[Multivariate model to predict Streptococcus pyogenes tonsillitis]. / Modelo multivariado para predecir amigdaltis estreptócócica.
Rev Med Inst Mex Seguro Soc
; 46(4): 383-90, 2008.
Article
em Es
| MEDLINE
| ID: mdl-19213209
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções Estreptocócicas
/
Streptococcus pyogenes
/
Tonsilite
/
Modelos Teóricos
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Es
Revista:
Rev Med Inst Mex Seguro Soc
Assunto da revista:
MEDICINA
/
MEDICINA SOCIAL
Ano de publicação:
2008
Tipo de documento:
Article
País de publicação:
México