ADULT BACTERIAL NASOPHARYNGITIS - A CLINICAL ENTITY

被引：23

作者：

HEALD, A ^{[1
]}

AUCKENTHALER, R ^{[1
]}

BORST, F ^{[1
]}

DELASPRE, O ^{[1
]}

GERMANN, D ^{[1
]}

MATTER, L ^{[1
]}

KAISER, L ^{[1
]}

STALDER, H ^{[1
]}

机构：

[1] UNIV GENEVA,HOP CANTONAL,POLICLIN MED,CENT LAB BACTERIOL,24 RUE MICHELI CREST,CH-1211 GENEVA 4,SWITZERLAND

来源：

JOURNAL OF GENERAL INTERNAL MEDICINE | 1993年 / 8卷 / 12期

关键词：

UPPER RESPIRATORY INFECTION; NASOPHARYNGITIS; BACTERIA;

D O I：

10.1007/BF02598283

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: To investigate bacterial nasopharyngitis as a cause of adult upper respiratory infection. Design: Prospective case series. Setting: Walk-in medical clinic of a university hospital. Patients: 507 patients with cold or flu symptoms, sore throat, or recent cough; 21 control subjects without symptoms of upper respiratory infection. Measurements and main results: After thorough history and physical examination, the patients underwent nasopharyngeal aspiration and throat culture. Nasopharyngeal specimens were cultured for both bacteria and viruses; antigens for influenza, parainfluenza, and respiratory syncytial virus were sought by enzyme-linked immunosorbent assay (ELISA); serum antibodies to viral respiratory pathogens were determined. Group A beta-hemolytic streptococci grew from the throat specimens of 39 of the 507 patients (8%) or 38 of 3 34 patients (11%) who had clinical diagnoses of pharyngitis. Thirty-three cases of influenza A, 20 cases of influenza B, and seven cases of parainfluenza infections were diagnosed. Bacteria were cultured from the nasopharyngeal secretions of 284 patients (56%). In contrast to pharyngeal culture, commensal mixed flora were rarely found in nasopharyngeal culture. Nasopharyngeal culture of bacteria usually considered to be respiratory pathogens was significantly associated with the presence of leukocytes. Streptococcus pneumoniae (odds ratio 6.0, 95% confidence interval 2.6-14.2), Moraxella catarrhalis (odds ratio 12.9, 95% confidence interval 3.1-79.5), and Hemophilus influenzae (odds ratio 3.0, 95% confidence interval 1.2-7.4) were all associated with the presence of leukocytes. In contrast, nasopharyngeal culture of coagulase-negative staphylococci, mixed flora, and the documentation of a viral infection were not associated with the presence of leukocytes. For none of 21 control subjects were ''pathogenic'' bacteria found. Conclusions: These data suggest that potentially pathogenic bacteria may have a causal role in adult nasopharyngitis, although further data are needed to confirm this hypothesis.

引用

页码：667 / 673

页数：7

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