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Streptococcal pharyngitis

Deborah A Williamson, Pierre R Smeesters, Andrew C Steer, Julie Morgan, Mark Davies, Philip Carter, Arlo Upton, Stephen Y C Tong, John Fraser, Nicole J Moreland
BACKGROUND: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are responsible for a significant disease burden amongst Māori and Pacific populations in New Zealand (NZ). However, contemporary data are lacking regarding circulating group A Streptococcal (GAS) strains in NZ. Such information is important in guiding vaccine development. METHODS: GAS isolates from April to June 2015 were recovered from skin and pharyngeal samples from children living in areas of high social deprivation in Auckland, NZ, a significant proportion of which are Māori or Pacific...
October 12, 2016: BMC Infectious Diseases
Mieke L van Driel, An Im De Sutter, Hilde Habraken, Sarah Thorning, Thierry Christiaens
BACKGROUND: Antibiotics provide only modest benefit in treating sore throat, although effectiveness increases in participants with positive throat swabs for group A beta-haemolytic streptococci (GABHS). It is unclear which antibiotic is the best choice if antibiotics are indicated. OBJECTIVES: To assess the evidence on the comparative efficacy of different antibiotics in: (a) alleviating symptoms (pain, fever); (b) shortening the duration of the illness; (c) preventing relapse; and (d) preventing complications (suppurative complications, acute rheumatic fever, post-streptococcal glomerulonephritis)...
September 11, 2016: Cochrane Database of Systematic Reviews
Sophie Shay, Nina L Shapiro, Neil Bhattacharyya
OBJECTIVES/HYPOTHESIS: Determine the national incidence and disparities for common pediatric otolaryngologic conditions. STUDY DESIGN: Cross-sectional analysis of a nationally representative database. METHODS: The National Health Interview Survey (2012) was analyzed, extracting children with frequent ear infections (FEI), nonstreptococcal sore throat (NSST), streptococcal pharyngitis (SP), hay fever, and sinusitis. Demographic data including age, sex, race, Hispanic ethnicity, geographic region, poverty level, and insurance status were extracted...
September 7, 2016: Laryngoscope
Carla Penney, Robert Porter, Mary O'Brien, Peter Daley
Background. Acute pharyngitis caused by Group A Streptococcus (GAS) is a common presentation to pediatric emergency departments (ED). Diagnosis with conventional throat culture requires 18-24 hours, which prevents point-of-care treatment decisions. Rapid antigen detection tests (RADT) are faster, but previous reports demonstrate significant operator influence on performance. Objective. To measure operator influence on the diagnostic accuracy of a RADT when performed by pediatric ED nurses and clinical microbiology laboratory technologists, using conventional culture as the reference standard...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
Woranuch Saengcharoen, Pornchanok Jaisawang, Palita Udomcharoensab, Kittika Buathong, Sanguan Lerkiatbundit
Background Inappropriate use of antibiotic treatment for pharyngitis by community pharmacists is prevalent in developing countries. Little is known about how the pharmacists identify patients with bacterial pharyngitis. Objective To ascertain the appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria and to identify factors related to antibiotic dispensing. Setting 1040 Thai community pharmacists. Method A cross-sectional survey of community pharmacists was conducted in November 2012 to March 2013...
October 2016: International Journal of Clinical Pharmacy
Shuangsheng Wu, Xiaomin Peng, Zuyao Yang, Chunna Ma, Daitao Zhang, Quanyi Wang, Peng Yang
BACKGROUND: Burden of Group A streptococcus (GAS) pharyngitis is scarce in developing countries, still unknown in China. The objective of this study was to determine the incidence of clinical cases of pharyngitis and GAS culture-positive pharyngitis, and their outpatient visits among children aged 0-14 years in Beijing, the capital of China. METHODS: Multiplier model was used to estimate the numbers of pharyngitis cases, based on reported numbers of clinical cases and GAS culture-positive rates from GAS surveillances in Beijing, consultation rate, population coverage of GAS surveillances, sampling success rate, and test sensitivity of GAS culture from previous studies, surveys and surveillances...
2016: BMC Infectious Diseases
Aysha Ahmed, Abraham T Yacoub, Arun Ponnuru, Smitha Pabbathi, Sowmya Nanjappa, Albert L Vincent, John Greene
Is tonsillectomy an appropriate treatment modality for this adult patient's refractory group A β-hemolytic streptococcal pharyngitis, in light of her history of recurrent infections?
