Beta-Hemolytic Streptococcus Milleri Group Misidentified as Streptococcus Pyogenes on Throat Culture

Hamrick, Harvey J.; Mangum, Mary Ellen

doi:10.1097/00006454-199901000-00022

Cited by 7 publications

(9 citation statements)

References 9 publications

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“…Large colonies of SMG that are betahemolytic, as well as large-colony, beta-hemolytic strains of group C or group G streptococci; may be bacitracin sensitive and thus may be misidentified as group A streptococci on a BAP culture if bacitracin sensitivity is utilized as the basis for categorizing organisms as members of group A. However, because of the absence of the group A carbohydrate antigen, these isolates produce a negative RADT result (31).…”

Section: Reasons For False-positive and Apparent False-positive And Fmentioning

confidence: 99%

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

2004

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Although commercial rapid antigen detection tests (RADTs) are more expensive than blood agar plate (BAP) cultures, the advantage they offer is the speed with which they provide results. Rapid identification and consequent prompt treatment of patients with pharyngitis due to group A beta-hemolytic streptococci (GABHS) can reduce the risk of spread of GABHS, can allow patients to return to school or work sooner, and may reduce the acute morbidity of this illness. In most studies, RADTs have been compared with BAP cultures as the criterion standard. However, these comparisons are complicated by the fact that there is no universally accepted procedure for performing a BAP culture. The great majority of the RADTs that are currently available have a high specificity (i.e., 95% or greater) and a sensitivity of between 70 and 90% compared with BAP cultures. Few published studies have compared the performance of various RADTs to each other or examined the performance of various RADTs in the office setting. There is also relatively little published information about how physicians in practice actually use RADTs, but the available information suggests that many physicians do not follow recommended guidelines. While the development of easy-to-perform RADTs for the diagnosis of GABHS pharyngitis has altered clinical practice substantially, only limited data about cost-effectiveness are currently available

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Section: Reasons For False-positive and Apparent False-positive And Fmentioning

confidence: 99%

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

2004

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“…En cepas β hemolíticas, se recomienda las pruebas de laboratorio y diferenciación que se muestra en la Tabla 1, recordando que un tercio posee grupo antigénico de Lancefield (A, C, F o G). En cepas no β hemolíticas primero se recomienda descartar S. pneumoniae y Streptococcus bovis (especie clínicamente relevante dentro del grupo bovis) con las pruebas descritas en la Tabla 3, y posteriormente determinar si corresponde a Streptococcus grupo anginosus, para lo cual, se recomienda realizar a lo menos dos pruebas adicionales: Voges-Proskauer e hidrólisis de arginina, que resultan positivas en estas cepas 2,[17][18][19][20][21] . Los tests fenotípicos para la caracterización de especies dentro de este grupo bacteriano están basados principalmente en la actividad de distintas enzimas y su realización es bastante laboriosa para ser utilizada rutinariamente; con métodos semiautomatizados se ha observado 57 a 98% de concordancia con estudios genotípicos, lo que varía dependiendo de la especie aislada 1,[22][23][24] .…”

Section: Grupo Mitis S Mitis S Sanguis; S Parasanguis S Gordoniunclassified

Empiema pleural por Streptococcus grupo anginosus en un preescolar y revisión de la literatura: Case report and review

et al. 2004

Rev. chil. infectol.

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Empiema pleural por Streptococcus grupo anginosus en un preescolar y revisión de la literaturaStreptococcus anginosus pleural emphyema in a child. Case report and review Left pneumonectomy in a child with congenital pulmonary malformation was performed two months prior to admission. Within one week he had high fever. Chest CT scan showed massive left pleural effusion. Both Streptococcus anginosus group and Prevotella spp. grew from the fluid obtained by pleural punction. Antimicrobial therapy was immediately initiated with clindamycin and penicillin. Streptococus anginosus group is quite confusing in terms of classification and taxonomy. Now it is well recognized that three species belong to this genera: S. anginosus S. constellatus and S. intermedius. They all are considered normal flora of the oropharynx, nasopharynx, gastrointestinal tract and vagina but also they have been identified as agents of suppurative infections in children and adults. Many reports show adequate response to penicillin, however there is some emerging resistance in strains isolated in other studies. In this article we also suggest some diagnostic and microbiologic recommendations.

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“…Dentro de éstas, la faringoamigdalitis aguda (FA) ocupa un lugar importante. Streptococcus pyogenes es la causa bacteriana más común de esta patología, aislándose en 15 a 30% de los niños 2 y en 5 a 10% de los adultos con FA 3,4 ; el resto es principalmente de etiología viral 4,5 . Se cree que otras bacterias de la microbiota orofaríngea pueden influir en el desarrollo de FA 6 .…”

Section: Introductionunclassified

“…Se han hecho esfuerzos en distintos países en generar guías de práctica clínica para el manejo de la FA y evitar así el uso excesivo de antimicrobianos 21 . A pesar de contar actualmente con suficiente evidencia que apoya el uso de alguno de los métodos diagnósticos expuestos 5,[9][10][11][22][23][24] , éstos aún no son usados universalmente en nuestro país, principalmente por no estar disponibles en todos los centros de atención ambulatoria de pacientes, por la demora en disponer del informe (en el caso del cultivo bacteriológico), y por su costo.…”

Section: Introductionunclassified

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Faringitis aguda, ¿estreptocóccica? Empleo del estudio etiológico y de antimicrobianos en dos centros pediátricos universitarios

Muñoz

Córdova

Cifuentes

2005

Rev. chil. infectol.

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Sore throat, ¿streptococcal etiology? Use of etiological screening and antimicrobial prescription in two university pediatric centersThe diagnosis and treatment of sore throat in pediatric patients attending one of two facilities at a university hospital: pediatric ambulatory facility (PAF) and emergency unit (EU) in a period of 14 months are described. There were 421 patients at the PAF and 289 at the EU, of whom 65% and 76% were studied for Streptococcus pyogenes respectively. Streptococcus were detected in both centers in 37% of cases, with a peak detection of 50% at ages 6 to 10 years. There were 217 patients without any bacteriological study, of whom 162 (75%) received antibiotics. The importance of bacteriological confirmation prior to antibiotic prescription in this disease is emphasized.

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Beta-Hemolytic Streptococcus Milleri Group Misidentified as Streptococcus Pyogenes on Throat Culture

Cited by 7 publications

References 9 publications

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci

Empiema pleural por Streptococcus grupo anginosus en un preescolar y revisión de la literatura: Case report and review

Faringitis aguda, ¿estreptocóccica? Empleo del estudio etiológico y de antimicrobianos en dos centros pediátricos universitarios

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