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At least 253 records · Page 14Linked to original sources
PubMed1985

Effect of atmosphere of incubation on the isolation of group A streptococci from throat cultures.

The optimal atmosphere of incubation for the isolation of group A beta-hemolytic streptococci from throat cultures has been the subject of considerable debate. To resolve this issue, we examined 5992 consecutive throat cultures performed at a private pediatric office in children with acute upper respiratory tract infections. All throat cultures were streaked onto duplicate blood agar plates, one of which was then incubated anaerobically and the other aerobically. beta-Hemolytic streptococci were isolated in cultures from 1885 (31.5%) of the patients; 1479 (24.7%) were identified as group A, and 406 (6.8%) were identified as non-group A. Group A streptococci were recovered significantly more often from the plates incubated anaerobically than from those incubated aerobically (1467 vs. 1054; anaerobic only, 425; aerobic only, 12; P less than 0.01). Non-group A streptococci were also recovered significantly more often from the plates incubated anaerobically than from the plates incubated aerobically (397 vs. 170; anaerobic only, 236; aerobic only, 9;P less than 0.01). Anaerobic incubation maximizes the yield of the throat culture. The additional cost and effort of anaerobic incubation are small, and would appear to be justified by the increased isolation rate of group A beta-hemolytic streptococci. The significance of the increased isolation rate of non-group A beta-hemolytic streptococci with anaerobic incubation needs to be investigated further.

Adolescent↗
PubMed1985

Bacteriology of sore throats in a Sudanese population.

One hundred and eighty-six throat swabs were collected from patients with sore throats and 164 throat swabs were collected from healthy controls. All swabs were investigated bacteriologically, and sensitivity tests were performed on all pathogenic isolates. Group A Streptococcus pyogenes was the predominant pathogenic organism (24.7%) and Proteus vulgaris the least predominant organism (0.5%) isolated from patients with sore throats. Streptococcus pyogenes infection was found to be most common among school children between the ages of 9 and 12 (61.5%). The pathogenic organisms were found to be sensitive to erythromycin (92.6%).

Adolescent↗
PubMed1983

Antibiotics, sore throats and acute nephritis.

A study was carried out of 274 children in Scotland aged 0 to 13 years recorded as having had acute nephritis over a four-year period (1976-79). The medical records for 223 of the patients were examined and 79 cases of poststreptococcal nephritis were identified, giving an estimated incidence of 2.1 episodes per 100,000 children per year. Using a number of assumptions, the authors sought the answers to two important questions: What is the risk that glomerulonephritis will develop after sore throat/inflamed throat illness? Is this risk influenced by the prescribing of an antibiotic for the original illness?The risks of developing nephritis after an antibiotic-treated sore throat and after a non-antibiotic treated sore throat were assessed as being equivalent (1:13,000 and 1:17,000 respectively). Furthermore, it appears that, during his lifetime, a general practitioner has a chance of only one in six of seeing a child with post-streptococcal nephritis after a sore throat.

Acute Disease↗
PubMed1983

Should young adults with sore throat be treated with antibiotics?

The diagnosis of streptococcal sore throat on clinical grounds remains a problem. In this study the clinical prediction in a group of young adults corresponded with laboratory findings indicative of a streptococcal (group A or non-A) infection in 23% of cases. The culture of throat swabs was of little value, as the only group A culture-positive patient did not show an antibody response, indicating a carrier state. In 5 cases a streptococcal infection was diagnosed on rising antibody titres only, as culture remained negative. The value of rising antibody titres as a diagnostic tool is also questioned, since they occurred more frequently in the healthy controls than in the sore-throat group. Antibiotic treatment for sore throat was rarely supported by laboratory findings in the young adult population studied.

Adult↗
PubMed1981

[The value of throat and nasopharyngeal cultures in acute bacterial otitis media in childhood].

