitis causes the most outpatient visits and frequent antibiotic prescriptions among children. In the study area, there is a lack of studies on the prevalence and antimicrobial susceptibility pattern of GAS pharyngitis.

To determine the throat swab culture positivity rate, antimicrobial resistance patterns, and associated factors of S. pyogenes infection among children with acute pharyngitis attending Jigjiga University Sheik Hassan Yebere Referral Hospital from February 8 to August 4, 2024, in Jigjiga, Ethiopia.

A cross‐sectional study was conducted among 468 participants recruited from the hospital pediatrics department through a convenience sampling method. Sociodemographic and clinical data were collected from the study participants using a structured questionnaire. Oropharyngeal swabs were collected and processed to identify the S. pyogenes pathogen using the conventional culture, followed by specific biochemical tests according to standard operating procedures. The Kirby–Bauer disk diffusion method was implemented for antimicrobial susceptibility testing. Data were entered into EpiData and then exported to SPSS Version 20, and the analysis was done.

Among the 468 study participants, 269 (57.5%) were males, and the mean age of the participants was 4, with a standard deviation (SD) of 3.6. The prevalence of S. pyogenes infection among children with pharyngitis attending the hospital was 14.3% (95% CI: 11.3–17.8). The presence of household smoking (AOR = 2.67; 95% CI: 1.47–4.89) and tonsillar swelling (AOR = 2.1; 95% CI: 1.03–4.19) were significantly associated with S. pyogenes infection. The isolated organisms showed resistance to tetracycline (17.9%), azithromycin (11.9%), chloramphenicol (10.4%), and clindamycin (9%).

The findings indicate that the prevalence of S. pyogenes infection in this study was slightly higher than that in comparable studies. The presence of household smokers and of tonsillar swelling was significantly associated with the positive S. pyogenes diagnosis.