Beta-Hemolytic Nongroup A Streptococcal Pharyngitis in Children

To evaluate the epidemiology, clinical features, and antibiotic prescribing patterns for nongroup A streptococci (NGAS) in children. Throat cultures obtained for pharyngitis were assessed at a large community-based health system over 10 years. Epidemiologic and clinical features of children with NGA...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of pediatrics 2019-03, Vol.206, p.268-273.e1
Main Authors: Frost, Holly M., Fritsche, Thomas R., Hall, Matthew C.
Format: Article
Language:English
Subjects:
antibiotics
children
epidemiology
pharyngitis
Streptococcus
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c359t-88263300dfc4e4b6faa6e788c8716a86c6ebd5006bdb5222243d6ce9274244c43
cites cdi_FETCH-LOGICAL-c359t-88263300dfc4e4b6faa6e788c8716a86c6ebd5006bdb5222243d6ce9274244c43
container_end_page 273.e1
container_issue
container_start_page 268
container_title The Journal of pediatrics
container_volume 206
creator Frost, Holly M.
Fritsche, Thomas R.
Hall, Matthew C.
description To evaluate the epidemiology, clinical features, and antibiotic prescribing patterns for nongroup A streptococci (NGAS) in children. Throat cultures obtained for pharyngitis were assessed at a large community-based health system over 10 years. Epidemiologic and clinical features of children with NGAS were compared with children with group A Streptococcus (GAS) and negative cultures. Antibiotic prescribing patterns were evaluated. A total of 224 328 rapid streptococcal antigen tests and 116 578 throat cultures were performed. Clinical analysis was completed for 602 GAS-positive patients, 535 NGAS-positive patients, and 480 patients with negative cultures. Incidence of NGAS did not vary annually or by season but increased with age from 2% at ≤5 years to 7% at 18 years of age. Patients with NGAS were more likely than those with negative cultures to have tonsillar exudate (20.3% vs 13.1%, P = .003) and enlarged tonsils (28.6% vs 19.3%, P 
doi_str_mv 10.1016/j.jpeds.2018.10.048
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2155146867</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022347618315555</els_id><sourcerecordid>2155146867</sourcerecordid><originalsourceid>FETCH-LOGICAL-c359t-88263300dfc4e4b6faa6e788c8716a86c6ebd5006bdb5222243d6ce9274244c43</originalsourceid><addsrcrecordid>eNp9kEtLAzEUhYMotj5-gSCzdDP15jGZdCFSi1qhqKCuw0xy26ZMJ2MyFfrvndrq0ru5cDjnPj5CLigMKFB5vRwsG7RxwICqThmAUAekT2GYp1Jxfkj6AIylXOSyR05iXALAUAAckx6HjKlcQp_c3mFbpBNc-WrTOpM8-3oe_LpJRslbG7BpvfHGFFXyuijCpp671sXE1cl44SobsD4jR7Oiini-76fk4-H-fTxJpy-PT-PRNDU8G7apUkxyDmBnRqAo5awoJOZKGZVTWShpJJY2A5ClLTPWleBWGhyyXDAhjOCn5Go3twn-c42x1SsXDVZVUaNfR81ollEhlcw7K99ZTfAxBpzpJrhVd72moLfk9FL_kNNbcluxI9elLvcL1uUK7V_mF1VnuNkZsHvzy2HQ0TisDVoX0LTaevfvgm-7w38q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2155146867</pqid></control><display><type>article</type><title>Beta-Hemolytic Nongroup A Streptococcal Pharyngitis in Children</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Frost, Holly M. ; Fritsche, Thomas R. ; Hall, Matthew C.</creator><creatorcontrib>Frost, Holly M. ; Fritsche, Thomas R. ; Hall, Matthew C.</creatorcontrib><description>To evaluate the epidemiology, clinical features, and antibiotic prescribing patterns for nongroup A streptococci (NGAS) in children. Throat cultures obtained for pharyngitis were assessed at a large community-based health system over 10 years. Epidemiologic and clinical features of children with NGAS were compared with children with group A Streptococcus (GAS) and negative cultures. Antibiotic prescribing patterns were evaluated. A total of 224 328 rapid streptococcal antigen tests and 116 578 throat cultures were performed. Clinical analysis was completed for 602 GAS-positive patients, 535 NGAS-positive patients, and 480 patients with negative cultures. Incidence of NGAS did not vary annually or by season but increased with age from 2% at ≤5 years to 7% at 18 years of age. Patients with NGAS