One hundred children suffering from acute bacterial otitis media in Hacettepe Children's Hospital were investigated in two groups. Simultaneous throat and nasopharyngeal cultures were taken from 75 children of the first group, showing hyperaemic and hypertrophic tympanic membrane in one or both sides. In 42 of 75 throat cultures, same bacteria were grown as in nasopharyngeal cultures. From the second group, showing perforated tympanic membrane in the first 6 weeks, cultures were also taken. Same bacteria were grown again in the cultures of throat and ear discharges in 19 of 25 children. This high percentages denote the necessity and usefulness of taking also simultaneous throat cultures in acute otitis media cases.

Child↗
PubMed1993

Duration of positive throat cultures for group A streptococci after initiation of antibiotic therapy.

OBJECTIVE: To determine if it is appropriate to recommend that patients with group A beta-hemolytic streptococcal pharyngitis, who are clinically well by the morning after starting antibiotic treatment, can return to school or day care, or if they should wait until they have completed 24 hours of antibiotics as recommended by the American Academy of Pediatrics Committee on Infectious Diseases. METHODS: We examined the duration of positivity of the throat culture after antibiotics were begun as a means of assessing the potential risk of transmission to close school contacts. Forty-seven children (4 to 17 years of age) with pharyngitis and a positive throat culture for group A streptococci in an outpatient, staff model health maintenance organization clinic were enrolled and were randomly selected to receive therapy with either oral penicillin V, intramuscular benzathine penicillin G, or oral erythromycin estolate. Additional throat cultures were obtained and clinical findings were recorded for each child during three home visits in the 24 hours after their initial clinic visit. Acute and convalescent sera were obtained for determination of anti-streptolysin O and anti-DNase B titers. RESULTS: Seventeen (36.2%) of the 47 patients had a positive culture the morning after initiating antibiotic therapy. However, thirty-nine (83%) of the patients became "culture negative" within the first 24 hours. Neither the time interval to the first negative culture nor the presence or absence of group A streptococcal organisms on any single convalescent culture could be predicted by clinical findings. Six of the eight children who failed to convert to a "negative" throat culture within 24 hours of initiating therapy were receiving erythromycin. We could detect no difference in either time to conversion to a negative culture or the presence of a positive culture 24 hours after starting antibiotics between those who demonstrated a significant antibody increase and those who did not. CONCLUSION: The data from this study strongly suggest that children with group A beta-hemolytic streptococcal pharyngitis should complete a full 24 hours of antibiotics before returning to school or daycare.

Adolescent↗
PubMed1997

An approach to diagnosing the acute sore throat.

Sore throat is a common presenting complaint. Although patients often are concerned that they may have group A beta-hemolytic streptococcal (GABHS) pharyngitis, most sore throats are not caused by this infection. A number of illnesses and conditions present as sore throat. After life-threatening conditions are excluded, efforts to identify and treat patients with GABHS pharyngitis are appropriate. Efforts should include a directed history and physical examination, looking for exudative pharyngitis with fever, adenopathy and lack of cough or other respiratory symptoms. These findings predict a positive GABHS culture rate of 50 percent or more. The rapid Streptococcus test has a high positive predictive value, but it has a lower sensitivity rate. Treatment strategies for patients with sore throat are based on epidemiologic factors, signs and symptoms, and results of laboratory tests.

Acute Disease↗
PubMed1996

[The effect of the laryngeal mask airway on the postoperative incidence of vomiting and sore throat in children].

UNLABELLED: 100 ASA I and II children, aged 4 to 14 years, and scheduled for strabismus surgery, were randomly assigned to one of the following groups: group 1 (n = 50): endotracheal tube, group 2 (n = 50): laryngeal mask airway. Apart from airway management, the anaesthesiological procedures were identical in both groups: induction with 2-3 mg/kg propofol, 0.02 mg/kg alfentanil, 0.05 mg/kg vecuronium, and 0.01 mg/kg atropine. After endotracheal intubation or insertion of the laryngeal mask, anaesthesia was continued with 6-15 mg/kg.h propofol and 10-30 micrograms/kg.h alfentanil. All patients were ventilated with N2O/O2 (2:1). No antiemetics were given, gastric contents were not aspirated. Postoperative nausea and vomiting (PONV) were recorded by 24 h, the incidence of sore throats was recorded 8, 12, and 24 h post-operatively. RESULTS: The incidence of PONV was higher in group 1 (vomiting 48% vs 32%), nausea 28% vs 16% n.s.). Group 1 children had a higher incidence of sore throats (20% vs. 12%, n.s.), of a "lump in the throat" (10% vs 4%, n.s.), hoarseness (24% vs 0%, p < 0.001) and dysarthria (10% vs 4%, n.s.). CONCLUSIONS: In children undergoing strabismus surgery, the laryngeal mask airway was superior to the endotracheal tube in terms of PONV and was associated with fewer local complications such as sore throat.

