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[A组咽炎的临床诊断及评分系统的应用进展]

[Clinical diagnosis of group A pharyngitis and progress in the application of scoring systems].

作者信息

Chen Si-Yu, Guo Meng-Yang, Deng Jiang-Hong, Yao Kai-Hu

机构信息

National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Infection and Microbiology, Beijing Pediatric Research Institute/National Clinical Research Center for Respiratory Diseases/National Key Discipline of Pediatrics/Key Laboratory of the Ministry of Education for Research on Major Pediatric Diseases, Beijing 100045, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 Aug 15;26(8):893-898. doi: 10.7499/j.issn.1008-8830.2403044.

Abstract

Pharyngitis can be caused by various pathogens, including viruses and bacteria. Group A (GAS) is the most common bacterial cause of pharyngitis. However, distinguishing GAS pharyngitis from other types of upper respiratory tract infections is challenging in clinical settings. This often leads to empirical treatments and, consequently, the overuse of antimicrobial drugs. With the advancement of antimicrobial drug management and healthcare payment reform initiatives in China, reducing unnecessary testing and prescriptions of antimicrobial drugs is imperative. To promote standardized diagnosis and treatment of GAS pharyngitis, this article reviews various international guidelines on the clinical diagnosis and differential diagnosis of GAS pharyngitis, particularly focusing on clinical scoring systems guiding laboratory testing and antimicrobial treatment decisions for GAS pharyngitis and their application recommendations, providing a reference for domestic researchers and clinical practitioners.

摘要

咽炎可由多种病原体引起,包括病毒和细菌。A组链球菌(GAS)是咽炎最常见的细菌病因。然而,在临床环境中,区分GAS咽炎与其他类型的上呼吸道感染具有挑战性。这往往导致经验性治疗,进而导致抗菌药物的过度使用。随着中国抗菌药物管理和医疗支付改革举措的推进,减少抗菌药物的不必要检测和处方势在必行。为促进GAS咽炎的规范化诊断和治疗,本文综述了关于GAS咽炎临床诊断和鉴别诊断的各种国际指南,特别关注指导GAS咽炎实验室检测和抗菌治疗决策的临床评分系统及其应用建议,为国内研究人员和临床医生提供参考。

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本文引用的文献

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Group A Streptococcus Infections.A 组链球菌感染。
Pediatr Rev. 2024 Mar 1;45(3):143-151. doi: 10.1542/pir.2023-005976.
5
Clinical Practice Guideline: Sore Throat.临床实践指南:咽痛。
Dtsch Arztebl Int. 2021 Mar 19;118(11):188-94. doi: 10.3238/arztebl.m2021.0121.
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Lemierre's syndrome: A forgotten and re-emerging infection.勒米埃里氏综合征:一种被遗忘又重现的感染。
J Microbiol Immunol Infect. 2020 Aug;53(4):513-517. doi: 10.1016/j.jmii.2020.03.027. Epub 2020 Apr 4.

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