Posts filed under ‘Infecciones oro-faríngeas’

The association between vitamin D levels and recurrent group A streptococcal tonsillopharyngitis in adults.

International  Journal of Infectious Diseases October 2012 V.16 N.10 e735-7388.

Nseir W1, Mograbi J, Abu-Rahmeh Z, Mahamid M, Abu-Elheja O, Shalata A.

Author information

1 Department of Internal Medicine, Infectious Disease Unit, Holy Family Hospital, Nazareth, Israel.



To determine the association between recurrent group A streptococcal (GAS) tonsillopharyngitis and serum 25-hydroxy (25(OH)) vitamin D among adult subjects.


Adult patients with tonsillopharyngitis between January 2007 and December 2009 were reviewed and identified retrospectively. Cases with a medical history of recurrent GAS tonsillopharyngitis were compared to age- and gender-matched individuals without a medical history of GAS tonsillopharyngitis. Recurrent tonsillopharyngitis was defined as three or more episodes of GAS tonsillopharyngitis per year for a period of two consecutive years.


Fifty-four cases with recurrent GAS tonsillopharyngitis and 50 controls were enrolled. There were no significant differences between cases and controls with regard to mean age (41 ± 13 vs. 42 ± 12 years; p=0.7) and male gender (55% vs. 54%; p=0.6). Mean serum levels of 25(OH) vitamin D among subjects with recurrent GAS tonsillopharyngitis were significantly lower from the controls (11.5 ng/ml ± 4.7 vs. 26 ng/ml ± 7; p=0.001). Multiple regression analysis showed that a serum 25(OH) vitamin D level <20 ng/ml was associated with recurrent GAS tonsillopharyngitis (odds ratio 1.62, 95% confidence interval 1.51-1.76; p < 0.001).


Our findings indicate a link between vitamin D deficiency and the recurrence of GAS tonsillopharyngitis.



August 1, 2017 at 3:38 pm

Comparison of serological and molecular test for diagnosis of infectious mononucleosis.

Adv Biomed Res. 2016 May 30;5:95.

Salehi H1, Salehi M2, Roghanian R3, Bozari M3, Taleifard S3, Salehi MM4, Salehi M4.
Author information
1 Department of Infectious Diseases, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Student Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Department of Biology, Faculty of Sciences, University of Isfahan, Isfahan, Iran.
4 Student Research Center, Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

Epstein-Bar virus (EBV) is the main etiology of infectious mononucleosis (IM) syndrome that is characterized by fever, sore throat, and lymph adenopathy. Since, this virus could be associated with a number of malignancies, some hematologic disorders, and chronic fatigue syndrome, identification of IM is very important. The aim of study was to evaluate the specificity, as well as sensitivity of the two different methods that is, serology versus molecular diagnosis that are currently used for diagnosis of IM.
In this study, during a period of 3.5 years, 100 suspected patients as case group and 100 healthy individuals as a control group were studied. Fifty samples in each group were tested by polymerase chain reaction (PCR) and all the samples including case group and control group were carried out by enzyme-linked immunosorbent assay (ELISA).
In 76% of patients and in 20% of the healthy individuals, samples were detected EBV DNA by PCR. On the other hand, 68.5% of the samples belong to the case group and 46% in the control group showed positivity by ELISA.
By comparing the two methods, since PCR is very expensive and time consuming, and the percentages of difference ranges are narrow, ELISA could be applied as a first, easiest, and preliminary diagnostic test for IM. In addition, this test could be applied in various phases of the disease with a higher sensitivity comparing to PCR. Although PCR is routinely used for diagnosis of various infectious agents, it is considered as an expensive test and merely could be used after 1-2 weeks from the onset of the illness.

March 24, 2017 at 7:31 pm

Antibiotic prescribing in patients with self-reported sore throat

Journal of Antimicrobial Chemotherapy March 2017 V.72 N.3 P.914-922

Nishchay Mehta  Anne Schilder  Ellen Fragaszy  Hannah E. R. Evans  Oliver Dukes Logan Manikam  Paul Little  Sarah C. Smith  Andrew Hayward


To investigate the predictors of general practitioner (GP) consultation and antibiotic use in those developing sore throat.


