The Clinical Presentation of Fusobacterium-Positive and Streptococcal-Positive Pharyngitis in a University Health Clinic A Cross-sectional Study
The Clinical Presentation of Fusobacterium-Positive and Streptococcal-Positive Pharyngitis in a University Health Clinic A Cross-sectional Study
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DOI：
10.7326/m14-1305
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发表时间：
2015-02-17
影响因子：
39.2
通讯作者：
Waites, Ken B.
中科院分区：
文献类型：
--
作者：
Centor, Robert M.;Atkinson, Prescott;Waites, Ken B.
背景：咽炎指南只关注A组溶血性链球菌感染。欧洲数据显示，在15至30岁的患者中，至少10%的咽炎病例是由坏死梭杆菌引起的；然而，美国的数据很少。目的：了解死角镰孢菌的流行情况；肺炎支原体;以及A组和C/G组乙型溶血性链球菌性咽炎，以确定坏死链球菌性咽炎在临床上是否与A组乙型溶血性链球菌性咽炎相似。设计:横断面。单位：大学生健康诊所。患者：312名年龄在15至30岁之间的学生因急性喉咙痛到学生健康诊所就诊，180名无症状学生。测量方法：从咽拭子中进行聚合酶链反应测试，以检测4种细菌和体征和症状，用于计算Centor评分。结果：死亡梭杆菌检出率为20.5%，无症状学生检出率为9.4%。10.3%的患者和1.1%的无症状学生检出A组溶血性链球菌。9.0%的患者和3.9%的无症状学生检出C/G组乙型溶血性链球菌。肺炎支原体检出率为1.9%，无症状学生为0例。necrophorum、A组链球菌和C/G组链球菌的感染率随着Centor评分的增加而增加（P < 0.001）。局限性：该研究集中在一个有限的年龄组，并在一个机构进行。无症状的学生——而不是季节性控制的参与者——和一个方便的样本被使用。结论：在学生群体中，坏死梭杆菌阳性咽炎的发生率高于A组溶血性链球菌阳性咽炎，且坏死梭杆菌阳性咽炎在临床上与链球菌性咽炎相似。
Background: Pharyngitis guidelines focus solely on group A beta-hemolytic streptococcal infection. European data suggest that in patients aged 15 to 30 years, Fusobacterium necrophorum causes at least 10% of cases of pharyngitis; however, few U.S. data exist.Objective: To estimate the prevalence of F. necrophorum; Mycoplasma pneumoniae; and group A and C/G beta-hemolytic streptococcal pharyngitis and to determine whether F. necrophorum pharyngitis clinically resembles group A beta-hemolytic streptococcal pharyngitis.Design: Cross-sectional.Setting: University student health clinic.Patients: 312 students aged 15 to 30 years presenting to a student health clinic with an acute sore throat and 180 asymptomatic students.Measurements: Polymerase chain reaction testing from throat swabs to detect 4 species of bacteria and signs and symptoms used to calculate the Centor score.Results: Fusobacterium necrophorum was detected in 20.5% of patients and 9.4% of asymptomatic students. Group A beta-hemolytic streptococcus was detected in 10.3% of patients and 1.1% of asymptomatic students. Group C/G beta-hemolytic streptococcus was detected in 9.0% of patients and 3.9% of asymptomatic students. Mycoplasma pneumoniae was detected in 1.9% of patients and 0 asymptomatic students. Infection rates with F. necrophorum, group A streptococcus, and group C/G streptococcus increased with higher Centor scores (P < 0.001).Limitations: The study focused on a limited age group and took place at a single institution. Asymptomatic students-rather than seasonal control participants-and a convenience sample were used.Conclusion: Fusobacterium necrophorum-positive pharyngitis occurs more frequently than group A beta-hemolytic streptococcal-positive pharyngitis in a student population, and F. necrophorum-positive pharyngitis clinically resembles streptococcal pharyngitis.