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Acute sore throat and Fusobacterium necrophorum in primary healthcare : A systematic review and meta-analysis

Malmberg, Stefan ; Petrén, Susanna ; Gunnarsson, Ronny ; Hedin, Katarina LU and Sundvall, Pär Daniel (2021) In BMJ Open 11(6).
Abstract

Purpose The main objective of this review was to describe and quantify the association between Fusobacterium necrophorum (FN) and acute sore throat in primary healthcare (PHC). Methods In this systematic review and meta-analysis, we searched Scopus and PubMed for case-control studies reporting the prevalence of FN in patients attending primary care for an uncomplicated acute sore throat as well as in healthy controls. Only studies published in English were considered. Publications were not included if they were case studies, or if they included patients prescribed antibiotics before the throat swab, patients with a concurrent malignant disease, on immunosuppression, having an HIV infection, or patients having another acute infection in... (More)

Purpose The main objective of this review was to describe and quantify the association between Fusobacterium necrophorum (FN) and acute sore throat in primary healthcare (PHC). Methods In this systematic review and meta-analysis, we searched Scopus and PubMed for case-control studies reporting the prevalence of FN in patients attending primary care for an uncomplicated acute sore throat as well as in healthy controls. Only studies published in English were considered. Publications were not included if they were case studies, or if they included patients prescribed antibiotics before the throat swab, patients with a concurrent malignant disease, on immunosuppression, having an HIV infection, or patients having another acute infection in addition to a sore throat. Inclusion criteria and methods were specified in advance and published in PROSPERO. The primary outcome was positive etiologic predictive value (P-EPV), quantifying the probability for an association between acute sore throat and findings of FN in the pharynx. For comparison, our secondary outcome was the corresponding P-EPV for group A Streptococcus (GAS). Results PubMed and Scopus yielded 258 and 232 studies, respectively. Removing duplicates and screening the abstracts resulted in 53 studies subsequently read in full text. For the four studies of medium to high quality included in the meta-analysis, the cumulative P-EPV regarding FN was 64% (95% CI 33% to 83%). GAS, based on data from the same publications and patients, yielded a positive EPV of 93% (95% CI 83% to 99%). Conclusions The results indicate that FN may play a role in PHC patients with an acute sore throat, but the association is much weaker compared with GAS.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
diagnostic microbiology, epidemiology, infectious diseases, primary care
in
BMJ Open
volume
11
issue
6
article number
e042816
publisher
BMJ Publishing Group
external identifiers
  • pmid:34088705
  • scopus:85107902880
ISSN
2044-6055
DOI
10.1136/bmjopen-2020-042816
language
English
LU publication?
yes
id
471181c9-7ade-417a-98c3-5a7576d01f9a
date added to LUP
2021-06-28 10:33:07
date last changed
2024-07-13 15:23:50
@article{471181c9-7ade-417a-98c3-5a7576d01f9a,
  abstract     = {{<p>Purpose The main objective of this review was to describe and quantify the association between Fusobacterium necrophorum (FN) and acute sore throat in primary healthcare (PHC). Methods In this systematic review and meta-analysis, we searched Scopus and PubMed for case-control studies reporting the prevalence of FN in patients attending primary care for an uncomplicated acute sore throat as well as in healthy controls. Only studies published in English were considered. Publications were not included if they were case studies, or if they included patients prescribed antibiotics before the throat swab, patients with a concurrent malignant disease, on immunosuppression, having an HIV infection, or patients having another acute infection in addition to a sore throat. Inclusion criteria and methods were specified in advance and published in PROSPERO. The primary outcome was positive etiologic predictive value (P-EPV), quantifying the probability for an association between acute sore throat and findings of FN in the pharynx. For comparison, our secondary outcome was the corresponding P-EPV for group A Streptococcus (GAS). Results PubMed and Scopus yielded 258 and 232 studies, respectively. Removing duplicates and screening the abstracts resulted in 53 studies subsequently read in full text. For the four studies of medium to high quality included in the meta-analysis, the cumulative P-EPV regarding FN was 64% (95% CI 33% to 83%). GAS, based on data from the same publications and patients, yielded a positive EPV of 93% (95% CI 83% to 99%). Conclusions The results indicate that FN may play a role in PHC patients with an acute sore throat, but the association is much weaker compared with GAS. </p>}},
  author       = {{Malmberg, Stefan and Petrén, Susanna and Gunnarsson, Ronny and Hedin, Katarina and Sundvall, Pär Daniel}},
  issn         = {{2044-6055}},
  keywords     = {{diagnostic microbiology; epidemiology; infectious diseases; primary care}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Acute sore throat and Fusobacterium necrophorum in primary healthcare : A systematic review and meta-analysis}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2020-042816}},
  doi          = {{10.1136/bmjopen-2020-042816}},
  volume       = {{11}},
  year         = {{2021}},
}