Ann Intern Med:警惕学生群体中检出率不断上升的坏死梭杆菌型咽炎

2015-02-22 梁怀彬 译 MedSci原创

咽炎诊疗指南只关注A组β型溶血性链球菌这一感染类型,欧洲的数据已经显示在15到30岁的咽炎患者中,有至少10%的病人是由坏死梭杆菌感染引起。而这一方面美国却鲜有相关数据。 为了估计坏死梭杆菌感染、肺炎支原体、A组和C/G组β型溶血性链球菌的感染率,以及明确坏死梭杆菌和A组β型溶血性链球菌的临床相似性。研究者设计了一项横断面研究,观察了312名15至30岁的主诉喉咙或嗓子疼痛的大学生以及180名无症

咽炎诊疗指南只关注A组β型溶血性链球菌这一感染类型,欧洲的数据已经显示在15到30岁的咽炎患者中,有至少10%的病人是由坏死梭杆菌感染引起。而这一方面美国却鲜有相关数据。

为了估计坏死梭杆菌感染、肺炎支原体、A组和C/G组β型溶血性链球菌的感染率,以及明确坏死梭杆菌和A组β型溶血性链球菌的临床相似性。研究者设计了一项横断面研究,观察了312名15至30岁的主诉喉咙或嗓子疼痛的大学生以及180名无症状的健康学生。咽拭子取菌后行PCR测定,同时对体征和症状进行Centor评分。

研究结果显示:坏死梭杆菌在患者当中检出率为20.5%,在无症状健康学生中为9.4%。A组β型溶血性链球菌在患者中检出率10.3%,在对照组1.1%。C/G组β型溶血性链球菌在患者中检出率9.0% 对照组为3.9%。肺炎支原体患者中检出率1.9%,对照组为零。坏死梭杆菌、A组、C/G组溶血性链球菌感染率明显增加(Centor scores ,P < 0.001)。

研究者得出结论:在学生群体当中,坏死梭杆菌阳性的咽炎比A组β型溶血性链球菌阳性咽炎发生率更高,坏死梭杆菌阳性的咽炎临床表现和链球菌咽炎相似。

原始来源: 

Centor RM, Atkinson TP, Ratliff AE, Xiao L, Crabb DM, Estrada CA, et al. The Clinical Presentation of Fusobacterium-Positive and Streptococcal-Positive Pharyngitis in a University Health Clinic: A Cross-sectional Study. Ann Intern Med. 2015;162:241-247. doi:10.7326/M14-1305

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    2015-09-08 bioon1
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    2015-02-27 xjy13
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    2015-02-24 millore
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