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At least 307 records · Page 17Linked to original sources
PubMed1993

Beclomethasone prevents postoperative sore throat.

The effects of a dose of beclomethasone inhaler (50 micrograms) or lidocaine 10% spray on postoperative sore throat were studied in 120 patients undergoing tracheal intubation for elective surgical procedures. Fifty-four patients (90%) in the beclomethasone group scored no postoperative sore throat compared with 27 (45%) in the lidocaine group (P < 0.001). Beclomethasone inhaler seems to be highly effective in the prevention of postoperative sore throat and is therefore to be recommended before tracheal intubation for general anaesthesia.

Adult↗
PubMed1997

Susceptibility of Streptococcus pyogenes from throat cultures to macrolide antibiotics and influence of collection criteria.

OBJECTIVE: To assess the incidence of resistance to erythromycin and to the three other macrolide antibiotics most extensively used in Italy (azithromycin, clarithromycin and roxithromycin) among clinical strains of Streptococcus pyogenes freshly isolated from throat cultures of pediatric patients in an area of Central Italy. METHODS: Two sets of isolates were examined. The strains of the first set (n=100) were collected according to a protocol admitting only throat swabs from untreated patients with symptoms of acute pharyngotonsillitis. The second set (n=180) consisted of strains isolated from throat cultures during the routine activity of diagnostic laboratories, no particular protocol being applied. RESULTS: A trimodal distribution of strains was observed in relation to their macrolide susceptibility levels: two clusters were constituted by highly susceptible and highly resistant strains, respectively; a third, middle cluster consisted of strains displaying low-level resistance (or even intermediate susceptibility, in a minority of isolates, to clarithromycin). The distribution of individual isolates in the three modal clusters was the same with all four drugs. Both MIC ranges and MIC50s almost overlapped in the isolates of the two sets, whereas MIC90s were far higher in the strains of the second set (4 micro g/mL for clarithromycin, 8 micro g/mL for erythromycin and azythromycin, and 16 micro g/mL for roxithromycin) than in those of the first (0.125 micro g/mL for all four drugs). Resistant strains were 5% among the isolates of the first set and three times as many among those of the second. CONCLUSIONS: The lower incidence of macrolide resistance recorded in the first set is probably more reliable: the threefold incidence observed in the second set may be overestimated due to the lower frequency of strains involved in drug-responsive infections and to the increased occurrence of strains from unsuccessfully treated patients.

Journal Article↗
PubMed2005

Microbiology of sinusitis and the predictive value of throat culture for the aetiology of sinusitis.

A prospective study of throat cultures and maxillary sinus aspirates from children with chronic sinusitis (n = 21), acute sinusitis (n = 28) or a clinical diagnosis of chronic adenoiditis (n = 41) was performed. Seventy-two bacterial pathogens were isolated from sinus aspirates from 52% of the study population. Haemophilus influenzae was most common pathogen, followed by Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and group A streptococci. Quantitative throat cultures had positive predictive values of 41%, 53% and 75% for H. influenzae, Strep. pneumoniae and M. catarrhalis, respectively, while negative predictive values were 93-98%, indicating that these three pathogens do not cause sinusitis when absent from the throat.

Adenoids↗
PubMed1989

[Role of normal microflora in the throat in inhibition of adherence of pathogenic bacteria to host cells: in vitro competitive adherence between Corynebacterium pseudodiphtheriticum and Branhamella catarrhalis].

Our previous study showed the occurrence of Branhamella catarrhalis (B. catarrhalis) pulmonary infections which varies seasonally. To investigate the role of normal throat microflora in this seasonal variation of the occurrence of B. catarrhalis infection, seventy seven throat cultures were done in 45 patients with chronic pulmonary diseases from January to December in 1985. The isolation rate of Corynebacterium species as normal microflora was relatively higher in summer than in winter. Therefore in vitro competitive adherence to human epithelial cells between Corynebacterium pseudodiphtheriticum (C. pseudodiphtheriticum) and B. catarrhalis was done to examine bacterial interference. Preincubation or simultaneous incubation of C. pseudodiphtheriticum reduced the number of B. catarrhalis adherent to epithelial cells (p less than 0.02). The mean number of adherent C. pseudodiphtheriticum (average; 13.86) was higher than that (average; 1.22) of adherent B. catarrhalis. There was no antagonism in the growth on blood agar between C. pseudodiphtheriticum and B. catarrhalis. These findings suggest Corynebacterium species as normal throat microflora may interfere the adherence of B. catarrhalis to human epithelial cells and may protect against colonization and infection with B. catarrhalis. Bacterial interference of Corynebacterium species may be associated with the low occurrence of B. catarrhalis pulmonary infections in summer.