Adolescent↗
PubMedDate not supplied

Incidence of bacterial colonization in the throat and in urines at paediatric age with evaluation of sensitivity to common antibiotics.

OBJECTIVES: To evaluate the incidence of bacterial colonization in the throat and in urines of children admitted to a paediatric ward in the year 1994. To test the sensitivity of isolates on the most common antibiotics used in therapy. METHODS: The investigation was carried out on a group of 270 children (125 male and 145 female), aged between 3 months and 12 years, hospitalized with feverish infectious pathology in the department of infectious and Tropical Diseases of the University "La Sapienza" of Rome. The cultures of the throat swabs and on urines were performed on the admission of the children before the beginning of the therapy. RESULTS: The throat-swab cultures showed pathogenous microrganisms in 232 samples (85.9%) with a slight prevalence of Gram-negative bacteria (122) with respect to Gram-positive (110) and saprophytic microbial flora (38). The urine cultures proved to be positive in 81 cases (30%) with a prevalence of Gram-negative (56) above Gram-positive isolates (25). CONCLUSIONS: The two/thirds of paediatric patients hospitalized in an Infectious Diseases Department appeared to be colonized in the upper respiratory tract, whereas in about 10% of them a marked bacteriuria was clearly evident, often in the absence of specific symptoms. A few isolates either from the throat or from urines, showed resistance to the common antibacterial agents.

Anti-Bacterial Agents↗
PubMed1997

Comparison of nasopharyngeal and throat swabs for the detection of Chlamydia pneumoniae and Mycoplasma pneumoniae by polymerase chain reaction.

Nasopharyngeal and throat swabs taken from 66 patients presenting at the Department of Infectious Disease with symptoms of upper and lower respiratory tract infection were analysed by use of the polymerase chain reaction (PCR) for Chlamydia pneumoniae and Mycoplasma pneumoniae. A total of 18 patients (27%) were positive by PCR for C. pneumoniae. All 18 patients were positive from throat swabs, and three were also positive from nasopharyngeal specimens. The difference between the outcome of PCR using throat and nasopharyngeal swabs was statistically significant. A total of 7 patients (10.6%) were positive for M. pneumoniae and of these, 6 were positive from throat swabs and 2 were positive from nasopharyngeal swabs. This difference was not statistically significant, probably due to the low numbers of positive patient specimens.

Chlamydophila pneumoniae↗
PubMedDate not supplied

Throat swabs in chronic tonsillitis: a time-honoured practice best forgotten.

We have estimated that in 1995 more than 2 million pounds was spent by the National Health Service on throat swabs used to investigate chronic tonsillitis in the UK. This study was devised to assess the value of this investigation. The surface microflora, obtained using a throat swab, was compared with the microflora of the deep tonsil in 30 cases of chronic tonsillitis. None of the throat swabs grew pathogenic organisms, while in 16 cases, heavy growths of recognised pathogens were grown from the tonsillar tissue. This paper demonstrates that throat swabs have little value in the management of chronic tonsillitis, and if the investigation was omitted in this condition, a substantial saving could be made.

Adolescent↗
PubMed1991

Caffeine as an analgesic adjuvant. A double-blind study comparing aspirin with caffeine to aspirin and placebo in patients with sore throat.

