Abstract
The isolation rates of strains of group C beta-hemolytic streptococci from throat swab cultures of patients with exudative pharyngitis, the common cold, and healthy controls were compared. By using a cohort study design in a college health service, patients with exudative pharyngitis were retrospectively identified by description of tonsillar exudate on chart review. Patients with rhinoviral infection were prospectively identified during a common cold study. Healthy controls were prospectively recruited from patients presenting with noninfectious conditions. Isolation of Lancefield group A and C beta-hemolytic streptococci from throat cultures was used as an outcome measurement. A total of 265 students (62% female; average age 20.2 years) with exudative pharyngitis were identified. A total of 75 students (60% female; average age, 21.7 years) from a common cold study with rhinoviral infection were identified. A total of 162 students (53% female; average age, 22.6 years) were recruited as healthy controls. Group A beta-hemolytic streptococci were isolated from 5% of patients with pharyngitis but none of those with rhinovirus (P = 0.045) and none of the controls (P = 0.007). Group C Streptococcus dysglactiae subsp. equisimilis was isolated from 11% of patients with pharyngitis but none of those with rhinovirus (P = 0.006) and 2% of controls (P = 0.001). Lancefield group C Streptococcus anginosus was isolated from 8% of patients with pharyngitis but 3% of those with rhinovirus (P = 0.18) and 1% of controls (P = 0.006). Heavier growth of colonies on the primary culture plate was observed for patients from whom S. equisimilis and group A beta-hemolytic streptococci were isolated. Lancefield group C beta-hemolytic streptococci appear to be associated with exudative pharyngitis in college students.
Full Text
The Full Text of this article is available as a PDF (174.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Arruda E., Crump C. E., Rollins B. S., Ohlin A., Hayden F. G. Comparative susceptibilities of human embryonic fibroblasts and HeLa cells for isolation of human rhinoviruses. J Clin Microbiol. 1996 May;34(5):1277–1279. doi: 10.1128/jcm.34.5.1277-1279.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Arruda E., Hayden F. G. Detection of human rhinovirus RNA in nasal washings by PCR. Mol Cell Probes. 1993 Oct;7(5):373–379. doi: 10.1006/mcpr.1993.1055. [DOI] [PubMed] [Google Scholar]
- Barson W. J. Group C streptococcal osteomyelitis. J Pediatr Orthop. 1986 May-Jun;6(3):346–348. doi: 10.1097/01241398-198605000-00016. [DOI] [PubMed] [Google Scholar]
- Benjamin J. T., Perriello V. A., Jr Pharyngitis due to group C hemolytic streptococci in children. J Pediatr. 1976 Aug;89(2):254–256. doi: 10.1016/s0022-3476(76)80459-3. [DOI] [PubMed] [Google Scholar]
- Bradley S. F., Gordon J. J., Baumgartner D. D., Marasco W. A., Kauffman C. A. Group C streptococcal bacteremia: analysis of 88 cases. Rev Infect Dis. 1991 Mar-Apr;13(2):270–280. doi: 10.1093/clinids/13.2.270. [DOI] [PubMed] [Google Scholar]
- Bucher C., von Graevenitz A. Differentiation in throat cultures of group C and G streptococci from Streptococcus milleri with identical antigens. Eur J Clin Microbiol. 1984 Feb;3(1):44–45. doi: 10.1007/BF02032818. [DOI] [PubMed] [Google Scholar]
- Cimolai N., Elford R. W., Bryan L., Anand C., Berger P. Do the beta-hemolytic non-group A streptococci cause pharyngitis? Rev Infect Dis. 1988 May-Jun;10(3):587–601. doi: 10.1093/clinids/10.3.587. [DOI] [PubMed] [Google Scholar]
- Cimolai N., MacCulloch L., Damm S. The epidemiology of beta-haemolytic non-group A streptococci isolated from the throats of children over a one-year period. Epidemiol Infect. 1990 Feb;104(1):119–126. doi: 10.1017/s0950268800054595. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cimolai N., Macnab A. Schonlein-Henoch purpura and Streptococcus equisimilis. Br J Dermatol. 1991 Oct;125(4):403–403. doi: 10.1111/j.1365-2133.1991.tb14185.x. [DOI] [PubMed] [Google Scholar]
- Cimolai N., Mah D. Beta-D-glucuronidase activity assay for rapid differentiation of species within beta-haemolytic group C and G streptococci. J Clin Pathol. 1991 Oct;44(10):824–825. doi: 10.1136/jcp.44.10.824. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cimolai N., Morrison B. J., MacCulloch L., Smith D. F., Hlady J. Beta-haemolytic non-group A streptococci and pharyngitis: a case-control study. Eur J Pediatr. 1991 Sep;150(11):776–779. doi: 10.1007/BF02026709. [DOI] [PubMed] [Google Scholar]
- Dinn J. J. Brain abscess due to Streptococcus equisimilis in a maltworker. J Ir Med Assoc. 1971 Jan 21;64(404):50–51. [PubMed] [Google Scholar]
- Efstratiou A., Teare E. L., McGhie D., Colman G. The presence of M proteins in outbreak strains of Streptococcus equisimilis T-type 204. J Infect. 1989 Sep;19(2):105–111. doi: 10.1016/s0163-4453(89)91789-1. [DOI] [PubMed] [Google Scholar]
