Downloads & Free Reading Options - Results

Rapid antigen detection test for group A streptococcus in childrenwith pharyngitis (Review) .

Rapid antigen detection test for group A streptococcus in childrenwith pharyngitis (Review) .

Rapid antigen detection test for group A streptococcus in childrenwith pharyngitis (Review) .

This episode features Dr. Brent Egan discussing the target blood pressure in older adults, and Dr. Mark Aronson discussing the use of dexamethasone for acute pharyngitis pain in adults. Dr. Nancy Sokol hosts.

This article is from The Indian Journal of Medical Research , volume 133 . Abstract Background & objectives:: Group A streptococcal (GAS) pharyngitis, especially among children, leads to high prevalence of rheumatic fever (RF)/rheumatic heart disease (RHD) in India, as compared to the western world where invasive diseases are common. GAS encodes numerous virulence factors that cause diseases by exhibiting extraordinary biological diversity. Hence, we studied the virulence factors genes of GAS isolated from the throat of children with pharyngitis and also asymptomatic carriers. Methods:: Fifty GAS isolates cultured from throats of north Indian children aged 5-15 yr with mild pharyngitis (20), severe pharyngitis (24) and asymptomatic pharyngeal carriers (6), during 2000-2003 along with reference M1 strain were emm typed and characterized for virulence factors genes by PCR. The presence of virulence factors was also checked for their association with emm type in pharyngitis. Results:: Twenty emm types, six sequence types, and one non-typeable strain were found circulating in north India. The five most prevalent types were emm 74 (12%), 11 & StI129 (8% each) and emm 68 and NS292 (6% each). The spe B gene was found to be significantly higher (P=0.0007) in opacity factor (OF) negative isolates. emm 3, 11, 77, 86, 87, 109 and StI129 showed maximum virulence factors genes. Interpretation & conclusions:: GAS isolates collected from throats of children from north India possess highly virulent antigens. This study also supports concept of isolate-associated virulence rather than type relatedness.

This project seeks to characterize the pharyngeal microbiota of children presenting with pharyngitis to gain an understanding of the association between the microbiota and host during active and latent GAS infections.

Cannabis sativa is a herb with a rich diversity of active ingredients with various pharmacological properties ranging from psychoactive, sedative, analgesic, antiinflammatory and antimicrobial activities. This study was undertaken to evaluate the efficacy of leaf extracts of Cannabis sativa on inhibiting the growth of Lancefield Group A Streptococcus sp responsible for streptococcal pharyngitis also known as “strep throat”. The active ingredients of Cannabis sativa were extracted using water and methanol in a soxhlet apparatus and measured using standard protocols. 10 Group A Streptococcus spp. were isolated from clinical cases of streptococcal pharyngitis. The susceptibility of these isolates to the methanolic extract of Cannabis sativa was evaluated using the Kiby-Bauer agar-well diffusion assay technique and tube dilution method. The antimicrobial inhibitory properties of the extracts were compared to three common antibiotics used in the treatment of strep throat (penicillin, amoxicillin and chloramphenicol). Results obtained shows the presence of bioactive compounds including; alkaloids, flavonoids, cardiac glycosides, phenols, terpenes, resins and steroids. These phytochemicals exerted antimicrobial activity against Streptococcus sp, resulting in zones of inhibitions between 18.80-22.80 mm against the test organisms, comparable to the zones obtained from commercially available  β -lactam antibiotics. Extracts of cannabis out-performed chloramphenicol in the inhibition of the test organism, producing larger zones. Tube dilution assays of the extracts gave a Minimum Inhibitory Concentration (MIC) of 20 mg/ml and Minimum Bactericidal Concentration (MBC) of 30 mg/ml, all comparable to the commercial antibiotics. Results of this study have highlighted the potential of cannabis extracts to control Lancefield Group A Streptococcus sp which are causative agents of pharyngitis.

Biomedical sciences's constant innovations have created a significant demand for Health Technology Assessment, such as incorporations reports and studies of new equipment or drugs, as well as reviews of existing technologies, especially related to drugs that may potentially lead to bacterial antibiotic resistance, such as amoxicillin. Therefore, studies that compare two antibiotics potencialy inductors of bacterial resistance and widely used in the Public Health System are important, as their results can update data to guide physicians in choosing the best treatment, contribute to the update of clinical guidelines, and support decision-making within the Unified Health System. The appropriate patient's treatment certainly ensures lower public spending budgets by reducing the likelihood of disease recurrence, minimizing patient returns to Health Centers and Polyclinics, and avoiding hospitalizations and complications that could even lead to ICU admissions.

