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Family Practice Vol. 18, No. 3, 266-271
© Oxford University Press 2001

Infectious Diseases

The prevalence of potential pathogenic bacteria in nasopharyngeal samples from individuals with a respiratory tract infection and a sore throat—implications for the diagnosis of pharyngotonsillitis

Ronny K Gunnarsson, Stig E Holma, and Margareta Söderström

Department of Primary Health Care, Göteborg University and
a Department of Clinical Bacteriology, Umeå University, Sweden.

Correspondence to Ronny K Gunnarsson, MD, Research and Development Unit, Primary Health Care, Ekenäsgatan 15, S-504 55 Borås, Sweden.

Background. Treatment failure in patients with pharyngotonsillitis after a traditional course of penicillin V is a common finding. Several factors have been proposed to explain the failure rate, but the presence of aetiological agents other than group A ß-haemolytic streptococci has attracted little attention.

Objectives. The aim of the present study was to investigate if a nasopharyngeal sample could suggest the aetiology of a sore throat in patients with a respiratory tract infection.

Methods. The prevalence of potentially pathogenic bacteria (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis) in nasopharyngeal samples from 618 healthy individuals was compared with that from 108 patients with a respiratory tract infection and a sore throat.

Results. The prevalence of H.influenzae was higher in patients with a sore throat than in healthy individuals of the same age. For the adult patients with a sore throat, the prevalence was 27.5% compared with 2.7% for the healthy carriers (P < 10–7). The corresponding figures for schoolchildren were 31.3% versus 6.1% (P = 0.004) and for pre-school children 37.8% versus 13.2% (P = 0.0003).

Conclusions. If H.influenzae is found in a nasopharyngeal sample from a patient with a respiratory tract infection and a sore throat, it might be the aetiological agent.

Keywords. Haemophilus influenzae, Moraxella catarrhalis, nasopharyngeal culture, respiratory tract infections, Streptococcus pneumoniae.


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