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2008, Number 4

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Rev Med Inst Mex Seguro Soc 2008; 46 (4)

Multivariate Model to Predict Streptococcus Pyogenes Tonsillitis

Villaseñor-Sierra A, Caballero-Hoyos JR, Jáuregui-Lomelí JJ, Flores-Sánchez J, Martínez-Sandoval F

Language: Spanish
References: 28
Page: 383-390
PDF size: 322.10 Kb.


ABSTRACT

Objective: to develop a multivariate model to predict the Streptococcus pyogenes isolation in patients with acute tonsillitis.
Methods: cross-sectional analytic study on patients with acute tonsillitis without a recent history of antimicrobial consumption. We evaluated 14 signs and 18 symptoms. A pharyngeal culture was realized on 5 % sheep blood agar. Group A streptococci was identified by standard methods. Statistical analysis: sensitivity, specificity, predictive values, χ2, p, Fisher’s exact test, crude and adjusted odds ratio (OR) with 95 % CI using dichotomical logistic regression with direct method and Hosmer and Lemeshow-goodness-fit test.
Results: there were 213 participants, 37 % were males; a mean age of 14.9 years. We isolated Streptococcus pyogenes in 15 %, and 84 % of them had received antimicrobials. We identified signs and symptoms associated with Streptococcus pyogenes isolation: painful swallowing (OR = 4.45, 95 % CI = 1.13-17.53); tonsils with exudates (OR = 3.20, 95 % CI = 1.22-8.43); smelly breath (OR = 2.78, 95 % CI = 1.09-7.10); painful neck nodes (OR = 2.70, 95 % CI = 1.05-6.96). The presence of nasal symptoms was a protective factor (OR = 0.25, 95 % CI = 0.09-0.71).
Conclusions: the prevalence of Streptococcus pyogenes tonsillitis was similar to other reports. We found signs and symptoms associated to Streptococcus pyogenes isolation that allowed us to elaborate a decision algorithm.


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