Despite its frequent clinical use in analgesic agents, caffeine has not been accepted unequivocally as an analgesic adjuvant. To evaluate this activity of caffeine, we used new study methods in a randomized controlled trial on patients with acute sore throat due to tonsillopharyngitis. Patients were randomly assigned to receive a single dose of one of three treatments: 800 mg of aspirin with 64 mg of caffeine (n = 70), 800 mg of aspirin (n = 68), or placebo (n = 69). Under double-blind conditions, during a 2-hour evaluation period, patients used different rating scales to assess pain intensity, change in pain, relief, and two qualities of throat pain, how swollen the throat felt, and difficulty swallowing. Aspirin with caffeine and aspirin alone were significantly more effective than placebo for all efficacy measurements from 30 minutes through 2 hours and overall. The aspirin-caffeine combination also showed evidence of activity at 15 minutes on the relief scale. Aspirin with caffeine was more effective than aspirin alone after 30 minutes and over the entire study period. For patients with fever, both active treatments were equally effective antipyretic agents. We conclude, therefore, that 800 mg of aspirin, given alone or with 64 mg of caffeine, is an effective analgesic and antipyretic agent. Because the aspirin-caffeine combination is significantly more effective than aspirin alone as an analgesic, we also conclude that 64 mg of caffeine is an analgesic adjuvant.

Adult↗
PubMed1984

Throat cultures for group A beta-hemolytic Streptococcus. Importance of anaerobic incubation.

The bacteriologic detection of group A Streptococcus in pharyngitis is vital in everyday practice to prevent serious potential sequelae. The purposes of this study were to determine whether throat cultures should be incubated in anaerobic atmosphere and whether an increased recovery rate could be obtained by stabbing of the plates (partial anaerobiosis) and by using a sulfamethoxazole-trimethoprim disk to enhance growth and identification. We examined 243 throat cultures, in duplicate, which were incubated in room air and in anaerobiosis (carbon dioxide, 10%). We found that, in aerobic incubation, the recovery rate of group A streptococci was 5.7%; in anaerobic incubation it was 19.8%. Stabbing of the agar to create a partial anaerobiosis was useless. When directly placed on the plate, the sulfamethoxazole-trimethoprim disk facilitated the identification of beta-hemolysis areas. To achieve maximum detection of group A streptococci in specimens obtained from the throats of infected children, we found that anaerobic incubation should be used.

Anaerobiosis↗
PubMed1992

Cephalexin and penicillin in the treatment of group A beta-hemolytic streptococcal throat infections.

OBJECTIVE: To determine whether cephalexin or penicillin is more effective in the treatment of group A beta-hemolytic streptococcal tonsillopharyngitis in children. DESIGN: Randomized, double-blind, crossover study conducted from 1981 to 1984. SETTING: Seven pediatric practices in the United States, including private offices and pediatric clinics. PARTICIPANTS: Of the 654 patients, 525 children and adolescents with clinical evidence of tonsillitis or pharyngitis and throat cultures positive for group A beta-hemolytic streptococcal infection were evaluable. Eighty percent of patients completed the study; none were withdrawn because of adverse reaction. SELECTION CRITERIA: Children and adolescents who had acute illness suggestive of group A beta-hemolytic streptococcal infection were enrolled in the study. Treatment was continued if the throat culture was positive for group A beta-hemolytic streptococcal infection. INTERVENTIONS: Four doses of cephalexin and penicillin (27 mg/kg per day) were prescribed to be taken on an empty stomach for 10 days. MEASUREMENTS/MAIN RESULTS: Symptomatic clinical failure occurred in 8% of penicillin-treated patients and in 3% of cephalexin-treated patients. Bacteriologic failure rates were 11% in the penicillin treatment group and 7% in the cephalexin treatment group. The combined treatment failure rate of clinical relapse plus asymptomatic bacteriologic failure was 19% in the penicillin treatment group and 10% in the cephalexin treatment group. Paired antistreptolysin-O titer increased significantly in 62.3% of penicillin-treated patients and in 64.2% of cephalexin-treated patients. Similarly, anti-DNase B titers rose 52.2% in penicillin-treated patients and 52.4% in cephalexin-treated patients. CONCLUSION: Cephalexin is a more effective drug than penicillin in the treatment of group A beta-hemolytic streptococcal throat infection in children.

Adolescent↗
PubMed1977

Neutralizing EBV-specific IgA in throat washings of nasopharyngeal carcinoma (NPC) patients.

