Beta-haemolytic streptococci isolated from acute sore-throat patients: cause or coincidence? A case-control study in general practice

Scand J Infect Dis. 2000;32(4):377-84. doi: 10.1080/003655400750044944.


As beta-haemolytic streptococci can be cultured in people with and in those without a sore throat, a case-control study was set up in 43 family practices in The Netherlands. The association was tested between the number of colony counts, specific T/M types and exotoxin genes and an acute sore throat. Duplicate throat swabs were taken from 663 sore-throat patients, selected by clinical criteria, and from 694 healthy controls. They were cultured for beta-haemolytic streptococci by combining several updated laboratory methods. Approximately 40% of the controls and 80% of the patients had beta-haemolytic streptococci-positive cultures. When focusing on cultures with high colony counts, not only group A (46%), but also non-group A streptococci (20%), predominated significantly in adult patients compared with controls. No T/M or exotoxin gene type was significantly more prevalent in patients than in controls. Thus, semiquantitative analysis, but not T/M and exotoxin gene typing, showed an association between beta-haemolytic streptococci and active disease. Groups A, C and G streptococci were found to be potentially pathogenic in adult sore-throat patients, and should be included in the discussion on the use of rapid antigen detection tests and penicillin treatment in primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Bacterial Proteins / genetics
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Exotoxins*
  • Family Practice
  • Female
  • Genotype
  • Humans
  • Male
  • Membrane Proteins / genetics
  • Pharyngitis / microbiology*
  • Streptococcus / classification
  • Streptococcus / isolation & purification*


  • Bacterial Proteins
  • Exotoxins
  • Membrane Proteins
  • SpeA protein, Streptococcus pyogenes