This article is from Journal of Community Hospital Internal Medicine Perspectives , volume 3 . Abstract Introduction: Sinus infections, sore throats, and upper respiratory tract infections (URI) are common reasons patients seek medical care. Well-established treatment guidelines exist for prescribing antibiotics in these clinical scenarios, but are not often followed. Objective: The objective of this study is to determine practice patterns related to prescribing antibiotics for sinusitis, URI, and pharyngitis. The main hypothesis is that attending physicians improve their adherence to antibiotic guidelines with a learner present. Methods: A retrospective cohort study was performed on patients treated for URI, sinusitis, and pharyngitis at an ambulatory faculty practice. The use of relevant ICD-9 codes from January 1, 2008 to January 30, 2012 resulted in 1,548 patient encounters which were reviewed for guideline adherence. Univariate analysis and multivariate logistic regression was performed for each outcome variable to determine if they influence antibiotic adherence. Variables studied were physician, presence of a learner, BMI, age, gender, day of the week, month, diabetes, immunosuppression, and COPD. Results: Multivariate analysis showed the statistically significant variables were age (p=0.038) for pharyngitis and provider (p=0.013) for URI. There were no significant findings for sinusitis. Guideline adherence was 24% in patients with pharyngitis, 42% in acute sinusitis, 79% in URI, and 57% overall. Conclusion: Guideline adherence varies depending on the treating physician and decreases when treating younger patients with pharyngitis. The presence of a learner did not improve prescribing habits. The reason for these findings remain unclear, but considerations for improvement could include following antibiotic adherence as a quality measure, giving patients handouts educating them about the impact of overprescribing antibiotics, and further education amongst faculty and residents about adhering to nationally recognized guidelines.

This article is from Journal of Community Hospital Internal Medicine Perspectives , volume 3 . Abstract Introduction: Sinus infections, sore throats, and upper respiratory tract infections (URI) are common reasons patients seek medical care. Well-established treatment guidelines exist for prescribing antibiotics in these clinical scenarios, but are not often followed. Objective: The objective of this study is to determine practice patterns related to prescribing antibiotics for sinusitis, URI, and pharyngitis. The main hypothesis is that attending physicians improve their adherence to antibiotic guidelines with a learner present. Methods: A retrospective cohort study was performed on patients treated for URI, sinusitis, and pharyngitis at an ambulatory faculty practice. The use of relevant ICD-9 codes from January 1, 2008 to January 30, 2012 resulted in 1,548 patient encounters which were reviewed for guideline adherence. Univariate analysis and multivariate logistic regression was performed for each outcome variable to determine if they influence antibiotic adherence. Variables studied were physician, presence of a learner, BMI, age, gender, day of the week, month, diabetes, immunosuppression, and COPD. Results: Multivariate analysis showed the statistically significant variables were age (p=0.038) for pharyngitis and provider (p=0.013) for URI. There were no significant findings for sinusitis. Guideline adherence was 24% in patients with pharyngitis, 42% in acute sinusitis, 79% in URI, and 57% overall. Conclusion: Guideline adherence varies depending on the treating physician and decreases when treating younger patients with pharyngitis. The presence of a learner did not improve prescribing habits. The reason for these findings remain unclear, but considerations for improvement could include following antibiotic adherence as a quality measure, giving patients handouts educating them about the impact of overprescribing antibiotics, and further education amongst faculty and residents about adhering to nationally recognized guidelines.

An explosive outbreak of pharyngitis involving 1954 trainees at the Turkish Army Engineering Training Center, near Izmir, Turkey, between 8 and 14 May 1967, was determined to have been caused by a massive introduction of bacitracin-sensitive, beta-hemolytic streptococci into the three training battalions comprising the center, probably by means of a contaminated food item consumed on or two days before the onset of symptoms. The course of the epidemic may have been influenced by the change from spring to summer weather conditions which occurred between 5 and 9 May 1967, and by the prompt and efficacious chemotherapy administered by the Turkish medical staff.

