From the Department of Medicine.
Department of Public Health, University of Otago, Wellington, New Zealand.
Pediatr Infect Dis J. 2018 Jul;37(7):619-623. doi: 10.1097/INF.0000000000001847.
The aim of this study was to examine effectiveness of oral probiotic Streptococcus salivarius K12 in preventing group A streptococcus pharyngitis in 5- to 14-year-old children at high risk of acute rheumatic fever. New Zealand has high rates of acute rheumatic fever among Māori and Pacific children. Children were already enrolled in a school-based Ministry of Health throat swabbing and treatment program. Children self-identified and reported sore throats daily and were swabbed twice weekly.
A total of 1314 children were quasirandomized (based on odd or even birthdates) to receive either K12 (2.5 × 10(9) cfu per lozenge) or placebo lozenges and continued observed daily treatment (in the school week, during school time) for one school year.
A total of 801 children (61.0%) reported a sore throat on one or more occasions resulting in 2927 pharyngeal swabs. Of these swabs, 1525 (52.1%) were taken from 411 children receiving K12 and 119 (7.8%) of these were positive for group A streptococcus on routine culture. In addition, 1402 (47.8%) swabs were taken from 390 children receiving placebo and 124 (8.8%) were positive. Overall there was a nonsignificant 11.2% relative reduction in positive swabs among children receiving K12. This relative reduction was greater for older children, 7-9 years of age, 15.6%, and for children 10 years and older, 30.2%.
S. salivarius K12 had modest nonsignificant effects on culture-positive sore throats when given at school, during the school day. Based on our pragmatic trial, the routine use of this probiotic in the prevention of pharyngitis associated with GAS detection is not supported.
本研究旨在观察高风险急性风湿热的 5-14 岁儿童使用唾液链球菌 K12 口腔益生菌预防 A 组链球菌咽炎的效果。新西兰毛利人和太平洋岛民儿童的急性风湿热发病率较高。儿童已参与一项基于学校的卫生部咽喉拭子和治疗计划。儿童自我识别并每天报告喉咙痛，每周两次进行咽喉拭子检查。
共有 1314 名儿童（按生日奇偶数）进行半随机分组，分别接受 K12（2.5×10^9 个菌落形成单位/片）或安慰剂含片，并在一学年内每天接受观察性治疗（在学校周内，上学时间）。
共有 801 名儿童（61.0%）报告了一次或多次喉咙痛，导致 2927 次咽拭子检查。在这些拭子中，1525 个（52.1%）来自接受 K12 治疗的 411 名儿童，其中 119 个（7.8%）在常规培养中呈 A 组链球菌阳性。此外，1402 个（47.8%）拭子来自接受安慰剂的 390 名儿童，其中 124 个（8.8%）为阳性。总体而言，接受 K12 治疗的儿童中阳性拭子的相对减少率无显著意义，为 11.2%。对于年龄较大的 7-9 岁儿童，相对减少率为 15.6%，而对于 10 岁及以上的儿童，相对减少率为 30.2%。
唾液链球菌 K12 在学校上学期间使用时，对文化阳性喉咙痛的效果适中，无显著意义。基于我们的实用试验，不支持常规使用这种益生菌预防与 GAS 检测相关的咽炎。
