Villaseñor-Sierra Alberto, Caballero-Hoyos José Ramiro, Jáuregui-Lomelí Juan José, Flores-Sánchez Jesús, Martínez-Sandoval Francisco
Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco.
Rev Med Inst Mex Seguro Soc. 2008 Jul-Aug;46(4):383-90.
to develop a multivariate model to predict the Streptococcus pyogenes isolation in patients with acute tonsillitis.
cross-sectional analytic study on patients with acute tonsillitis without a recent history of antimicrobial consumption. We evaluated 14 signs and 18 symptoms. A pharyngeal culture was realized on 5% sheep blood agar. Group A streptococci was identified by standard methods.
sensitivity, specificity, predictive values, chi2, Fisher's exact test, crude and adjusted odds ratio (OR) with 95% CI using dichotomical logistic regression with direct method and Hosmer and Lemeshow-goodness-fit test.
there were 213 participants, 37% were males; a mean age of 14.9 years. We isolated Streptococcus pyogenes in 15%, and 84 % of them had received antimicrobials. We identified signs and symptoms associated with Streptococcus pyogenes isolation: painful swallowing (OR=4.45, 95% CI = 1.13-17.53); tonsils with exudates (OR=3.20, 95% CI = 1.22-8.43); smelly breath (OR=2.78, 95% CI = 1.09-7.10); painful neck nodes (OR=2.70, 95% CI = 1.05-6.96). The presence of nasal symptoms was a protective factor (OR=0.25, 95% CI = 0.09-0.71).
the prevalence of Streptococcus pyogenes tonsillitis was similar to other reports. We found signs and symptoms associated to Streptococcus pyogenes isolation that allowed us to elaborate a decision algorithm.
建立一个多变量模型来预测急性扁桃体炎患者中化脓性链球菌的分离情况。
对近期无抗菌药物使用史的急性扁桃体炎患者进行横断面分析研究。我们评估了14个体征和18个症状。在5%绵羊血琼脂上进行咽拭子培养。采用标准方法鉴定A组链球菌。
使用直接法二分类逻辑回归及Hosmer和Lemeshow拟合优度检验，计算敏感性、特异性、预测值、卡方、Fisher精确检验、粗比值比和调整比值比（OR）及其95%置信区间（CI）。
共有213名参与者，37%为男性；平均年龄14.9岁。我们分离出化脓性链球菌的比例为15%，其中84%的患者接受过抗菌药物治疗。我们确定了与化脓性链球菌分离相关的体征和症状：吞咽疼痛（OR = 4.45，95%CI = 1.13 - 17.53）；扁桃体有渗出物（OR = 3.20，95%CI = 1.22 - 8.43）；口臭（OR = 2.78，95%CI = 1.09 - 7.10）；颈部淋巴结疼痛（OR = 2.70，95%CI = 1.05 - 6.96）。鼻部症状的存在是一个保护因素（OR = 0.25，95%CI = 0.09 - 0.71）。
化脓性链球菌性扁桃体炎的患病率与其他报告相似。我们发现了与化脓性链球菌分离相关的体征和症状，这使我们能够制定一个决策算法。