We conducted a prospective population-based cohort study on 4461 participants in two rounds (2010–11) from 1897 households.


Participants reported 2193 sore throat illnesses, giving a community sore throat incidence of 1.57/ person-year. 13% of sore throat illnesses led to a GP consultation and 56% of these consultations led to antibiotic use. Participants most likely to have sore throats included women and children (e.g. school compared with retirement age); adjusted incidence rate ratio (aIRR) of 1.33 and 1.52, respectively. Participants with sore throat were more likely to consult their GP if they were preschool compared with retirement age [adjusted OR (aOR) 3.22], had more days of sore throat (aOR 1.11), reported more severe pain (aOR 4.24) or reported fever (aOR 3.82). Antibiotics were more often used by chronically ill individuals (aOR 1.78), those reporting severe pain (aOR 4.14), those reporting fever (aOR 2.58) or children with earache (aOR 1.85). Among those who consulted, males and adults who reported feeling anxious were more likely to use antibiotics; aOR 1.87 and 5.36, respectively.


Only 1 in 10 people who have a sore throat see a doctor and more than half of those attending get antibiotics. Further efforts to curb antibiotic use should focus on reducing initial GP consultations through public information promoting safe self-management, targeted at groups identified above as most likely to attend with sore throats.


March 11, 2017 at 7:02 pm

Manejo de la faringoamigdalitis estreptocóccica en pacientes adultos o adolescentes

Revista Chilena de Infectología 2002 V.19 N.2 P.739-741

Fica C, Alberto

Unidad de Infectología y Departamento de Medicina, Hospital Clínico Universidad de Chile.

Aunque una patología frecuente en la población pediátrica, la faringoamigdalitis aguda estreptocóccica es también observada en adolescentes y adultos jóvenes, declinando su importancia sólo después de los 35 años de edad.

Desde un escenario básicamente empírico, el diagnóstico se ha modificado en los últimos años hacia la incorporación de nuevas herramientas de fácil aplicación que permiten mejorar el reconocimiento de esta enfermedad y focalizar apropiadamente el tratamiento antimicrobiano.

A pesar de contar con recomendaciones sobre su tratamiento, la abundancia de compuestos que compiten comercialmente para tratar este problema prevalente de atención primaria, introduce cierto grado de confusión sobre la mejor opción disponible y sobre las bondades o desventajas relativas de cada uno de ellos.

Este artículo entrega una revisión de los aspectos diagnósticos relacionados con esta enfermedad, de los principios terapéuticos, de las innovaciones y alternativas terapéuticas disponibles y de la aplicación eficiente y racional de ellas


February 15, 2017 at 8:06 am

Epidemiology, clinical history and microbiology of peritonsillar abscess

European J of Clinical Microb & Infec Dis March 2015 V.34 N.3 P.549-554

Mazur , E. CzerwińskaAffiliated, I. Korona-Głowniak, A. Grochowalska, M. Kozioł-Montewka

Medical Microbiology Department, Medical University of Lublin, ul. Chodźki 1, 20-093, Lublin, Poland

Department of Otolaryngology, Regional Specialist Hospital in Radom, ul. Aleksandrowicza 5, 26-617, Radom, Poland

Department of Pharmaceutical Microbiology, Medical University of Lublin, ul. Chodźki 1, 20-093, Lublin, Poland

Microbiological Laboratory, Regional Specialist Hospital in Radom, ul. Aleksandrowicza 5, 26-617, Radom, Poland