Adult↗
PubMed2006

Identification of new genetic regions more prevalent in nontypeable Haemophilus influenzae otitis media strains than in throat strains.

Nontypeable (NT) Haemophilus influenzae strains cause significant respiratory illness and are isolated from up to half of middle ear aspirates from children with acute otitis media. Previous studies have identified two genes, lic2B and hmwA, that are associated with NT H. influenzae strains isolated from the middle ears of children with otitis media but that are not associated with NT H. influenzae strains isolated from the throats of healthy children, suggesting that they may play a role in virulence in otitis media. In this study, genomic subtraction was used to identify additional genetic regions unique to middle ear strains. The genome of NT H. influenzae middle ear strain G622 was subtracted from that of NT H. influenzae throat strain 23221, and the resultant gene regions unique to the middle ear strain were identified. Subsequently, the relative prevalence of the middle ear-specific gene regions among a large panel of otitis media and throat strains was determined by dot blot hybridization. By this approach, nine genetic regions were found to be significantly more prevalent in otitis media strains. Classification tree analysis of lic2B, hmwA, and the nine new potential otitis media virulence genes revealed two H. influenzae pathotypes associated with otitis media.

Bacterial Proteins↗
PubMed1982

Diagnosis of group A streptococcal infections directly from throat secretions.

The diagnosis of group A streptococcal disease still relies on isolation of group A streptococcal strains on sheep blood agar followed by presumptive identification based on bacitracin sensitivity or the results of the more precise serogrouping methods such as the Lancefield precipitin test. A technique that would permit rapid identification of streptococcal infections directly from throat secretions would allow immediate appropriate antimicrobial therapy for the management of streptococcal infections to be started. We have been able to identify soluble group A antigen directly from throat secretions by using a latex agglutination test. In a clinical trial in which latex (Streptex group A) and conventional culturing techniques were used, 53 throat secretion cultures were tested: 26 were positive by both procedures, 5 were positive by culture only, 3 were positive by the latex agglutination test only, and 19 were negative by both tests.

Antigens, Bacterial↗
PubMed1985

Ten-minute detection of group A streptococci in pediatric throat swabs.

A 10-min latex agglutination test kit, Culturette Brand Ten-Minute Group A Strep ID (Marion Scientific, Div. of Marion Laboratories, Inc., Kansas City, Mo.), was assessed for the rapid detection of group A beta-hemolytic streptococcus directly from a throat swab. Four hundred and thirty-five throat swab specimens from children with suspected group A streptococcal infection were tested by the Ten-Minute Group A Strep ID and by concurrent conventional culture. The strep test was effective in detecting group A streptococcal infection; 90% (63/70) of culture-positive specimens gave positive latex tests. The specificity of the test was 99.2% (362/365). The predictive values were 95.5% for positives and 98.1% for negatives. Overall agreement with culture was 98% (425/435). This test offers a sensitive and specific method for the early detection of group A beta-hemolytic streptococci in throat swabs of children and would be most useful in a hospital laboratory or pediatrician's office.

Adolescent↗
PubMed1985

Lack of reliability of primary grouping of beta-hemolytic streptococci by culture of throat swabs with streptocult supplemented with bacitracin disks in general practice.

Fifty-eight general practitioners took throat swabs from 434 patients with sore throats. Office cultures were performed on Streptocult supplemented with bacitracin disks in an attempt to carry out primary grouping of beta-hemolytic streptococci (BHS). In 424 cases the findings were compared with those obtained in a microbiological laboratory. Streptocult showed a sensitivity of 75% and a specificity of 84% in the detection of BHS. The office-performed grouping procedure of the correctly detected BHS, however, only had a sensitivity of 65% and a specificity of 87%. Overall, as many as 45% of the patients with BHS group A were misdiagnosed. The unsatisfactory results obtained with primary grouping of BHS may be due partly to incorrect determinations of the diameter of the inhibition zone around the bacitracin disks and partly to an inappropriate choice of breakpoint. It is concluded that cultures of throat swabs on Streptocult in general practice should not be accompanied by attempts to carry out primary grouping with bacitracin disks. A laboratory investigation showed that incubation at room temperature for 48 h and at 35 degrees C for 24 h gave identical BHS positivity rates.

