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References 1. Anon. Nosocomial group A streptococcal infections associated with asymptomatic health-care workers - Maryland and California. MMWR 1997 2. Cynthia S. Hayes, Harold Williamson. Management of Group A Beta-Hemolytic Streptococcal Pharyngitis. Am Fam Physician. 2001 Apr 15;63(8):1557-1565 3. Roxana Moldovan. Practical Bacteriology. Mirton. Timisoara.1998 4. Manandhar A, Shah Y, Shrestha J. Study on the Prevalence of Beta Haemolytic Streptococcus Among School Children. J Nepal Paediatr Soc. 2013;33(1):45-47 5. Patterson MJ. Streptococcus. Medical


Infectious arthritides in goats is mainly caused by mycoplasmas and Caprine Arthritis- Encephalitis virus (CAEV). Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) is a member of Lancefield group C beta-hemolytic streptococcus that commonly colonizes the mucous membranes of healthy equids which is also capable to induce different pathological conditions in many animal species. In this paper we described a case of polyarthritis in four Alpine goat-kids caused by S. zooepidemicus. Goat-kids originated from a farm where sheep, llamas, shepherd dogs, cows and horses were kept with goats. During the external examination of carcasses, crusts and discrete hyperemia were seen on the earlobes beneath the ear tag, as well as swollen joints. Necropsy findings included severe fibrinous polyarthritis in all four examined kids. Shoulder, knee and hip joints were affected. From all affected joints S. zooepidemicus was isolated. Neither Mycoplasma spp. nor CAEV genome were detected from the affected joints. Most likely the goatkids were infected with S. zooepidemicus through the lesions on earlobes which were made after the tagging. As a possible source of bacteria, we recognized the horses and dogs. Due to the lack of any signs of illness in other animal species on the farm, as well as negative pathomorphological findings in other organs, we assumed that the isolated strain is highly adapted to goat-kids. Our report is the first described case of polyarthritis in goat-kids caused by S. zooepidemicus.


The increased use of antibiotics for acute tonsillitis is a public health problem. 80% of the antibiotic prescriptions for acute tonsillitis are done in the Primary Care practice (PCP). The inappropriate use of the antibiotic causes bacterial resistance and treatment failure. Only patients with acute tonsillitis caused by Group A beta-hemolytic streptococcus (GAS) have benefit of the antibiotic treatment, which is a predict cause in 5-20%. In order to assess the antibiotic prescribing for acute tonsillitis by the doctors in the PCP in Macedonia we use the data from the national project about antibiotic prescribing for acute respiratory tract infections which was conducted in November 2014 during a period of 4 weeks as part of the E-quality program sponsored by the IPCRG. 86 general practitioners from Macedonia have participated. The group of 1768 patients, from 4 months to 88 years of age, with diagnosis of acute tonsillitis was analyzed. The antibiotic prescriptions according to the Centor score criteria were compared to the Cochran’s guidelines which are translated and recommended as national guidelines. 88.8% of the patients with acute tonsillitis were treated with antibiotics, of which 52.9% with Centor score 0 to 2 were treated inappropriate. The diagnosis is mostly made based on the clinical picture and the symptoms. Only (23.6%) of the patients were treated with antibiotics (Penicillin V and cephalexin) according to the guidelines.

We concluded that there is a low adherence to the national guidelines. The clinical assessment is not accurate in determining the etiology. Also, there is a high nonadherence in prescribing the first choice of antibiotics. We emphasize the need to change the general practitioners’ prescription behavior according to the guidelines.

Peritoneal Dialysis. Ann Intern Med 1980; 92(1): 7-13. 5. Port FK, Held PJ, Nolph KD, et al . Risk of peritonitis and technique failure by CAPD connection technique: a national study. Kidney Int 1992; 42: 967-974. 6. Borra SI, Chandarana J, Kleinfeld M. Fatal peritonitis due to group B beta-hemolytic streptococcus in a patient receiving chronic ambulatory peritoneal dialysis. Am J Kidney Dis 1992; 19: 375-377.

( Paralichthys olivaceus ) using selective isolation procedures – Aquaculture, 205: 7-17. Pier G.B., Madin S.H. 1976 – Streptococcus iniae sp. nov., a beta-hemolytic streptococcus isolated from and Amazon freshwater dolphin, Inia geoffrensis – Int. J. Syst. Bacteriol. 26: 545-553. Roberts R.J. 2001 – Fish pathology – W.B. Saunders Press, London, p. 324. Shin G.W., Palaksha K.J., Kim Y.R., Nho S.W., Kim S., Heo G.J., Park S.C., Jung T.S. 2007 – Application of immunoproteomics in developing Streptococcus iniae vaccine for olive flounder ( Paralichthys olivaceus ) – J

al. Erythromycin-resistant genes in group A β-haemolytic Streptococci in Chengdu, Southwestern China. Indian J Med Microbiol. 2014; 32:290-3. 10.4103/0255-0857.136568 Zhou W Jiang YM Wang HJ Kuang LH Hu ZQ Shi H et al Erythromycin-resistant genes in group A β-haemolytic Streptococci in Chengdu, Southwestern China Indian J Med Microbiol 2014 32 290 3 18 Zavadska D, Bērziņa D, Drukaļska L, Pugacova N, Miklasevics E, Gardovska D. Macrolide resistance in group A beta haemolytic Streptococcus isolated from outpatient children in Latvia. APMIS. 2010; 118: 366-70. 10