An explosive outbreak of pharyngitis involving 1954 trainees at the Turkish Army Engineering Training Center, near Izmir, Turkey, between 8 and 14 May 1967, was determined to have been caused by a massive introduction of bacitracin-sensitive, beta-hemolytic streptococci into the three training battalions comprising the center, probably by means of a contaminated food item consumed on or two days before the onset of symptoms. The course of the epidemic may have been influenced by the change from spring to summer weather conditions which occurred between 5 and 9 May 1967, and by the prompt and efficacious chemotherapy administered by the Turkish medical staff.

An explosive outbreak of pharyngitis involving 1954 trainees at the Turkish Army Engineering Training Center, near Izmir, Turkey, between 8 and 14 May 1967, was determined to have been caused by a massive introduction of bacitracin-sensitive, beta-hemolytic streptococci into the three training battalions comprising the center, probably by means of a contaminated food item consumed on or two days before the onset of symptoms. The course of the epidemic may have been influenced by the change from spring to summer weather conditions which occurred between 5 and 9 May 1967, and by the prompt and efficacious chemotherapy administered by the Turkish medical staff.

This article is from BMC Family Practice , volume 15 . Abstract Background: Ambroxol has a local anaesthetic action and is marketed for pain relief for sore throat. The objective is to examine the efficacy and safety of ambroxol for the relief of pain associated with acute uncomplicated sore throat. Methods: A systematic review of the literature and meta-analysis. Selection criteria consisted of randomized controlled trials which compared ambroxol to placebo or any other treatment for sore throat. Two reviewers independently assessed for relevance, inclusion, and risk of bias. Weighted mean differences (WMDs) were calculated and are reported with corresponding 95% confidence intervals (CIs). Results and conclusion: From 14 potentially relevant citations, five trials reported in three publications met the inclusion criteria, three of them were published twice. Ambroxol lozenges were compared in different dosages (5–30 mg) with mint flavoured lozenges and once with benzocaine. Main outcome was a ratio of pain reduction measured repeatedly over 3 h compared to baseline on 6-item verbal rating scale. A total of 1.772 adult patients participated in the trials. Pain intensity decreased in both study arms. A meta-analysis of the 5 controlled trials resulted in a difference in pain reduction compared to placebo of -0.11 (95% CI [-0.15, -0.07]; p 

This article is from Iranian Journal of Microbiology , volume 3 . Abstract Background and Objective: Group A beta-hemolytic streptococcus (GABHS) is an important pharyngotonsillitis etiologic agent in children. The objective of this study was diagnosis of streptococcal pharyngitis based on rapid antigen detection test and conventional pharyngeal culture. Materials and Methods: The rapid GABHS antigen detection test was compared to culture on blood agar, the gold standard for the diagnosis of this etiologic agent. Results: Streptococcal antigen was detected in pharyngeal specimens of 34.5% of cases by rapid strip test. We detected group A Streptococcus in 17.2% of pharyngeal culture. There was no agreement between two methods ( PV < 0.1). The negative pharyngeal culture results are probably due to antibiotic usage in 43.2% of patients. Positive rapid test results in pharyngeal swab was age dependent ( P < 0.05). There was good correlation between observing the “petechia in pharynx of patients” and positive rapid test in pharyngeal swab (P < 0.004). Throat culture results were relatated to previous antibiotic usage ( P < 0.03). Conclusion: The rapid test in pharyngeal swab is helpful for rapid diagnosis and treatment of GABHS pharyngitis. Diagnosis of GABHS pharyngitis based on soley clinical findings is misleading in the majority of cases. Petechia observed in pharynx of the cases was highly predictive of streptococcal pharyngitis.

This article is from Journal of Family & Community Medicine , volume 9 . Abstract Aim:: This study was carried out to assess the prevalence of Group A Streptococcal (GAS) bacteria in the throat specimens of children with tonsillitis and pharyngitis compared to healthy children of the same age group. Methodology:: The study was a prospective one. Throat swabs were obtained from 73 children aged 1-12 years diagnosed with acute tonsillitis and pharyngitis (sore throat and pyrexia >38.5°C) visiting a pediatric outpatient clinic between December, 1999 and April, 2000. In the same period throat swabs were obtained from 465 healthy primary school children aged 6-12 years. GAS from patients was tested for sentivity to penicillin, erythromycin, and cefaclor. Results:: In children with tonsillitis and pharyngitis GAS was found in 29 out of 73 (40%). In healthy school children GAS was found in 15 out of 465 (3%).In the patients group GAS was sensitive to penicillin in 14(48%), erythromycin in 27(93%), and cefaclor in 28(96%) Conclusion:: Although the prevalence of GAS among healthy children was similar to international studies, the GAS infection was high among children with acute tonsillitis and pharyngitis. Sensitivity to penicillin was less than 50% and more than 90% for erythromycin and cefaclor. We recommend routine throat swab for children with acute tonsillitis and pharyngitis and the proper treatment of GAS positive patients to prevent further complications.