Bacitracin↗
PubMed1987

Comparison of throat and nasopharyngeal swab specimens for culture diagnosis of Bordetella pertussis infection.

During a 9-month period, we evaluated the relative sensitivity of throat and nasopharyngeal swab cultures for isolation of Bordetella pertussis. Of 38 pertussis cases, 36 (95%) had positive nasopharyngeal cultures, while only 16 of 36 (44%) had positive throat cultures. There were no cases of nasopharyngeal-negative, throat-positive cultures. The sensitivity of the direct fluorescent-antibody test was 70% when compared with culture.

Bordetella pertussis↗
PubMed1979

Evaluation of sulfamethoxazole-trimethoprim blood agar plates for recovery of group A streptocci from throat cultures.

We compared the selective blood agar medium of Gunn et al. (J. Clin. Microbiol. 5:650-655, 1977) which contains sulfamethoxazole plus trimethoprim (SXT-BA) to the conventional blood agar surface plate (SBA) and a modified blood agar pour plate plus broth method for the recovery of group A streptococci from throat swabs. The influence of CO(2) and ambient air incubation of the SXT-BA and SBA plates was also evaluated. A total of 696 throat swabs from symptomatic children were cultured simultaneously by the five methods and observed after overnight incubation; 204 positive cultures were detected overall. Recovery rates of each individual method were: SXT-BA (CO(2)), 90.7%; SXT-BA (air), 87.7%; pour plate plus broth, 83.3%; SBA (CO(2)), 79.4%; and SBA (air) 77%. Approximately one-half of the false-negative cultures in the SXT-BA (CO(2)) and SXT-BA (air) methods had colony counts of >/=10 to 100 colonies per plate. In contrast, for the SBA (CO(2)), SBA (air), and pour plate plus broth methods, approximately 70% of the false-negative cultures had colony counts of >/=10 to 100/plate. False-positive cultures obtained by the SXT-BA (CO(2)) and SXT-BA (air) methods were 11 and 12.7%, respectively-one-half as high as the rates obtained by the remaining methods. Beta-hemolytic streptococci, groups C, F, and G, are inhibited on the SXT-BA plates and were the primary cause of the higher false-positive rates on SBA and pour plate plus broth methods. An additional 3% positive cultures were obtained by incubating SXT-BA (CO(2)) plates up to 48 h before discarding as negative. We recommend either the SXT-BA (CO(2)) or the SXT-BA (air) method with up to 48 h of incubation for routine use in throat cultures.

Adolescent↗
PubMed1998

Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats.

OBJECTIVES: To better understand reasons for antibiotics being prescribed for sore throats despite well known evidence that they are generally of little help. DESIGN: Qualitative study with semi-structured interviews. SETTING: General practices in South Wales. SUBJECTS: 21 general practitioners and 17 of their patients who had recently consulted for a sore throat or upper respiratory tract infection. MAIN OUTCOME MEASURES: Subjects' experience of management of the illness, patients' expectations, beliefs about antibiotic treatment for sore throats, and ideas for reducing prescribing. RESULTS: Doctors knew of the evidence for marginal effectiveness yet often prescribed for good relationships with patients. Possible patient benefit outweighed theoretical community risk from resistant bacteria. Most doctors found prescribing "against the evidence" uncomfortable and realised this probably increased workload. Explanations of the distinction between virus and bacterium often led to perceived confusion. Clinicians were divided on the value of leaflets and national campaigns, but several favoured patient empowerment for self care by other members of the primary care team. Patient expectations were seldom made explicit, and many were not met. A third of patients had a clear expectation for antibiotics, and mothers were more likely to accept non-antibiotic treatment for their children than for themselves. Satisfaction was not necessarily related to receiving antibiotics, with many seeking reassurance, further information, and pain relief. CONCLUSIONS: This prescribing decision is greatly influenced by considerations of the doctor-patient relationship. Consulting strategies that make patient expectations explicit without damaging relationships might reduce unwanted antibiotics. Repeating evidence for lack of effectiveness is unlikely to change doctors' prescribing, but information about risk to individual patients might. Emphasising positive aspects of non-antibiotic treatment and lack of efficacy in general might be helpful.

