在大学健康诊所中，梭杆菌阳性和链球菌阳性咽炎的临床表现：一项横断面研究。

The clinical presentation of Fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study.

出版信息

Ann Intern Med. 2015 Feb 17;162(4):241-7. doi: 10.7326/M14-1305.

Abstract

BACKGROUND

Pharyngitis guidelines focus solely on group A β-hemolytic streptococcal infection. European data suggest that in patients aged 15 to 30 years, Fusobacterium necrophorum causes at least 10% of cases of pharyngitis; however, few U.S. data exist.

OBJECTIVE

To estimate the prevalence of F. necrophorum; Mycoplasma pneumoniae; and group A and C/G β-hemolytic streptococcal pharyngitis and to determine whether F. necrophorum pharyngitis clinically resembles group A β-hemolytic streptococcal pharyngitis.

DESIGN

Cross-sectional.

SETTING

University student health clinic.

PATIENTS

312 students aged 15 to 30 years presenting to a student health clinic with an acute sore throat and 180 asymptomatic students.

MEASUREMENTS

Polymerase chain reaction testing from throat swabs to detect 4 species of bacteria and signs and symptoms used to calculate the Centor score.

RESULTS

Fusobacterium necrophorum was detected in 20.5% of patients and 9.4% of asymptomatic students. Group A β-hemolytic streptococcus was detected in 10.3% of patients and 1.1% of asymptomatic students. Group C/G β-hemolytic streptococcus was detected in 9.0% of patients and 3.9% of asymptomatic students. Mycoplasma pneumoniae was detected in 1.9% of patients and 0 asymptomatic students. Infection rates with F. necrophorum, group A streptococcus, and group C/G streptococcus increased with higher Centor scores (P < 0.001).

LIMITATIONS

The study focused on a limited age group and took place at a single institution. Asymptomatic students-rather than seasonal control participants-and a convenience sample were used.

CONCLUSION

Fusobacterium necrophorum-positive pharyngitis occurs more frequently than group A β-hemolytic streptococcal-positive pharyngitis in a student population, and F. necrophorum-positive pharyngitis clinically resembles streptococcal pharyngitis.

PRIMARY FUNDING SOURCE

University of Alabama at Birmingham and the Justin E. Rodgers Foundation.

摘要

背景

咽炎指南仅关注 A 组β-溶血性链球菌感染。欧洲数据表明，在 15 至 30 岁的患者中，坏死梭杆菌至少导致 10%的咽炎病例；然而，美国的数据很少。

目的

评估坏死梭杆菌、肺炎支原体以及 A 组和 C/G 组β-溶血性链球菌性咽炎的流行率，并确定坏死梭杆菌性咽炎在临床上是否类似于 A 组β-溶血性链球菌性咽炎。

设计

横断面研究。

地点

大学生健康诊所。

患者

312 名年龄在 15 至 30 岁之间的学生因急性咽痛就诊于学生健康诊所，以及 180 名无症状学生。

测量方法

通过咽喉拭子进行聚合酶链反应检测以检测 4 种细菌，并计算使用 Centor 评分的体征和症状。

结果

20.5%的患者和 9.4%的无症状学生检测到坏死梭杆菌。10.3%的患者和 1.1%的无症状学生检测到 A 组β-溶血性链球菌。9.0%的患者和 3.9%的无症状学生检测到 C/G 组β-溶血性链球菌。1.9%的患者和 0 名无症状学生检测到肺炎支原体。随着 Centor 评分的升高，坏死梭杆菌、A 组链球菌和 C/G 链球菌的感染率增加（P<0.001）。