[Multivariate model to predict Streptococcus pyogenes tonsillitis].
| Autor: | Villaseñor-Sierra A; Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco. avillase@prodigy.net.mx, Caballero-Hoyos JR, Jáuregui-Lomelí JJ, Flores-Sánchez J, Martínez-Sandoval F |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Revista medica del Instituto Mexicano del Seguro Social [Rev Med Inst Mex Seguro Soc] 2008 Jul-Aug; Vol. 46 (4), pp. 383-90. |
| Abstrakt: | 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, chi2, 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. |
| Databáze: | MEDLINE |
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