Anti-Bacterial Agents↗
PubMed1994

Foreign body in the throat.

The management of 104 patients complaining of foreign body (FB) in the throat in an accident and emergency (A&E) department was analysed over a period of 7 months. The majority of these patients (88.4%), underwent a soft tissue radiograph of the neck. Less than 10% of the radiographs were thought to be abnormal by the A&E staff. Two thirds of the patients (69.2%) were referred to the ear, nose and throat (ENT) surgeons. Of these 84.7% had indirect laryngoscopy. Eighteen (17.3%) FBs were found in addition to five (4.8%) other causes of the symptom. It is concluded that routine use of radiographs in the assessment of FB in the throat is inappropriate. By contrast thorough clinical examination and indirect laryngoscopy (IDL) have a high diagnostic yield. A protocol is suggested for managing the condition.

Adolescent↗
PubMed1999

Group C streptococci isolated from throat swabs: a laboratory and clinical study.

AIMS: To determine the prevalence of beta haemolytic, Lancefield group C streptococci in throat swabs taken in routine clinical practice, and correlate the species identified with presenting clinical features. METHODS: One year, laboratory based prospective study, using a questionnaire to elicit clinical information. RESULTS: 4.4% of throat swabs yielded group C streptococci, of which 38% belonged to S equisimilis and 53% to S anginosus-milleri group (SAM). Pyrexia was more common in patients with S equisimilis, but other clinical features did not differ significantly between the two groups. No S zooepidemicus was isolated. CONCLUSIONS: Species identification of group C streptococci from throat swabs does not appear to be clinically useful in this patient population. However, the prevalence and spectrum of organisms is similar to that reported in N America, where studies suggest a possible role in some cases of severe pharyngitis. Observational studies such as this lack power to resolve the issue of pathogenicity, for which a placebo controlled trial of antibiotic treatment is ideally required.

Adolescent↗
PubMed1981

Yersinia enterocolitica isolated from throats of swine in eastern and western Canada.

Examination of the throat flora from swine in Ontario for Yersinia enterocolitica found the incidence of serotype O:3 to vary from 20% from tonsils to 50% for throat swabs and 55% for tongues. In contrast, there were no isolations of serotype O:3 from throat swabs taken from swine in the western provinces of British Columbia and Alberta. This incidence of serotype O:3 in swine correlates well with the human incidence of the same serotype which is 81% for all human isolations of Y. enterocolitica in the eastern provinces and 4% in the western provinces of Canada. The opposite relationship is true for serotype O:5,27, which was not isolated from Ontario swine but occurred with a frequency of 3% in British Columbia swine and 24% in Alberta swine. The relative incidence in humans for serotype O:5,27 is 5% of all isolations of Y. enterocolitica in Ontario, 8% in British Columba, and 26% in Alberta. Serotype O:8, the most common human serotype in the western provinces (40% of all isolations), was not isolated from swine in this survey. The majority of Y. enterocolitica cultures of biotype 4 (serotype O:3) and biotype 2 (serotype O:5,27) were positive for autoagglutination, a test which has been associated with virulence, whereas all cultures of biotype 1 were negative. The results from this study strongly suggest that swine are an important source of human infections with both serotype O:3 and O:5,27 of Y. enterocolitica. The source of human infections in western Canada with serotype O:8 remains unidentified.

Animals↗
PubMed2001

Prevalence of habitual snoring in a sample of French males. Role of "minor" nose-throat abnormalities.

BACKGROUND: No data on snoring prevalence obtained with a standard questionnaire exist for France. Major nose-throat abnormalities have been demonstrated in cases with obstructive sleep apnea; evidence of "minor" abnormalities in community studies is scarce. OBJECTIVES: The first objective of our study was to estimate the prevalence of habitual snoring in a sample of middle-aged active males in France. The second objective was to test the hypothesis that "minor" nose-throat abnormalities could be associated with habitual snoring in a field survey. METHODS: Three hundred thirty-four male employees of a local university volunteered for the study (93.6% of those contacted by mail); 300 returned a sleep questionnaire. The protocol also included anthropometry and a noninvasive nose-throat examination. RESULTS: Complete data were obtained in 299 subjects aged 23-63 years. When "habitual snorers" (= 32%) were compared with never-snorers, significant differences were found for all anthropometric variables, except height. In univariate analysis, habitual snoring was associated with a large number of variables, including a large soft palate, a large uvula, and altered nose patency. A logistic regression model retained 8 factors independently associated with snoring: age, neck circumference, tobacco consumption, breathing pauses during sleep, not feeling rested during the day, need for coffee to stay awake, blocked or running nose at night and a large soft palate. CONCLUSIONS: The prevalence of habitual snoring in this sample of middle-aged French males was 32%. We confirmed the significant association of habitual snoring with age, weight excess, and tobacco smoking, and identified two further factors: blocked nose at night and a large soft palate.