July 2016: Journal of Family Practice
Mohammad Reza Sharif, Marzieh Aalinezhad, Seyyed Mohammad Sajad Sajadian, Mostafa Haji Rezaei
INTRODUCTION: Group A β-hemolytic Streptococcus is the most common cause of bacterial pharyngitis among 5 - 15-year-old children, but it is uncommon in children less than three years old and rarely happens in infants less than one year old. CASE PRESENTATION: The patient was a 62-day-old female infant who presented with fever and poor feeding since two days before admission. At the time of admission, the patient was febrile and ill. Upon examination, a rectal temperature of 38...
May 2016: Jundishapur Journal of Microbiology
Sunil D Saroj, Lisa Maudsdotter, Raquel Tavares, Ann-Beth Jonsson
Streptococcus pyogenes [Group A streptococcus (GAS)], a frequent colonizer of the respiratory tract mucosal surface, causes a variety of human diseases, ranging from pharyngitis to the life-threatening streptococcal toxic shock-like syndrome. Lactobacilli have been demonstrated to colonize the respiratory tract. In this study, we investigated the interference of lactobacilli with the virulence phenotypes of GAS. The Lactobacillus strains L. rhamnosus Kx151A1 and L. reuteri PTA-5289, but not L. salivarius LMG9477, inhibited the hemolytic activity of S...
2016: Frontiers in Microbiology
Kumara V Nibhanipudi
Objective. A study to determine if addition of palatal petechiae to Centor criteria adds more value for clinical diagnosis of acute strep pharyngitis in children. Hypothesis. In children, Centor Criteria does not cover all the symptoms and signs of acute strep pharyngitis. We hypothesize that addition of palatal petechiae to Centor Criteria will increase the possibility of clinical diagnosis of group A streptococcal pharyngitis in children. Methods. One hundred patients with a complaint of sore throat were enrolled in the study...
2016: Global Pediatric Health
Jean-Louis Excler, Jerome H Kim
Group A Streptococcus (GAS) infections cause substantial worldwide morbidity and mortality, mostly associated with suppurative complications such as pharyngitis, impetigo, and non-suppurative immune syndromes such as acute rheumatic fever, rheumatic heart disease, and acute post-streptococcal glomerulonephritis. Deaths occur mostly in children, adolescents, and young adults in particular pregnant women in low- and middle-income countries. GAS strains are highly variable, and a GAS vaccine would need to overcome the issue of multiple strains...
July 2016: Clinical and Experimental Vaccine Research
Kristofer Wollein Waldetoft, Tirthankar Mohanty, Christofer Karlsson, Matthias Mörgelin, Inga-Maria Frick, Johan Malmström, Lars Björck
Streptococcal pharyngitis is among the most common bacterial infections, but the molecular mechanisms involved remain poorly understood. Here we investigate the interactions among three major players in streptococcal pharyngitis: streptococci, plasma, and saliva. We find that saliva activates the plasma coagulation system through both the extrinsic and the intrinsic pathways, entrapping the bacteria in fibrin clots. The bacteria escape the clots by activating host plasminogen. Our results identify a potential function for the intrinsic pathway of coagulation in host defense and a corresponding role for fibrinolysis in streptococcal immune evasion...
October 2016: Infection and Immunity
Bobbi S Pritt, Robin Patel, Thomas J Kirn, Richard B Thomson
Nucleic acid amplification tests (NAATs) have frequently been the standard diagnostic approach when specific infectious agents are sought in a clinic specimen. They can be applied for specific agents such as S. pyogenes, or commercial multiplex NAATs for detection of a variety of pathogens in gastrointestinal, bloodstream, and respiratory infections may be used. NAATs are both rapid and sensitive. For many years, S. pyogenes testing algorithms used a rapid and specific group A streptococcal antigen test to screen throat specimens, followed, in some clinical settings, by a throat culture for S...
October 2016: Journal of Clinical Microbiology
M Skwarczynski, Khairunnisa Abdulghaffar, Ashwini Kumar Giddam, Michael Batzloff, Michael Good, Istvan Toth
Group A streptococcus (GAS) infections can led to a large variety of diseases in humans including the most common acute pharyngitis. If untreated, GAS infections lead to life- threatening conditions such as rheumatic heart diseases and post-streptococcal glomerulonephritis. GAS primarily colonises the mucosal region of the upper respiratory tract, slowly leading to systemic infections. Thus, GAS-specific antibody responses are desirable at mucosal sites for early prevention against GAS colonisation. Although several GAS vaccines are currently in clinical trials, these vaccines aim to stimulate systemic immunity, not mucosal immunity, thus will not protect against colonization...
