Influence of antibiotic treatment on the isolation rate of group a streptococci from peritonsillar abscesses

AbstractOne hundred and twenty-six patients who underwent tonsillectomy because of recurrent acute tonsillitis, tonsillar hypertrophy or sleep apnoea were evaluated by tonsillar core culturing. The sleep apnoea patients served as controls, since none of them had tonsillar hypertrophy at ENT examination or any history of recurrent acute tonsillitis, and thus their tonsillar core flora could be regarded as normal.The isolation rate ofH. influenzaewas much lower among sleep apnoea controls (2.7 per cent) than among either the patients with recurrent acute tonsillitis (20.3 per cent) or those with tonsillar hypertrophy (36.7 per cent) (p<0.05), as was that of group A streptococci, 5.4 per centversus16.9 and 20 per cent, respectively (though the latter differences were not statistically significant). The isolation frequencies ofB. catarrhalis, pneumococci, group C and G streptococci did not differ between the three groups.The high tonsillar core recovery rates ofH. influenzaeand group A streptococci both in patients with recurrent acute tonsillitis and in those with tonsillar hypertrophy, as compared with normal controls, suggests the possible involvement of these bacteria in both conditions.

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Association between bacterial finding, antibiotic treatment and clinical course in patients with pharyngotonsillitis: a registry-based study in primary healthcare in Sweden

BMC Infectious Diseases ◽

10.1186/s12879-021-06511-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jon Pallon ◽

Martin Sundqvist ◽

Mattias Rööst ◽

Katarina Hedin

Keyword(s):

Antibiotic Treatment ◽

Primary Healthcare ◽

Antibiotic Prescription ◽

Electronic Medical Record System ◽

Group A Streptococci ◽

Record System ◽

Bacterial Aetiology ◽

Medical Record System ◽

Group A ◽

Return Visits

Abstract Background The role of non-group A streptococci and Fusobacterium necrophorum in pharyngotonsillitis has been disputed and few prospective studies have evaluated the effect of antibiotic treatment. This study uses registry data to investigate the relation between antibiotic prescription for pharyngotonsillitis in primary healthcare and return visits for pharyngotonsillitis, complications, and tonsillectomy. Methods Retrospective data were extracted from the regional electronic medical record system in Kronoberg County, Sweden, for all patients diagnosed with pharyngotonsillitis between 2012 and 2016. From these data, two cohorts were formed: one based on rapid antigen detection tests (RADT) for group A streptococci (GAS) and one based on routine throat cultures for β-haemolytic streptococci and F. necrophorum. The 90 days following the inclusion visit were assessed for new visits for pharyngotonsillitis, complications, and tonsillectomy, and related to bacterial aetiology and antibiotic prescriptions given at inclusion. Results In the RADT cohort (n = 13,781), antibiotic prescription for patients with a positive RADT for GAS was associated with fewer return visits for pharyngotonsillitis within 30 days compared with no prescription (8.7% vs. 12%; p = 0.02), but not with the complication rate within 30 days (1.5% vs. 1.8%; p = 0.7) or with the tonsillectomy rate within 90 days (0.27% vs. 0.26%; p = 1). In contrast, antibiotic prescription for patients with a negative RADT was associated with more return visits for pharyngotonsillitis within 30 days (9.7% vs. 7.0%; p = 0.01). In the culture cohort (n = 1 370), antibiotic prescription for patients with Streptococcus dysgalactiae ssp. equisimilis was associated with fewer return visits for pharyngotonsillitis within 30 days compared with no prescription (15% vs. 29%; p = 0.03). Conclusions Antibiotic prescription was associated with fewer return visits for pharyngotonsillitis in patients with a positive RADT for GAS but with more return visits in patients with a negative RADT for GAS. There were no differences in purulent complications related to antibiotic prescription.

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Infections due to Gram-Positive Cocci

10.2310/im.1084 ◽

2009 ◽

Author(s):

Dennis L. Stevens

Keyword(s):

Rheumatic Fever ◽

Antibiotic Treatment ◽

Acute Rheumatic Fever ◽

Clinical Manifestations ◽

Underlying Disease ◽

Adverse Outcomes ◽

Group A Streptococci ◽

Gram Positive ◽

Group A ◽

Gram Positive Cocci

The gram-positive cocci that produce infection include pneumococci, group A streptococci, non?group A streptococci (including groups B, C, D, G, and nongroupable streptococci), anaerobic streptococci, enterococci, and staphylococci. This chapter discusses the pathogenesis, diagnosis, and treatment of infections associated with each of these gram-positive cocci, including methicillin-resistant Staphylococcus aureus (MRSA). The clinical infections caused by each of these organisms are reviewed. Tables describe the incidence of pneumococcal disease according to age and underlying disease, factors associated with adverse outcomes in pneumococcal pneumonia; medically important streptococci and enterococci; antibiotic treatment for penicillin-resistant Streptococcus pneumoniae, enterococcal infections, and staphylococcal infections; laboratory tests for streptococcal pharyngitis; clinical manifestations and antibiotic treatment for staphylococcal toxic-shock syndrome (TSS); revised Jones criteria for the diagnosis of acute rheumatic fever, and drug treatment of acute rheumatic fever. This review contains 105 references.

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A study of acute respiratory disease in the community of Port Chalmers I. Illnesses within a group of selected families and the relative incidence of respiratory pathogens in the whole community

Journal of Hygiene ◽

10.1017/s0022172400053766 ◽

1978 ◽

Vol 81 (1) ◽

pp. 49-66 ◽

Cited By ~ 10

Author(s):

L. C. Jennings ◽

R. D. MacDiarmid ◽

J. A. R. Miles

Keyword(s):

Respiratory Disease ◽

Respiratory Diseases ◽

Median Number ◽

Nasopharyngeal Swab ◽

Respiratory Pathogens ◽

Group A Streptococci ◽

Isolation Rate ◽

Group A ◽

Upper Respiratory ◽

Intensive Surveillance

SUMMARYA study of respiratory diseases in the semi-isolated community of Port Chalmers, New Zealand, began in April 1973. The intensive surveillance of a selected group of 26 families involved the weekly reporting of illness, the collection of specimens for virus, Group A streptococci and Mycoplasma pneumoniae isolation and the collection of sera at 6-month intervals. A total of 956 illnesses were reported during 32 months. The median number of illnesses per year were: infants 4·4, children 2·5, female adults 2·4 and male adults 2·0. Of all these illnesses, 57% were upper respiratory, 31% were lower respiratory and 9% were enteric. The severity of these illnesses was not greater than would be expected in open communities. Surveillance by pathogen isolation only of the whole community through the patients in the general practice was carried out concurrently.A total of 640 nasopharyngeal swab specimens were collected from which 161 viruses, 47 Group A streptococci and 2 M. pneumoniae were isolated. The overall isolation rate was 33%. The similarities between the epidemiological patterns of respiratory disease in the open community and the isolated community are discussed.

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