Publication: Is group C beta-hemolytic Streptococci associated with pharyngitis? A systematic review and meta-analysis

Is group C beta-hemolytic Streptococci associated with pharyngitis? A systematic review and meta-analysis
Manchal N, Gunnarsson R.
Montreal: 45th NAPCRG (North American Primary Care Research Group) Annual Meeting; 2017.

Abstract

Context: Sore throat is one of the 5 most common reasons patients visit their primary care physicians. Although most cases of pharyngitis are viral in origin, the role played by bacteria like Group C beta-hemolytic streptococcus (GCS) is not clear. In the era of antibiotic resistance, it is imperative that research guides primary care physicians to be informed about the causative role played by this bacterium.rnObjective: The aim of the study was to ascertain if GCS should be considered as a pathogen in sporadic cases of pharyngitis. This objective was studied in adults and children separately.rnDesign: A systematic review of studies on GCS associated pharyngitis and a meta-analysis to calculate the cumulative positive etiologic predictive value (P-EPV).rnSetting: Included studies were conducted in a primary health care setting.rnPatients: All prospective and retrospective studies with GCS and community acquired pharyngitis / tonsillitis were included. The studies had to be published in English. Information had to be presented for children from 3-18 years and adults above 18yrs separately. Studies with patients already treated with antibiotics, case reports, GCS infections other than pharyngitis and those with immune compromised patients were excluded.rnResults: The cumulative P-EPV of a throat swab was 54% (95% CI 38-67%) in adults when only including studies with comparative healthy controls. There was no point in calculating cumulative P-EPV for children as the prevalence of GCS was identical among patients and healthy controls.rnConclusions: There is enough evidence to ignore GCS as a pathogen in children with an uncomplicated sore throat. In adults a finding of GCS indicates a 54% chance for this bacterium to truly be associated with the sore throat indicating a weak association.


, from James Cook University
http://au.researchweb.org/is/jcu/user/publication?ref=2826481