BACKGROUND Throat pain is a common complaint in the ambulatory setting. Diagnosis of group A Streptococcus is made with a culture, molecular test or a rapid antigen detection test from the tonsils or the posterior pharyngeal wall, while other areas of the oral cavity are considered unacceptable. The purpose of the study is to compare cultures from the tonsils or posterior pharyngeal wall (throat) with cultures from the oral cavity (mouth). METHODS A prospective study conducted in ambulatory care. Eleven family physicians collected 2 swabs (throat and mouth) from 200 consecutive patients who complaint about throat pain. Inclusion criteria were throat pain and Centor Criteria > 2. Exclusion criteria were tonsillectomy and age (< 3 or > 65 years old). Participants were later divided into two groups - pediatrics (3-18 years old) and adults (19-65 year old). Sensitivity and specificity of mouth culture were calculated, with throat culture considered the reference gold standard. RESULTS Between November 2017 and March 2019, 200 swabs were collected (101 adults and 99 children). In the adult group sensitivity of mouth culture was 72.1% (95% Confidence Interval [CI] 59.9-82.3%) and specificity was 100% (95% CI 92.7-89.4%-100%). In the pediatric group sensitivity of mouth culture was 78.3% (95% CI 65.8-87.9%) and specificity was 100% (95% CI 92.5-100%). CONCLUSION Our study demonstrated higher sensitivity of mouth culture for GAS than previously published. This finding suggests that areas of the oral cavity that were considered as unacceptable sites for culture of GAS pharyngitis may be considered as acceptable swabbing sites. TRIAL REGISTRATION Trial registration: ClinicalTrials.gov, ID NCT03137823. Registered 3 May 2017.

中文翻译：

---

口腔拭子擦拭诊断链球菌的一项前瞻性研究。

背景技术喉痛是非卧床环境中的常见不适。A组链球菌的诊断是通过扁桃体或咽后壁的培养，分子测试或快速抗原检测测试进行的，而口腔的其他区域则被认为是不可接受的。该研究的目的是比较扁桃体或咽后壁（咽喉）的培养物与口腔（口）的培养物。方法对门诊进行的前瞻性研究。十一名家庭医生从连续200位抱怨喉咙痛的患者中收集了2个拭子（喉咙和口腔）。入选标准为咽喉疼痛，Centor Criteria>2。排除标准为扁桃体切除术和年龄（<3岁或> 65岁）。参与者后来分为两组-儿科（3-18岁）和成人（19-65岁）。计算了口腔培养的敏感性和特异性，以喉培养为参考金标准。结果2017年11月至2019年3月，收集了200支棉签（101名成人和99名儿童）。在成人组中，口腔培养的敏感性为72.1％（95％置信区间[CI] 59.9-82.3％），特异性为100％（95％CI 92.7-89.4％-100％）。在儿科组中，口腔培养的敏感性为78.3％（95％CI 65.8-87.9％），特异性为100％（95％CI 92.5-100％）。结论我们的研究表明口腔培养对GAS的敏感性比以前发表的更高。该发现表明，被认为是GAS咽炎培养的不可接受部位的口腔区域可以被视为可接受的拭子部位。试验注册试验注册：ClinicalTrials.gov，ID NCT03137823。2017年5月3日注册。