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J Med Microbiol 55 (2006), 989-992; DOI: 10.1099/jmm.0.46325-0
© 2006 Society for General Microbiology
ISSN 1473-5644

Increased recovery of Moraxella catarrhalis and Haemophilus influenzae in association with group A ß-haemolytic streptococci in healthy children and those with pharyngo-tonsillitis

Itzhak Brook and Alan E. Gober

Department of Pediatrics, Georgetown University, School of Medicine, Washington, DC, USA

Correspondence
Itzhak Brook
ib6{at}georgetown.edu

Received 9 September 2005
Accepted 22 March 2006

The inflamed tonsils harbour numerous types of bacteria, alone or in combination with group A ß-haemolytic streptococci (GABHS). The cohabitation of the tonsils by GABHS and certain other bacterial species may contribute to the inflammatory process and the failure of penicillin therapy. This study evaluated the recovery of Moraxella catarrhalis, Haemophilus influenzae, Staphylococcus aureus and Streptococcus pneumoniae in association with GABHS in healthy children and those with acute pharyngo-tonsillitis (APT). Pharyngo-tonsillar cultures were obtained from 548 children with APT and 866 healthy children. GABHS was recovered from 112 (20.4 %) children with APT. Of the 114 H. influenzae isolates, 32 were recovered in association with GABHS (29 % of all patients who had GABHS) and 82 were isolated without GABHS (19 %) (P=0.0267). Of the 69 M. catarrhalis isolates, 25 were recovered in association with GABHS (22 % of all patients who had GABHS) and 44 were isolated without GABHS (10 %) (P=0.0012). In contrast, there was no association between the isolation of GABHS and the recovery of Staph. aureus or Strep. pneumoniae. GABHS was recovered from 104 (12 %) healthy children. Of the 69 M. catarrhalis isolates, 24 were recovered in association with GABHS (23 % of all patients who had GABHS) and 80 were isolated without GABHS (10 %) (P=0.006). There was no association between the isolation of GABHS and the recovery of H. influenzae, Staph. aureus or Strep. pneumoniae. This study demonstrates an association between the recovery of GABHS and H. influenzae and M. catarrhalis from pharyngo-tonsillar cultures of patients with APT and M. catarrhalis from pharyngo-tonsillar cultures of healthy children.

Abbreviations: APT, acute pharyngo-tonsillitis; BLPB, ß-lactamase-producing bacteria; GABHS, group A ß-haemolytic streptococci.




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