Zwart S, Ruijs G J, Sachs A P, van Leeuwen W J, Gubbels J W, de Melker R A
Department of General Practice, University Medical Center Utrecht, The Netherlands.
Scand J Infect Dis. 2000;32(4):377-84. doi: 10.1080/003655400750044944.
As beta-haemolytic streptococci can be cultured in people with and in those without a sore throat, a case-control study was set up in 43 family practices in The Netherlands. The association was tested between the number of colony counts, specific T/M types and exotoxin genes and an acute sore throat. Duplicate throat swabs were taken from 663 sore-throat patients, selected by clinical criteria, and from 694 healthy controls. They were cultured for beta-haemolytic streptococci by combining several updated laboratory methods. Approximately 40% of the controls and 80% of the patients had beta-haemolytic streptococci-positive cultures. When focusing on cultures with high colony counts, not only group A (46%), but also non-group A streptococci (20%), predominated significantly in adult patients compared with controls. No T/M or exotoxin gene type was significantly more prevalent in patients than in controls. Thus, semiquantitative analysis, but not T/M and exotoxin gene typing, showed an association between beta-haemolytic streptococci and active disease. Groups A, C and G streptococci were found to be potentially pathogenic in adult sore-throat patients, and should be included in the discussion on the use of rapid antigen detection tests and penicillin treatment in primary care.
由于β溶血性链球菌可在有或无喉咙痛的人群中培养出来，因此在荷兰的43个家庭诊所开展了一项病例对照研究。对菌落计数、特定T/M型和外毒素基因数量与急性喉咙痛之间的关联进行了检测。从663例根据临床标准选取的喉咙痛患者以及694例健康对照者中采集了双份咽拭子。通过结合几种更新的实验室方法对它们进行β溶血性链球菌培养。大约40%的对照者和80%的患者β溶血性链球菌培养呈阳性。当关注高菌落计数的培养物时，与对照者相比，不仅A组（46%），而且非A组链球菌（20%）在成年患者中显著占主导。患者中没有哪种T/M或外毒素基因类型比对照者更普遍。因此，半定量分析而非T/M和外毒素基因分型显示β溶血性链球菌与活动性疾病之间存在关联。发现A、C和G组链球菌在成年喉咙痛患者中具有潜在致病性，在基层医疗中关于快速抗原检测试验的使用和青霉素治疗的讨论中应将其纳入。