The purpose of this investigation was to explore the epidemiology, clinical history and microbiology of peritonsillar abscess (PTA). A retrospective review of PTA cases treated at the Department of Otolaryngology, Regional Specialist Hospital in Radom, Poland between 1st October 2003 and 30th September 2013 was undertaken. A total of 111 PTA patients were admitted. The study population consisted of 57.7 % males and 42.3 % females, with an average age of 31.0 (range 5–78) years. Smokers comprised 22.0 % of the study group. The seasonal variation of PTA was statistically insignificant (p = 0.45). Recurrent tonsillitis occurred in 35.5 % of patients. In comparison with the rest of the study population, patients with a history of recurrent pharyngotonsillitis had higher incidence of previous PTA episodes [odds ratio (OR) 17.8, 95 % confidence interval (CI) 2.1–148.7, p = 0.001]. Also, they were more frequently treated with antibiotics prior to hospitalisation (OR 4.6, 95 % CI 2.0–10.9, p = 0.0005) and had significantly longer hospital stay (p = 0.03). Bacterial cultures of abscess aspirates were performed in 40.5 % of patients. Monomicrobial growth was detected in 77.8 % of aerobic cultures. Streptococcus pyogenes, growing most frequently in monoculture, was found in 28.9 % of aerobic cultures. PTA patients with and without recurrent pharyngotonsillitis differed with regard to clinical history and course of disease. The percentage of smokers among PTA patients was lower than that described in the literature. Monomicrobial growth predominated in PTA aspirate cultures. S. pyogenes proved to be the most frequent pathogen.



January 28, 2016 at 2:32 pm

Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America.

Clin Infect Dis. 2012 Nov 15;55(10):e86-102.

Shulman ST1, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C; Infectious Diseases Society of America.

Author information

1Department of Pediatrics, Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.




November 18, 2015 at 8:17 am

Decline in macrolide resistance rates among Streptococcus pyogenes causing pharyngitis in children isolated in Italy

European J of Clinical Microb & Inf Diseases SEPT 2015 V.34 N.9 P.1797-1802

  1. Gherardi, D. Petrelli, M. C. Di Luca…
  2. University Campus Bio-Medico, 00128, Roma, Italy
  3. School of Biosciences and Veterinary Medicine, University of Camerino, 62032, Camerino, MC, Italy
  4. Department of Microbiology and Infection Control, University Hospital of North Norway, 9038, Tromsø, Norway
  5. Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
  6. Unit of Microbiology, Bambino Gesù Children’s Hospital, Roma, Italy
  7. Azienda Ospedaliera di Perugia, Struttura Complessa di Microbiologia, Santa Maria della Misericordia Hospital Perugia, Perugia, Italy
  8. Azienda Ospedaliera di Macerata, Macerata, Italy
  9. School of Pharmacy, Microbiology Unit, University of Camerino, via Gentile III da Varano, 62032, Camerino, MC, Italy

Macrolides are often used to treat group A streptococcus (GAS) infections, but their resistance rates reached high proportions worldwide.

The aim of the present study was to give an update on the characteristics and contemporary prevalence of macrolide-resistant pharyngeal GAS in Central Italy.

A total of 592 isolates causing pharyngitis in children were collected in the period 2012–2013. Clonality was assessed by emm typing and pulsed-field gel electrophoresis (PFGE) for all macrolide-resistant strains and for selected susceptible isolates.

Genetic determinants of resistance were screened by polymerase chain reaction (PCR). Forty-four GAS were erythromycin-resistant (7.4 %).

Among them, 52.3 % and 50 % were clindamycin- and tetracycline-resistant, respectively. erm(B)-positive isolates (52.3 %) expressed the constitutive cMLSB phenotype. mef(A) and its associated M phenotype were recorded in 40.9 % of the cases.

The remaining erm(A)-positive isolates expressed the iMLSB phenotype. Seventeen tetracycline-resistant isolates carried tet(M) and five isolates carried tet(O). Twenty-five emm types were found among all strains, with the predominance of emm types 12, 89, 1, and 4.

Eleven emm types and 12 PFGE clusters characterized macrolide-resistant strains, with almost two-thirds belonging to emm12, emm4, and emm11. Macrolide-susceptible and -resistant emm types 12, 89, 11, and 4 shared related PFGE profiles.

There was a dramatic decline in macrolide resistance in Central Italy among pharyngeal GAS isolates in 2012–2013 when compared to previous studies from the same region (p<0.05), although macrolide consumption remained stable over the past 15 years.

We observed a decrease in the proportion of macrolide-resistant strains within emm types commonly associated with macrolide resistance in the past, namely emm12, 1, and 89.





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September 6, 2015 at 6:55 pm

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