• Limor Adler, Or Tzadok Zehavi, Miriam Parizade, Yair Hershkovitz, Menashe Meni Amran, Robert Hoffman, Tal Hakmon Aronson, Erela Rotlevi, Bar Cohen, and Ilan Yehoshua.
• Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
• Isr Med Assoc J. 2024 Apr 1; 26 (4): 232235232-235.

BackgroundThe prevalence of Group A streptococcus (GAS) carriage among adults is studied less than in children. The variability of reported carriage rates is considerably large and differs among diverse geographic areas and populations.ObjectivesTo evaluate the prevalence of GAS carriage among adults in Israel.MethodsIn this prospective study, conducted in a large healthcare maintenance organization in Israel, we obtained pharyngeal cultures from adults attending the clinic without upper respiratory tract complaints or fever. Patient data included sex, age, number of children, and religious sectors.ResultsFrom May to December 2022, eight family physicians collected a total of 172 throat swabs (86% response rate). The median age was 37 years (range 18-65); 72.7% were females, 22.7% were ultra-Orthodox Jewish, and 69.2% had children. The prevalence of GAS carriage was 6.98%, 95% confidence interval (95%CI) 3.7%-11.9%. GAS carriers were younger (31.7 vs. 39.3 years, P = 0.046), and the majority were ultra-Orthodox Jews (58.3% vs. 20%, P = 0.006). All GAS carriers were from lower socioeconomic status. When assessing risk factors for GAS carriage using multivariate analysis, only being an ultra-Orthodox Jew was positively related to GAS carriage (adjusted odds ratio 5.6, 95%CI 1.67-18.8).ConclusionsBeing an ultra-Orthodox Jew was the single variable associated with a GAS carriage, which may be related to having many children at home and living in overcrowded areas. Primary care physicians in Israel should recognize this situation when examining patients with sore throats, mainly ultra-Orthodox Jews.

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