The Incidence of Group a Beta Hemolytic Streptococci in Patients With Acute Exudative Tonsilitis in Istanbul, a 14-Year Period

Abstract

Empiric antibiotic therapy is still habitually prescribed to patients with acute exudative tonsillitis in many out-patient clinics in Turkey, despite many studies worldwide showed low group A beta hemolytic streptococci (GABHS) and high viral infection incidence in those patients. In this study, we tried to show the real frequency of GABHS in acute exudative tonsillitis in Istanbul over a 14-year period. Methods:In this retrospective study, we looked through the patient files with acute exudative tonsillitis who had admitted internal medicine and ear-nose-throat out-patient clinics of our hospital in Istanbul, Turkey between 2000 and 2014. We included all patients with the diagnosis of exudative tonsillitis who had a throat swap and culture. We obtained data from the results of throat swab cultures for GABHS. Demographic data and microbiological results were analyzed. Results: Results of throat swab cultures of 967 patients were enrolled in this study (525 male, 442 female; mean age 21±7 years; range 14 to 70 years). In our retrospective analysis GABHS was isolated in only 105 (10.8%) of all patients. Of those patients in whom GABHS were isolated, 56 (5.7%) were males and 49 (5.06%) females. There was no significant difference between men and women with respect to infection rate (p>0.05). Conclusion:The incidence of GABHS was also low in acute exudative tonsillitis in Istanbul over a 14-year period. Acute exudative tonsillitis was caused by GABHS in only about 10% of all our patients. Tests such as throat culture and rapid antigen test must be performed as soon as possible to confirm diagnosis when there is a suspicion of GABHS infection but routine or immediate antibiotic therapy for acute exudative tonsillitis in adults is not necessary.