were more likely than those with negative cultures to have tonsillar exudate (20.3% vs 13.1%, P = .003) and enlarged tonsils (28.6% vs 19.3%, P &lt; .001). Modified Centor scores did not differ between groups (score ≥2, P = 1.0; score ≥3, P = .50). Patients with GAS were more likely than those with NGAS to have fever (32.6% vs 24.5%, P = .003), palatal petechiae (14.0% vs 3.1%, P &lt; .001), and modified Centor score ≥2 (47.8% vs 27.1%; P &lt; .001). Of patients with NGAS, 65% were prescribed antibiotics. NGAS likely exist in both carriage and infectious states and incidence increases with age. Infections associated with NGAS are milder than with GAS, and complications are rare. Laboratory reporting of NGAS results in high antibiotic use, despite current recommendations against treatment.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2018.10.048</identifier><identifier>PMID: 30528760</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>antibiotics ; children ; epidemiology ; pharyngitis ; Streptococcus</subject><ispartof>The Journal of pediatrics, 2019-03, Vol.206, p.268-273.e1</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-88263300dfc4e4b6faa6e788c8716a86c6ebd5006bdb5222243d6ce9274244c43</citedby><cites>FETCH-LOGICAL-c359t-88263300dfc4e4b6faa6e788c8716a86c6ebd5006bdb5222243d6ce9274244c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30528760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Frost, Holly M.</creatorcontrib><creatorcontrib>Fritsche, Thomas R.</creatorcontrib><creatorcontrib>Hall, Matthew C.</creatorcontrib><title>Beta-Hemolytic Nongroup A Streptococcal Pharyngitis in Children</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To evaluate the epidemiology, clinical features, and antibiotic prescribing patterns for nongroup A streptococci (NGAS) in children. Throat cultures obtained for pharyngitis were assessed at a large community-based health system over 10 years. Epidemiologic and clinical features of children with NGAS were compared with children with group A Streptococcus (GAS) and negative cultures. Antibiotic prescribing patterns were evaluated. A total of 224 328 rapid streptococcal antigen tests and 116 578 throat cultures were performed. Clinical analysis was completed for 602 GAS-positive patients, 535 NGAS-positive patients, and 480 patients with negative cultures. Incidence of NGAS did not vary annually or by season but increased with age from 2% at ≤5 years to 7% at 18 years of age. Patients with NGAS were more likely than those with negative cultures to have tonsillar exudate (20.3% vs 13.1%, P = .003) and enlarged tonsils (28.6% vs 19.3%, P &lt; .001). Modified Centor scores did not differ between groups (score ≥2, P = 1.0; score ≥3, P = .50). Patients with GAS were more likely than those with NGAS to have fever (32.6% vs 24.5%, P = .003), palatal petechiae (14.0% vs 3.1%, P &lt; .001), and modified Centor score ≥2 (47.8% vs 27.1%; P &lt; .001). Of patients with NGAS, 65% were prescribed antibiotics. NGAS likely exist in both carriage and infectious states and incidence increases with age. Infections associated with NGAS are milder than with GAS, and complications are rare. Laboratory reporting of NGAS results in high antibiotic use, despite current recommendations against treatment.</description><subject>antibiotics</subject><subject>children</subject><subject>epidemiology</subject><subject>pharyngitis</subject><subject>Streptococcus</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kEtLAzEUhYMotj5-gSCzdDP15jGZdCFSi1qhqKCuw0xy26ZMJ2MyFfrvndrq0ru5cDjnPj5CLigMKFB5vRwsG7RxwICqThmAUAekT2GYp1Jxfkj6AIylXOSyR05iXALAUAAckx6HjKlcQp_c3mFbpBNc-WrTOpM8-3oe_LpJRslbG7BpvfHGFFXyuijCpp671sXE1cl44SobsD4jR7Oiini-76fk4-H-fTxJpy-PT-PRNDU8G7apUkxyDmBnRqAo5awoJOZKGZVTWShpJJY2A5ClLTPWleBWGhyyXDAhjOCn5Go3twn-c42x1SsXDVZVUaNfR81ollEhlcw7K99ZTfAxBpzpJrhVd72moLfk9FL_kNNbcluxI9elLvcL1uUK7V_mF1VnuNkZsHvzy2HQ0TisDVoX0LTaevfvgm-7w38q</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Frost, Holly M.