July 21, 2016: Current Drug Delivery
T Thornley, G Marshall, P Howard, A P R Wilson
OBJECTIVES: The UK 5 year antimicrobial resistance strategy recognizes the role of point-of-care diagnostics to identify where antimicrobials are required, as well as to assess the appropriateness of the diagnosis and treatment. A sore throat test-and-treat service was introduced in 35 community pharmacies across two localities in England during 2014-15. METHODS: Trained pharmacy staff assessed patients presenting with a sore throat using the Centor scoring system and patients meeting three or all four of the criteria were offered a throat swab test for Streptococcus pyogenes, Lancefield group A streptococci...
July 20, 2016: Journal of Antimicrobial Chemotherapy
Monica G Kalra, Kim E Higgins, Evan D Perez
Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and early spring. The strongest independent predictors of GABHS pharyngitis are patient age of five to 15 years, absence of cough, tender anterior cervical adenopathy, tonsillar exudates, and fever. To diagnose GABHS pharyngitis, a rapid antigen detection test should be ordered in patients with a modified Centor or FeverPAIN score of 2 or 3. First-line treatment for GABHS pharyngitis includes a 10-day course of penicillin or amoxicillin...
July 1, 2016: American Family Physician
Ridvan Tupai-Firestone, Jia-Yun Catherine Tsai, Philippa Anderson, Laura Broome, Tracy McKee, Diana R Lennon
AIM: To evaluate antimicrobial usage in the school-based clinics against operating guidelines. METHOD: Antimicrobial prescribing data (2014) from 10/18 participating pharmacies serving 14,153/23,588 primary school children of the programme were accessible. Prescriptions from 5/10 pharmacies were available for identifying type, amount, and indication of the medicine. One pharmacy serving a defined population (n=3,513) with single healthcare provider delivering the school programme was selected for detailed evaluation and identifying individuals receiving multiple treatments...
2016: New Zealand Medical Journal
José Paulo de Souza, Amanda Ribeiro Santos, Geraldo Renato de Paula, Rosana Rocha Barros
BACKGROUND: Streptococcus dysgalactiae subsp. equisimilis (SDSE) has been increasingly associated with several infectious diseases, ranging from pharyngitis to life-threatening conditions, such as necrotizing fasciitis and streptococcal toxic shock syndrome. However, its molecular epidemiology in some geographical areas remains unclear. METHODS: In this study, 44 isolates of SDSE, recovered from noninvasive infections (37) and from carriage (7), during 2008-2013, were submitted to antimicrobial susceptibility testing, emm typing and pulsed-field gel electrophoresis (PFGE) analysis...
September 2016: Infectious Diseases
Christina Lindgren, Mark I Neuman, Michael C Monuteaux, Kenneth D Mandl, Andrew M Fine
BACKGROUND AND OBJECTIVES: Identifying symptomatic patients who are at low risk for group A streptococcal (GAS) pharyngitis could reduce unnecessary visits and antibiotic use. The accuracy with which patients and parents report signs and symptoms of GAS has not been studied. Our objectives were to measure agreement between patient or parent and physician-reported signs and symptoms of GAS and to evaluate the performance of a modified Centor score, based on patient or parent and physician reports, for identifying patients at low risk for GAS pharyngitis...
July 2016: Pediatrics
Philip David Bright, Bongani M Mayosi, William John Martin
Acute rheumatic fever (ARF) and the related rheumatic heart disease (RHD) are autoimmune diseases thought to be triggered by group A streptococcal (GAS) pharyngitis. RHD is a leading cause of mortality in the developing world. The strong epidemiological association between GAS throat infection and ARF is highly suggestive of causation, but does not exclude other infections as contributory. There is good evidence of both humoral and cellular autoreactivity and GAS/self cross-reactivity in established RHD. RHD pathogenesis could feasibly be triggered and driven by humoral and/or cellular molecular cross-reactivity between GAS and host cardiac tissues (molecular mimicry)...
October 1, 2016: Heart: Official Journal of the British Cardiac Society
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