This article is from Virology Journal , volume 9 . Abstract Respiratory viral infections can trigger asthma attack which may lead to sever morbidity. In this report, using molecular methods, we show the chronological association between human coronavirus - HKU1 infection and asthma exacerbation in a two years and seven months old asthmatic girl who was not under treatment and was otherwise healthy.

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This article is from North American Journal of Medical Sciences , volume 3 . Abstract Background:: The roles of group C and F streptococci in causing endemic pharyngitis are still controversial, although group C streptococci are implicated in the outbreaks of pharyngitis and associated disorders. Aim:: The aim of this study was to determine the prevalence and the role of these groups of β-hemolytic streptococci in acute pharyngitis with emphasis on the Streptococcus anginosus group. The antimicrobial susceptibility profile of these bacterial isolates and their ability to produce some virulence factors was also determined. Materials and Methods:: Throat swab specimens were collected from 177 patients suffering from acute pharyngitis who had been admitted to the Hilla Teaching Hospital, Hilla, Iraq, during October 2009 to January 2010. The necessary biochemical tests were conducted and the organisms identified using standard procedures. Susceptibility of isolates pathogens to several antibiotics was examined using standard susceptibility testing. Virulence factors of these isolates were also determined using standard methods. Results:: Results revealed that a total of 67 isolates belonged to β-hemolytic streptococci, of which 11(16.4%) isolates belonged to anginosus group streptococci, which possessed Lancefield group C and F antigens. Most of these bacterial isolates have the ability to produce more than one virulence factor such as capsule, hemolysin, CFA III, and lipase enzyme. The bacterial isolates were highly resistant to ampicillin, cefotaxime, and cefepime while they exhibited moderate resistance to tetracycline, ceftriaxone, and ciprofloxacin. On the other hand, they showed a high sensitivity to vancomycin, ofloxacin, and clindamycin. Conclusion:: This study concluded that groups C and F Streptococci were implicated as a cause of acute pharyngitis in 6.2% of the specimens among other groups of streptococci. Most of these isolates have the ability to produce more than one virulence factor. There was a high rate of resistance among isolates for β-lactam antibiotics; however, they were highly susceptible to vancomycin, ofloxacin, and clindamycin.

This paper is in the public domain in USA. Metadata comes from the CrossRef API, see full record in the source URL below.

This article is from Journal of Community Hospital Internal Medicine Perspectives , volume 4 . Abstract Background: Upper respiratory infections, acute sinus infections, and sore throats are common symptoms that cause patients to seek medical care. Despite well-established treatment guidelines, studies indicate that antibiotics are prescribed far more frequently than appropriate, raising a multitude of clinical issues. Methods: The primary goal of this study was to increase guideline adherence rates for acute sinusitis, pharyngitis, and upper respiratory tract infections (URIs). This study was the first Plan-Do-Study-Act (PDSA) cycle in a quality improvement program at an internal medicine resident faculty practice at a university-affiliated community hospital internal medicine residency program. To improve guideline adherence for respiratory infections, a package of small-scale interventions was implemented aimed at improving patient and provider education regarding viral and bacterial infections and the necessity for antibiotics. The data from this study was compared with a previously published study in this practice, which evaluated the adherence rates for the treatment guidelines before the changes, to determine effectiveness of the modifications. After the first PDSA cycle, providers were surveyed to determine barriers to adherence to antibiotic prescribing guidelines. Results: After the interventions, antibiotic guideline adherence for URI improved from a rate of 79.28 to 88.58% with a p-value of 0.004. The increase of adherence rates for sinusitis and pharyngitis were 41.7–57.58% (p=0.086) and 24.0–25.0% (p=0.918), respectively. The overall change in guideline adherence for the three conditions increased from 57.2 to 78.6% with the implementations (p

