Can strep hide in the body from a throat culture?

[pmoreno]

The assumption would be that the strep was not completely killed off the first time. They did check to see that the strep bacteria which re-grew was of "concordent serotype" which I took to mean the same strain (or something like that) as the original infection.

 

Although, I suppose it is possible that someone could have gotten re-infected with the same strain as before. However, the interesting thing is it looked like the mean age of participants in the Kaplan study were 26 years old and for the vast majority, this was their first infection in a year. In other words, these were not like our younger kids who get many repeated strep infections in a school year (from lots of exposure) and it seems more logical that these adults are presenting with their own strep infections which were not completely killed off.

 

 

I am wondering if a child who has strep hiding in a biofilm (for instance, middle ear fluid) would that cause an ASO titer to be elevated? I took my daughter in today to have her throat cultured and she will have an ASO titer drawn tommorrow. They mentioned that she had a very small amount of fluid in her middle ear - not enough to worry about - she said. However, I'm wondering if even just a "small" amount would be enough to harbor strep bacteria. Her rapid strep test was negative, of course. They said they would also do a 24 hr. one. I mentioned that it usually doesn't grow out until 72 hrs, but they said they only do 24 hr ones.

[peglem]

I am wondering if a child who has strep hiding in a biofilm (for instance, middle ear fluid) would that cause an ASO titer to be elevated? I took my daughter in today to have her throat cultured and she will have an ASO titer drawn tommorrow. They mentioned that she had a very small amount of fluid in her middle ear - not enough to worry about - she said. However, I'm wondering if even just a "small" amount would be enough to harbor strep bacteria. Her rapid strep test was negative, of course. They said they would also do a 24 hr. one. I mentioned that it usually doesn't grow out until 72 hrs, but they said they only do 24 hr ones.

 

Of course I don't know for sure at all, but, my daughter tested positive on the rapid whenever she was not on antibiotics: I think reinfecting herself from biofilms. She never had high titers. But, i'm thinking with biofilms, the "cloaking device" hides them from the immune system so you probably won't see high titers as a result of that. I think there are very few docs who even know what to do with the titer results. Even if it comes back high...they don't even know if it indicates current infection (they'd say no in the face of a neg culture) or how long ago an infection occured. BUT....ASO and antidNase are antibodies to byproducts (or is it antigens? info overload here) of strepA. not the strep itself. So, I suppose if those products are being transported out of the biofilm you could get an immune response to them anyway.

 

So the answer to your question is....heck, I don't know!

[pmoreno]

I am wondering if a child who has strep hiding in a biofilm (for instance, middle ear fluid) would that cause an ASO titer to be elevated? I took my daughter in today to have her throat cultured and she will have an ASO titer drawn tommorrow. They mentioned that she had a very small amount of fluid in her middle ear - not enough to worry about - she said. However, I'm wondering if even just a "small" amount would be enough to harbor strep bacteria. Her rapid strep test was negative, of course. They said they would also do a 24 hr. one. I mentioned that it usually doesn't grow out until 72 hrs, but they said they only do 24 hr ones.

 

Of course I don't know for sure at all, but, my daughter tested positive on the rapid whenever she was not on antibiotics: I think reinfecting herself from biofilms. She never had high titers. But, i'm thinking with biofilms, the "cloaking device" hides them from the immune system so you probably won't see high titers as a result of that. I think there are very few docs who even know what to do with the titer results. Even if it comes back high...they don't even know if it indicates current infection (they'd say no in the face of a neg culture) or how long ago an infection occured. BUT....ASO and antidNase are antibodies to byproducts (or is it antigens? info overload here) of strepA. not the strep itself. So, I suppose if those products are being transported out of the biofilm you could get an immune response to them anyway.

 

So the answer to your question is....heck, I don't know!

 

 

I think you're right - you would think that there would be an immune response (especially if you're seeing behaviors) so it seems that there would be an increase in antibodies (high titers) in response to the antigen (strep). Pat

[EAMom]

http://www.journals.uchicago.edu/doi/pdf/10.1086/320745