Adolescent↗
PubMed2005

Inside-out complete tonsillectomy: extended intracapsular tonsillectomy for severe sore throat.

OBJECTIVES: This consecutive case series is presented to describe inside-out complete tonsillectomy and to assess its effects on postoperative pain and bleeding and its initial effectiveness in controlling recurrent sore throat and peritonsillar abscess formation. METHODS: Bipolar electrosurgical scissors are used for bloodless resection of 90% of the tonsillar mass. During controlled resection, tonsil tissue is intentionally left at the superior and inferior poles and at the deepest part of the tonsillar fossa to provide coverage for nutrient arteries and the tonsillar plexus of veins. This tissue is then electrodesiccated and removed under direct vision and indirect mirror guidance to achieve complete tonsillectomy. RESULTS: One hundred eighty-three consecutive tonsillectomies were performed by a single surgeon in a 16-month period, 47 of which were for the indication of recurrent sore throat (44) or recurrent peritonsillar abscess (3). Among these 47 children, there were 2 readmissions for dehydration. There were no immediate or delayed bleeding episodes. The average child required 4 days of narcotic pain medication. The mean annualized number of severe sore throats decreased from 5.24 before operation to 0.36 after operation (p < .0001, Student's paired t-test). There were no recurrent peritonsillar abscesses. CONCLUSIONS: Inside-out complete tonsillectomy achieves the surgical goal of complete tonsillectomy with the smallest possible wound and minimal injury to the surrounding tissue. The perioperative morbidity is markedly decreased compared to that of historical controls. The initial results suggest effectiveness similar to that of extracapsular tonsillectomy.

Child↗
PubMed1998

Cytokine evaluation in throat infections.

Inflammatory cytokines have been shown to play an important role in the pathogenesis of various inflammatory processes. In throat infections, intracellular inflammatory cytokines have been detected from the sites of inflammation. The present study aimed to evaluate serum cytokine levels of patients with throat infections and correlate them to the inflammatory parameters and type of inflammation. Significantly higher inflammatory cytokine levels (interleukin [IL]-6 > 7 pg/mL, IL-1 > 1 beta pg/mL, tumor necrosis factor alpha > 1 pg/mL) were detected in most of the patients as opposed to healthy controls. Clinical parameters of infection (fever > 38 degrees C, leukocytosis > 11,000 white blood cells per cubic millimeter, polymorphonuclear neutrophils > 75%) were significantly correlated with high levels of inflammatory cytokines: mainly IL-6 and tumor necrosis factor alpha, and to a lesser degree with IL-1 beta. No correlation, however, was found between the type of inflammation and cytokine levels. The present study indicates a role of inflammatory cytokines in the pathogenesis of throat infections and the need for an anti-inflammatory and anticytokine therapeutic approach.

Adolescent↗
PubMedDate not supplied

Effect of an explicit decision-support tool on decisions to prescribe antibiotics for sore throat.

Studies of scoring rules for sore throat have failed to show that they lower antibiotic prescription rates. The authors studied the effect of an explicit decision-support tool, incorporating a modified score, on antibiotic-prescription decisions. Four hundred and fifty family physicians received an information package, a score card, and a recording form to use during one sore-throat encounter. The physicians randomly received either a control form or an intervention form that required them to interact with the score during the clinical recording process. There was a trend towards a reduction in antibiotic prescriptions (21%, p=0.09) in the physicians using the intervention form. A greater reduction (45%, p=0.06) was observed for patients whose probabilities of infection with group A streptococcus were low. Sore-throat-scoring rules may reduce unnecessary antibiotic prescriptions if physicians are specifically cued to use them during clinical encounters and appropriate management responses are linked to score estimates for the likelihood of group A streptococcus infection.

Adult↗