Çocukluk Çağının Akut Tonsillofarenjitinde A Grubu Olmayan Beta Hemolitik Streptokokların Rolü

Öz

Amaç: Çocuklarda akut tonsillofarenjit vakalarında boğaz kültüründe A grubu olmayan beta hemolitik streptokok izole edilen vakaların klinik ve laboratuvar özelliklerinin belirlenmesi amaçlandı. Gereç ve Yöntem: Bu klinik retrospektif vaka dosyası değerlendirme araştırması 2010-2011 döneminde akut tonsillofarenjit tanısı alan 2679 vakanın hastane kayıtlarının geriye dönük değerlendirilmesi ile yürütüldü. Vakaların hepsinden boğaz kültürü alınmıştı. Bulgular: Vakaların n:1017 % 38,0’inden boğazdan olası patojen bakteriyel etken izole edilmişti. Boğaz kültüründen grup A streptokok izole edilenler Grup 1‘i yaş ortalaması 6,59 yıl; n:729; % 27,2 , boğaz kültüründen A grubu olmayan beta hemolitik streptokok izole edilenler Grup 2’yi yaş ortalaması 5,04 yıl; n: 288, % 10,8 normal boğaz florası izole edilenler de viral etiyolojisi olanlar Grup 3’ü yaş ortalaması 5,6 yıl; n:1662; % 62 oluşturdu. Centor skorlama sisteminin ≥3 olması Grup 1 vakalarında % 47 iken, Grup 2’de % 34 ve Grup 3’te ise % 19 idi

Anahtar Kelimeler

• Çocuk,infeksiyon,tonsillit,streptokok

Impotance of Non-Group A β-Hemolytic Streptococci in Childhood Tonsillopharyngitis

Öz

Aim: We aimed to determine the clinical and laboratory features of children with acute tonsillopharyngitis who had positive throat cultures of non group A beta hemolytic streptococcus.Material and Methods: Medical records of the 2679 patients with a diagnosis of acute tonsillopharyngitis in 20102011 years were retrospectively reviewed. All of the cases had a throat culture.Results: A bacterial possible agent was isolated in 38.0 % of the cases n:1017 . All cases divided into 3 groups based on the throat culture results. The patients with positive group A beta hemolytic streptococcus cultures constituted Group 1 the mean age 6.59 years; n:729; 27.2 % . The children with non Group A beta hemolytic streptococcus formed Group 2 the mean age 5.04 years; n:288; 10.8 % . The patients with no positive cultures and probably with a viral agent was defined as Group 3 the mean age 5.6 years; n:1662; 62 % . The Centor score was ≥3 in 47 % of Group 1; 34 % of Group 2 and 19% of Group 3

Anahtar Kelimeler

• Child,infection,tonsillitis,streptococcus

Kaynakça

1. American Academy of Pediatrics, Committee on Infectious Diseases. Group A streptococcal infections. In: Pickering LK, ed. Red Book: 2006 Report of the Committee on Infectious
2. Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006:612-13.
3. Tiemstra J, Miranda RLF. Role of non-group A streptococci in acute pharyngitis. J Am Board Fam Med 2009;22:663-9. http://dx.doi.org/10.3122/jabfm.2009.06.090035 PMid:19897695
4. JW, de Meller RA. Beta-haemolytic streptococci isolated from acute sore throat patients: case or coincidence? A case control study in gerenral practise. Scand J Infect Dis 2000;32: 84. http://dx.doi.org/10.1080/003655400750044944 PMid:10959645 cocci in the pharynx. Pathogens or innocent bystanders? Am J Dis Child 1989; 143:794-7. PMid:2741849
5. J. Beta hemolytic non-group A streptococci and pharyngitis: a acse control study. Eur J Pediatr 1991;150:776-9. http://dx.doi.org/10.1007/BF02026709 PMid:1959540 hemolytic streptococci in children. J Pediatr 1976;89:254-6. http://dx.doi.org/10.1016/S0022-3476(76)80459-3 coccal endocarditis. Pediatr Infect Dis 1986;5:703-4. http://dx.doi.org/10.1097/00006454-198611000-00021 PMid:3797302
6. C and group G streptococci in acute pharyngitis in children. Clin Microbiol Infect 2004;10:37-40. http://dx.doi.org/10.1111/j.1469-0691.2004.00732.x PMid:14706084 office isolation from children and adolescents with pharyngi- tis. Clin Pediatr 1986;25:496-502. http://dx.doi.org/10.1177/000992288602501003
7. Murren D. Association of group C beta-hemolytic streptococ- ci with endemic pharyngitis among collage students. JAMA ;264:2644-7. http://dx.doi.org/10.1001/jama.1990.03450200052030 PMid:2232040
8. P. The clinical pattern of group C streptococcal pharyngitis in children. J Infect Chemother 2009;15:228-32. http://dx.doi.org/10.1007/s10156-009-0694-8 PMid:19688241 associated with human infection. J Bacteriol 1943;46:391-2. PMid:16560716 PMCid:373833 as common isolates from throat culture among collage stu- dents with pharyngitis. J Am Coll Health 2011;59:237. http://dx.doi.org/10.1080/07448481.2010.519014 PMid:21308581

9. MRA, Al-Ayed IH, Al-Sanie AM. Non-group A streptococci: are they pathogens in the throat. J R Soc Health 1997;117:160- http://dx.doi.org/10.1177/146642409711700307 PMid:9195830 group A beta hemolytic streptococci in childhood pharyngitis. Sauthern Med J 1988;81:329-31. http://dx.doi.org/10.1097/00007611-198803000-00011
10. Çıragil P, Gül M, Aral M, Güler İ. Çeşitli örneklerden izole edilen beta-hemolitik streptokokların gruplandırılması ve antibiyotik duyarlılıkları. ANKEM Derg 2003;17:414-7.