Faringoamigdalitis y estreptococo, ¿enemigo o colonizador?

Abstract

Introduction: the main etiology of acute pharyngotonsillitis (AAT) is viral, and among the bacterial etiology, Streptococcus pyogenes is a non-negligible colonizer of the healthy pediatric population. The aim of this study is to know how the rapid streptococcal diagnostic test (RDT) is used in pediatric emergency departments in order to optimize its use, reduce the overdiagnosis of streptococcal AAP and the prescription of antibiotics. Material and methods: we collected retrospective information on the number of RDTs performed on patients seen in the Pediatric Emergency Department of a tertiary hospital, from January 2022 to January 2023 (both inclusive). Information was also collected on the number of patients who underwent more than one RDT and the time elapsed. Results: during the 13 months studied, a total of 1610 TDRs were performed (43% in < 5 years). More than one TDR was performed in 89 patients (53% in < 5 years) and 40% of these were performed in the first 40 days. Discussion: microbiological tests for Streptococcus pyogenes are not able to differentiate between active infection and healthy carrier state. According to the results of our study there seems to be an inadequate use of RDTs; most tests are performed in < 5 years, where streptococcal etiology is less frequent and healthy carrier status predominant. This leads to overdiagnosis of FAAE, antibiotic overtreatment, occurrence of adverse effects and bacterial resistance.