The University of Southampton
University of Southampton Institutional Repository

Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study

Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study
Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study
Background: management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs.

Aim: to assess the incidence and clinical variables associated with streptococcal infections.

Design and setting: prospective diagnostic cohort study in UK primary care.

Method: the presence of pathogenic streptococci from throat swabs was assessed among patients aged ?5 years presenting with acute sore throat.

Results: pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient's assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors' assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42).

Conclusion: non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting
0960-1643
787-794
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Hobbs, F.D. Richard
0935e839-463a-436b-b66f-f99679d6839a
Mant, David
d2e30212-70ec-48c9-b80a-a45cf4bcc46e
McNulty, Cliona A.M.
c82aedfc-4ced-4231-8d7a-06e0d1592b26
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Leydon, Geraldine
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Hobbs, F.D. Richard
0935e839-463a-436b-b66f-f99679d6839a
Mant, David
d2e30212-70ec-48c9-b80a-a45cf4bcc46e
McNulty, Cliona A.M.
c82aedfc-4ced-4231-8d7a-06e0d1592b26
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Leydon, Geraldine
c5cdaff5-0fa1-4d38-b575-b97c2892ec40

Little, Paul, Hobbs, F.D. Richard, Mant, David, McNulty, Cliona A.M., Mullee, Mark, Moore, M. and Leydon, Geraldine (2012) Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study. British Journal of General Practice, 62 (604), 787-794. (doi:10.3399/bjgp12X658322). (PMID:23211183)

Record type: Article

Abstract

Background: management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs.

Aim: to assess the incidence and clinical variables associated with streptococcal infections.

Design and setting: prospective diagnostic cohort study in UK primary care.

Method: the presence of pathogenic streptococci from throat swabs was assessed among patients aged ?5 years presenting with acute sore throat.

Results: pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient's assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors' assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42).

Conclusion: non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting

This record has no associated files available for download.

More information

Published date: 2012
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 347576
URI: http://eprints.soton.ac.uk/id/eprint/347576
ISSN: 0960-1643
PURE UUID: c2e171ae-e575-42cc-bb79-8af08034b246
ORCID for M. Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for Geraldine Leydon: ORCID iD orcid.org/0000-0001-5986-3300

Catalogue record

Date deposited: 25 Jan 2013 11:39
Last modified: 15 Mar 2024 03:23

Export record

Altmetrics

Contributors

Author: Paul Little
Author: F.D. Richard Hobbs
Author: David Mant
Author: Cliona A.M. McNulty
Author: Mark Mullee
Author: M. Moore ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×