This article is from BMC Microbiology , volume 12 . Abstract Background: A few lineages of Group A streptococci (GAS) have been associated with a reemergence of severe invasive streptococcal disease in developed countries. However, the majority of the comparisons between invasive and non-invasive GAS isolates have been performed for collections of reduced genetic diversity or relied on limited typing information to distinguish clones. We characterized by several typing methods and compared a collection of 160 isolates recovered from normally sterile sites with 320 isolates associated with pharyngitis and recovered in the same time period in Portugal. Results: Although most of the isolates belonged to clones that were equally prevalent in invasive infections and pharyngitis, we identified markers of invasiveness, namely the emm types 1 and 64, and the presence of the speA and speJ genes. In contrast, emm4, emm75, and the ssa and speL/M genes were significantly associated with pharyngitis. There was a strong agreement between the emm type, the superantigen (SAg) genes and the clusters defined by pulsed-field gel electrophoresis (PFGE) profiling. Therefore, combinations of particular emm types and SAg genes frequently co-occurred in the same PFGE cluster, but there was no synergistic or antagonistic interaction between them in determining invasiveness. Only macrolide-susceptible PFGE clones were significantly associated with invasive infections or pharyngitis, while the clones of resistant isolates sharing all other molecular properties analyzed were equally prevalent in the two groups of isolates. Conclusions: This study confirmed the importance of the widely disseminated emm1-T1-ST28 clone in invasive infections but also identified other clones linked to either invasive infections (emm64-ST164) or pharyngitis (emm4-T4-ST39), which may be more limited in their temporal and geographical spread. Clonal properties like some emm types or SAg genes were associated with disease presentation, highlighting the importance of bacterial genetic factors to the outcome of GAS infections, although other, yet unidentified factors may also play an important role.

This article is from Experimental and Therapeutic Medicine , volume 7 . Abstract Chronic pharyngitis is chronic inflammation that is often caused by repeated occurrences of acute pharyngitis or upper respiratory tract infections, including Streptococcus and Staphylococcus. The present study aimed to investigate the effects of Yanshu spraying agent (Yanshu) in relieving chronic pharyngitis, as well as the possible underlying mechanisms. The results revealed that Yanshu inhibited chronic inflammation in ammonia-induced chronic pharyngitis in rabbits and cotton pellet-induced granuloma tissue formation in rats. Yanshu also demonstrated antibacterial effects on Streptococcus and Staphylococcus in vitro. Yanshu did not exhibit any effects on the immune system, including the spleen and thymus indexes, immunocyte count and monocyte-macrophage function, when compared with the effects of dexamethasone. Therefore, the results of the present study indicate that Yanshu may relieve chronic pharyngitis via its anti-inflammatory and antibacterial activities.

This article is from BMC Infectious Diseases , volume 13 . Abstract Background: Group A streptococcus (GAS) is the most common bacterial cause of sore throat. School-age children bear the highest burden of GAS pharyngitis. Accurate diagnosis is difficult: the majority of sore throats are viral in origin, culture-based identification of GAS requires 24–48 hours, and up to 15% of children are asymptomatic throat carriers of GAS. The aim of this study was to develop a quantitative polymerase chain reaction (qPCR) assay for detecting GAS pharyngitis and assess its suitability for clinical diagnosis. Methods: Pharyngeal swabs were collected from children aged 3–18 years (n = 91) and adults (n = 36) located in the Melbourne area who presented with sore throat. Six candidate PCR assays were screened using a panel of reference isolates, and two of these assays, targeting speB and spy1258, were developed into qPCR assays. The qPCR assays were compared to standard culture-based methods for their ability to detect GAS pharyngitis. GAS isolates from culture positive swabs underwent emm-typing. Clinical data were used to calculate McIsaac scores as an indicator of disease severity. Results: Twenty-four of the 127 samples (18.9%) were culture-positive for GAS, and all were in children (26%). The speB qPCR had 100% sensitivity and 100% specificity compared with gold-standard culture, whereas the spy1258 qPCR had 87% sensitivity and 100% specificity. Nine different emm types were found, of which emm 89, 3, and 28 were most common. Bacterial load as measured by qPCR correlated with culture load. There were no associations between symptom severity as indicated by McIsaac scores and GAS bacterial load. Conclusions: The speB qPCR displayed high sensitivity and specificity and may be a useful tool for GAS pharyngitis diagnosis and research.