- Fox K., Turner J., Fox A. Role of beta-hemolytic group C streptococci in pharyngitis: incidence and biochemical characteristics of Streptococcus equisimilis and Streptococcus anginosus in patients and healthy controls. J Clin Microbiol. 1993 Apr;31(4):804–807. doi: 10.1128/jcm.31.4.804-807.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Glezen W. P., Fernald G. W., Lohr J. A. Acute respiratory disease of university students with special reference to the etiologic role of Herpesvirus hominis. Am J Epidemiol. 1975 Feb;101(2):111–121. doi: 10.1093/oxfordjournals.aje.a112077. [DOI] [PubMed] [Google Scholar]
- Gossling J. Occurrence and pathogenicity of the Streptococcus milleri group. Rev Infect Dis. 1988 Mar-Apr;10(2):257–285. doi: 10.1093/clinids/10.2.257. [DOI] [PubMed] [Google Scholar]
- Hayden G. F., Murphy T. F., Hendley J. O. Non-group A streptococci in the pharynx. Pathogens or innocent bystanders? Am J Dis Child. 1989 Jul;143(7):794–797. doi: 10.1001/archpedi.1989.02150190044018. [DOI] [PubMed] [Google Scholar]
- Huovinen P., Lahtonen R., Ziegler T., Meurman O., Hakkarainen K., Miettinen A., Arstila P., Eskola J., Saikku P. Pharyngitis in adults: the presence and coexistence of viruses and bacterial organisms. Ann Intern Med. 1989 Apr 15;110(8):612–616. doi: 10.7326/0003-4819-110-8-612. [DOI] [PubMed] [Google Scholar]
- Keiser P., Campbell W. 'Toxic strep syndrome' associated with group C Streptococcus. Arch Intern Med. 1992 Apr;152(4):882–884. doi: 10.1001/archinte.152.4.882a. [DOI] [PubMed] [Google Scholar]
- Lebrun L., Guibert M., Wallet P., de Maneville M. M., Pillot J. Human Fc(gamma) receptors for differentiation in throat cultures of group C "Streptococcus equisimilis" and group C "Streptococcus milleri". J Clin Microbiol. 1986 Nov;24(5):705–707. doi: 10.1128/jcm.24.5.705-707.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Meier F. A., Centor R. M., Graham L., Jr, Dalton H. P. Clinical and microbiological evidence for endemic pharyngitis among adults due to group C streptococci. Arch Intern Med. 1990 Apr;150(4):825–829. [PubMed] [Google Scholar]
- Mogabgab W. J. Acute respiratory illnesses in university (1962-1966), military and industrial (1962-1963) populations. Am Rev Respir Dis. 1968 Sep;98(3):359–379. doi: 10.1164/arrd.1968.98.3.359. [DOI] [PubMed] [Google Scholar]
- Ramaswamy G., Ng A., Quinlan L., Tchertkoff V. Streptococcus equisimilis (group C) as a cause of ophthalmic infections. Am J Clin Pathol. 1983 Mar;79(3):385–387. doi: 10.1093/ajcp/79.3.385. [DOI] [PubMed] [Google Scholar]
- Ruoff K. L., Kunz L. J., Ferraro M. J. Occurrence of Streptococcus milleri among beta-hemolytic streptococci isolated from clinical specimens. J Clin Microbiol. 1985 Aug;22(2):149–151. doi: 10.1128/jcm.22.2.149-151.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Salata R. A., Lerner P. I., Shlaes D. M., Gopalakrishna K. V., Wolinsky E. Infections due to Lancefield group C streptococci. Medicine (Baltimore) 1989 Jul;68(4):225–239. doi: 10.1097/00005792-198907000-00005. [DOI] [PubMed] [Google Scholar]
- Schwartz R. H., Knerr R. J., Hermansen K., Wientzen R. L. Acute epiglottitis caused by beta-hemolytic group C Streptococci. Am J Dis Child. 1982 Jun;136(6):558–559. doi: 10.1001/archpedi.1982.03970420082024. [DOI] [PubMed] [Google Scholar]
- Siefkin A. D., Peterson D. L., Hansen B. Streptococcus equisimilis Pneumonia in a compromised host. J Clin Microbiol. 1983 Feb;17(2):386–388. doi: 10.1128/jcm.17.2.386-388.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Slifkin M., Gil G. M. Rapid biochemical tests for the identification of groups A, B, C, F, and G streptococci from throat cultures. J Clin Microbiol. 1983 Jul;18(1):29–32. doi: 10.1128/jcm.18.1.29-32.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sobrino J., Bosch X., Wennberg P., Villalta J., Grau J. M. Septic arthritis secondary to group C streptococcus typed as Streptococcus equisimilis. J Rheumatol. 1991 Mar;18(3):485–486. [PubMed] [Google Scholar]
- Turner J. C., Fox A., Fox K., Addy C., Garrison C. Z., Herron B., Brunson C., Betcher G. Role of group C beta-hemolytic streptococci in pharyngitis: epidemiologic study of clinical features associated with isolation of group C streptococci. J Clin Microbiol. 1993 Apr;31(4):808–811. doi: 10.1128/jcm.31.4.808-811.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Turner J. C., Hayden G. F., Kiselica D., Lohr J., Fishburne C. F., Murren D. Association of group C beta-hemolytic streptococci with endemic pharyngitis among college students. JAMA. 1990 Nov 28;264(20):2644–2647. [PubMed] [Google Scholar]
- Vance D. W., Jr Group C streptococci: "Streptococcus equisimilis" or Streptococcus anginosus? Clin Infect Dis. 1992 Feb;14(2):616–617. doi: 10.1093/clinids/14.2.616. [DOI] [PubMed] [Google Scholar]