Throat washings from 26 nasopharyngeal carcinoma (NPC) patients from Hong Kong and Tunisia were studied for the presence of transforming EBV. Only six (23%) were found positive which led to the hypothesis of a neutralizing factor in such salivas. The search for EBV-specific antibodies showed that NPC saliva contained neutralizing VCA and EA IgA (54 and 27% respectively) and VCA and EA IgG (73 AND 54% respectively). Both transforming and non-transforming throat washings contained virus particles as visualized by electron microscopy, but in non-transforming salivas (containing IgA and IgG) the particles were found to be clumped. Comparative study of throat washings from patients with Burkitt's lymphoma (BL); infectious mononucleosis (IM), immunodeficiencies, other cancers, and healthy subjects showed that IgA were restricted to NPC cases.

Antibodies, Viral↗
PubMed2006

Distribution of Epstein-Barr virus genotypes in throat washings, sera, peripheral blood lymphocytes and in EBV positive tumor biopsies from Slovenian patients with nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a malignancy closely associated with Epstein-Barr virus (EBV). It is prevalent among the Chinese of Southern China, whereas outside China, the position seems to be different. The aim of this study was to determine the distribution of EBV genotypes in the patients with NPC in Slovenia, which is a nonendemic area. Detection of EBV was undertaken by testing the throat washes, sera, peripheral blood lymphocytes (PBLs), and biopsies of primary tumors of 48 patients with NPC in Slovenia. The sera of 20 patients with serologically confirmed primary EBV infection served as a control clinical material. The analysis of genotypes was carried out on three regions of EBV genome; BamHI WYH, BamHI I, and BamHI F, using the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The results show that, in Slovenia, the predominant combination of EBV genotypes based on the differences in the three genomic regions is ADF. This combination was found in 56 out of 103 different EBV positive clinical samples (throat washes, sera, PBLs, and tumor biopsies) of patients with NPC and in 15 out of 17 sera of patients with primary EBV infection. Very low number of genotypes C and f were detected, in spite of the fact that these two genotypes were considered to be associated with the development and/or maintenance of NPC in Southern China. Genotype f was found in only two tumor biopsies; in all other clinical samples (throat washes, sera and PBLs), genotype F was detected. Genotype C was proven in 31/103 clinical samples, with the highest percentage in tumor biopsies (37.5%). As in the NPC patients from other countries (Alaska is an exception), genotype A was predominant and was detected in 86/103 clinical samples. Genotype B was found in 15 clinical samples of patients with NPC and in 3 the two genotypes A and B were found. In comparison to China, these results show different EBV genotypes distribution. It seems that the genetic disposition of human population is an important factor that may contribute to different susceptibility for specific EBV genotypes.

Adolescent↗
PubMed2002

Detection of varicella-zoster virus DNA in throat swabs of patients with herpes zoster and on air purifier filters.

Zoster patients are considered to be less contagious than those with varicella because their infectious lesions are localized. However, it is not known when the spread of varicella-zoster virus (VZV) from zoster patients begins, how long it continues, and how far the virus spreads from the zoster patients. Twelve cases of hospitalized zoster patients were studied. The polymerase chain reaction (PCR) was used to detect VZV DNA in samples taken from the surface of their eruptions, throats, and the air purifier filters in their rooms. In all patients, VZV DNA was detected in the samples from eruptions. VZV DNA was detected in 8 of 12 patients from the throats. VZV DNA was detected for 9 of 12 patients from the filter samples. This study shows the possibility of a wide distribution of VZV DNA to the environment from infected patients. VZV may be excreted from cutaneous eruptions or from the throats of patients.

Adult↗
PubMed1977

Throat-skeleton fractures by strangulation.

The frequency of throat-skeleton fractures was investigated in a series of 30 unselected cases of strangulation. Less than half of the victims showed fractures. From the data obtained, it seems to prove that this is a connection between the frequency of fractures and the age of the victims. The radiological investigation shows that this connection is based on the degree of ossification of the throat-skeleton. This ossification starts often already at early age and should be considered as a process of ageing. Notwithstanding the irregular occurrence of throat-skeleton fractures, these injuries are obviously of a vast diagnostic value.

Adolescent↗