Higher rates of streptococcal colonization among children in the Pacific Rim Region correlates with higher rates of group A streptococcal disease and sequelae

Clin Microbiol Infect. 2010 May;16(5):452-5. doi: 10.1111/j.1469-0691.2009.02879.x. Epub 2009 Jul 20.


Group A streptococcal (GAS) pharyngeal colonization rates were determined among 1061 asymptomatic students in Hawaii and American Samoa where acute rheumatic fever rates are high. All GAS isolates were emm sequence typed. Although pharyngeal colonization rates were low in Hawaii (3.4%), Pacific Islander children had significantly higher colonization rates (5.7% vs. 1.2% in other ethnic groups, p <0.05). The colonization rate was higher in American Samoa (13%). Few emm types that were infrequently observed in symptomatic infections in Hawaii were repeatedly identified in both sites. These emm types were previously described among asymptomatic children suggesting a type-specific association with pharyngeal colonization.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • American Samoa / epidemiology
  • Antigens, Bacterial / genetics
  • Bacterial Outer Membrane Proteins / genetics
  • Carrier Proteins / genetics
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Child
  • Female
  • Hawaii / epidemiology
  • Humans
  • Male
  • Multivariate Analysis
  • Pharynx / microbiology
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / microbiology
  • Streptococcus pyogenes / genetics
  • Streptococcus pyogenes / isolation & purification*


  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins
  • Carrier Proteins
  • streptococcal M protein