Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study.
BACKGROUND: Management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclea...
| Glavni autori: | , , , , |
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| Format: | Journal article |
| Jezik: | English |
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2012
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| _version_ | 1826293333874442240 |
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| author | Little, P Hobbs, F Mant, D McNulty, C Mullee, M |
| author_facet | Little, P Hobbs, F Mant, D McNulty, C Mullee, M |
| author_sort | Little, P |
| collection | OXFORD |
| description | BACKGROUND: Management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs. AIM: To assess the incidence and clinical variables associated with streptococcal infections. DESIGN AND SETTING: Prospective diagnostic cohort study in UK primary care. METHOD: The presence of pathogenic streptococci from throat swabs was assessed among patients aged ≥5 years presenting with acute sore throat. RESULTS: Pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient's assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors' assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42). CONCLUSION: Non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting. |
| first_indexed | 2024-03-07T03:28:30Z |
| format | Journal article |
| id | oxford-uuid:b9debdf3-fc38-4f17-b802-ec9c6be069e6 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:28:30Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:b9debdf3-fc38-4f17-b802-ec9c6be069e62022-03-27T05:06:02ZIncidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b9debdf3-fc38-4f17-b802-ec9c6be069e6EnglishSymplectic Elements at Oxford2012Little, PHobbs, FMant, DMcNulty, CMullee, MBACKGROUND: Management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs. AIM: To assess the incidence and clinical variables associated with streptococcal infections. DESIGN AND SETTING: Prospective diagnostic cohort study in UK primary care. METHOD: The presence of pathogenic streptococci from throat swabs was assessed among patients aged ≥5 years presenting with acute sore throat. RESULTS: Pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient's assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors' assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42). CONCLUSION: Non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting. |
| spellingShingle | Little, P Hobbs, F Mant, D McNulty, C Mullee, M Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. |
| title | Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. |
| title_full | Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. |
| title_fullStr | Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. |
| title_full_unstemmed | Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. |
| title_short | Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. |
| title_sort | incidence and clinical variables associated with streptococcal throat infections a prospective diagnostic cohort study |
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