Department of Research and Development, Region Kronoberg, Växjö, Sweden.
Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden.
BMC Infect Dis. 2021 Oct 26;21(1):1104. doi: 10.1186/s12879-021-06774-5.
Diagnosis and treatment of pharyngotonsillitis are commonly focused on group A streptococci (GAS), although the disease is often associated with other pathogens. While the incidence of pharyngotonsillitis is known to vary with season, seasonal variations in the prevalence of potential pathogens are sparsely explored. The aim of this study was to explore any seasonal variations in the use and outcome of rapid antigen detection tests (RADTs) for GAS and throat cultures among patients diagnosed with pharyngotonsillitis in primary care.
We retrieved and combined retrospective data from the electronic medical record system and the laboratory information system in Kronoberg County, Sweden. Primary care visits resulting in a diagnosis of tonsillitis or pharyngitis were included, covering the period 2013-2016. The monthly rate of visits was measured, along with the use and outcome of RADTs for GAS and throat cultures obtained on the date of diagnosis. The variations between calendar months were then analysed.
We found variations between calendar months, not only in the mean rate of visits resulting in a diagnosis of pharyngotonsillitis (p < 0.001), but in the mean proportion of RADTs being positive for GAS among the diagnosed (p < 0.001), and in the mean proportion of visits associated with a throat culture (p < 0.001). A lower mean rate of visits in August and September coincided with a lower proportion of RADTs being positive for GAS among them, which correlated with a higher proportion of visits associated with a throat culture.
This study suggests that the role of GAS in pharyngotonsillitis in Sweden is less prominent in August and September than during the rest of the year.
咽扁桃体炎的诊断和治疗通常集中在 A 组链球菌（GAS）上，尽管该疾病通常与其他病原体有关。虽然咽扁桃体炎的发病率随季节而变化，但潜在病原体的流行季节性变化研究甚少。本研究旨在探讨在初级保健中诊断为咽扁桃体炎的患者中，GAS 快速抗原检测试验（RADT）和咽喉培养的使用和结果是否存在季节性变化。
我们从瑞典 Kronoberg 县的电子病历系统和实验室信息系统中检索并合并了回顾性数据。包括 2013 年至 2016 年期间因诊断为扁桃体炎或咽炎而就诊的病例。测量每月就诊率，以及在诊断日进行的 GAS RADT 和咽喉培养的使用和结果。然后分析日历月之间的差异。
我们发现不仅在导致咽扁桃体炎诊断的就诊平均率之间存在差异（p<0.001），而且在诊断为 GAS 的 RADT 阳性率之间存在差异（p<0.001），以及在与咽喉培养相关的就诊率之间存在差异（p<0.001）。8 月和 9 月就诊平均率较低，与 RADT 检测 GAS 阳性的比例较低相关，这与与咽喉培养相关的就诊比例较高相关。
本研究表明，GAS 在瑞典咽扁桃体炎中的作用在 8 月和 9 月不如一年中其他时间那么突出。