</creator><creator>Fritsche, Thomas R.</creator><creator>Hall, Matthew C.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201903</creationdate><title>Beta-Hemolytic Nongroup A Streptococcal Pharyngitis in Children</title><author>Frost, Holly M. ; Fritsche, Thomas R. ; Hall, Matthew C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-88263300dfc4e4b6faa6e788c8716a86c6ebd5006bdb5222243d6ce9274244c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>antibiotics</topic><topic>children</topic><topic>epidemiology</topic><topic>pharyngitis</topic><topic>Streptococcus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Frost, Holly M.</creatorcontrib><creatorcontrib>Fritsche, Thomas R.</creatorcontrib><creatorcontrib>Hall, Matthew C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Frost, Holly M.</au><au>Fritsche, Thomas R.</au><au>Hall, Matthew C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Beta-Hemolytic Nongroup A Streptococcal Pharyngitis in Children</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2019-03</date><risdate>2019</risdate><volume>206</volume><spage>268</spage><epage>273.e1</epage><pages>268-273.e1</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To evaluate the epidemiology, clinical features, and antibiotic prescribing patterns for nongroup A streptococci (NGAS) in children. Throat cultures obtained for pharyngitis were assessed at a large community-based health system over 10 years. Epidemiologic and clinical features of children with NGAS were compared with children with group A Streptococcus (GAS) and negative cultures. Antibiotic prescribing patterns were evaluated. A total of 224 328 rapid streptococcal antigen tests and 116 578 throat cultures were performed. Clinical analysis was completed for 602 GAS-positive patients, 535 NGAS-positive patients, and 480 patients with negative cultures. Incidence of NGAS did not vary annually or by season but increased with age from 2% at ≤5 years to 7% at 18 years of age. Patients with NGAS were more likely than those with negative cultures to have tonsillar exudate (20.3% vs 13.1%, P = .003) and enlarged tonsils (28.6% vs 19.3%, P &lt; .001). Modified Centor scores did not differ between groups (score ≥2, P = 1.0; score ≥3, P = .50). Patients with GAS were more likely than those with NGAS to have fever (32.6% vs 24.5%, P = .003), palatal petechiae (14.0% vs 3.1%, P &lt; .001), and modified Centor score ≥2 (47.8% vs 27.1%; P &lt; .001). Of patients with NGAS, 65% were prescribed antibiotics. NGAS likely exist in both carriage and infectious states and incidence increases with age. Infections associated with NGAS are milder than with GAS, and complications are rare. Laboratory reporting of NGAS results in high antibiotic use, despite current recommendations against treatment.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30528760</pmid><doi>10.1016/j.jpeds.2018.10.048</doi></addata></record>
fulltext fulltext
identifier ISSN: 0022-3476
ispartof The Journal of pediatrics, 2019-03, Vol.206, p.268-273.e1
issn 0022-3476
1097-6833
language eng
recordid cdi_proquest_miscellaneous_2155146867
source ScienceDirect Freedom Collection 2022-2024
subjects antibiotics
children
epidemiology
pharyngitis
Streptococcus
title Beta-Hemolytic Nongroup A Streptococcal Pharyngitis in Children
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T09%3A55%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Beta-Hemolytic%20Nongroup%20A%20Streptococcal%20Pharyngitis%20in%20Children&rft.jtitle=The%20Journal%20of%20pediatrics&rft.au=Frost,%20Holly%20M.&rft.date=2019-03&rft.volume=206&rft.spage=268&rft.epage=273.e1&rft.pages=268-273.e1&rft.issn=0022-3476&rft.eissn=1097-6833&rft_id=info:doi/10.1016/j.jpeds.2018.10.048&rft_dat=%3Cproquest_cross%3E2155146867%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c359t-88263300dfc4e4b6faa6e788c8716a86c6ebd5006bdb5222243d6ce9274244c43%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2155146867&rft_id=info:pmid/30528760&rfr_iscdi=true