DOI: https://doi.org/10.53350/pjmhs211592182 ORIGINAL ARTICLE 2182 P J M H S Vol. 15, NO.9, SEP 2021 Prevalence of Microorganisms in Acute Pharyngitis from Throat Swab in a tertiary care hospital MUMTAZ AHMAD UMAR 1 , MIRZA NASHEED BAIG 2 , NIGHAT ARIF 3 , NAVEED ARSHAD 4 , AYESHA JAWAD 5 , MAHNOOR FATIMA 6 1 Assistant Professor, Islamabad Medical and Dental College, Islamabad 2 Associate Professor, KRL Hospital, Islamabad 3 Associate Professor Railway Hospital, Rawalpindi 4 Assistant Professor, Islamabad Medical and Dental College, Islamabad 5 Assistant Professor Shifa College of Medicine, Islamabad 6 Senior Registrar, Islamabad Medical and Dental College, Islamabad Correspondence to Dr. Mohibullah Mushwani, Email: mohibullah@imdcollege.edu.pk , Cell: +92-3215010450 ABSTRACT Background: Acute pharyngitis is the inflammation of the mucous membrane of oropharynx which is caused by various infectious organisms like bacteria, viruses and fungi. The other less common seen causes include allergies and gastro-esophageal reflux disease. Aim: To look for range of microorganisms involved in causing acute pharyngitis on throat swab specimens. Methods: After getting consent all the pharyngitis patients attending ENT Department at Akbar Niazi Teaching Hospital (ANTH), Islamabad from January to June 2017 were included in the study. From total of 100 patients throat swabs were obtained by established aseptic method and were sent for culture. The organisms involved were recognized by biochemical tests & their propensity to antimicrobial agents was established by established methods. Data was entered and analyzed by using SPSS v.21. Results: Out of 100 specimens’ microorganisms were identified in 25 specimens while 75 specimens had no growth. Streptococcus pyogenes was the frequently seen organism 9(90%), while the list was followed by Staphylococcus aureus 14(56%) and Candida albicans 3(12%). In 40% single pathogen was identified with Streptococcus pyogenes in 9 samples (90%) and Staphylococcus aureus in 1(10%), whereas 60% of the culture reports were that of the mix infection. Conclusion: The study concluded that streptococcus pyogenes and staphylococcus aureus were responsible for majority of single organism infections, while candida albicans together with these bacteria were isolated from mixed infections. Keywords: Pharyngitis; Streptococcus pyogenes; Throat; Microorganisms. INTRODUCTION Acute pharyngitis is the inflammation of the mucous membrane of oropharynx which is caused by various infectious organisms like bacteria, viruses and fungi. The other less common seen causes includes allergies and gastro-esophageal reflux disease 1 . It is the commonest infection that is seen and diagnosed at primary health clinics. Of these about 50% to 80% are viral in origin while most common bacterial pathogen is Group A beta- hemolytic streptococcus (GABHS), which is Gram-positive pathogen and is involved in 5-15% of adult cases and among 20-30% younger patients. The other microorganisms that can cause an acute pharyngitis are H. influenza, staphylococcus, streptococcus pneumonae, candida albicans and mycoplasma pneumonae 2 . Streptococcus hemolyticus which is now known as Streptococcus pyogenes whose incubation period is 2-5 days and infection due to this organism recovers spontaneously within 7-10 days but can cause mild to severe infections like pharyngitis, impetigo, toxic shock syndrome and necrotizing fasciitis with possible sequel as tonsillar abscess, otitis media, rheumatic fever and post- streptococcal glomerulonephritis (PSGN) 3,4 . Currently Streptococcus pharyngitis cases are ------------------------------------------------------------------------------- Received on 13-04-2021 Accepted on 19-08-2021 reduced in the developed countries due to use of broad spectrum antibiotic treatment but it is estimated that approximately 600 million symptomatic pharyngitis due to GABHS are caused annually in younger people of age over four years and of these about 550 million are seen in under developed countries 5,6 . Clinical signs and symptoms between bacterial and viral pharyngitis usually overlap and is difficult to make a precise diagnosis of pharyngitis due to group A streptococcal GABHS as only 20–30% of patients present with classical symptoms of bacterial pharyngitis. Centor’s criteria (Fever of ≥38°C, Tonsillar swelling or exudates, palpable Jugulo-digastric lymph node and absence of cough) are the standard for bacterial pharyngitis 4,7,8 . Accurate diagnosis can be made on the result of throat swab cultures which usually takes 2-3 days to isolate the organisms from the specimen obtained by swabbing from the tonsil and posterior pharyngeal wall and presence of Streptococcus pyogenes confirm the streptococcal pharyngitis while the outcomes are further evaluated and identified on biochemical test such as Gram stain and Pyrrolidonyl acrylamides test 9 . The throat swab sensitivity and specificity of the cultures is 81.1% and 94.9% respectively 10 . Our study was intended to explain the frequency of possible pathogenic microbes in throat swab specimens from patients with pharyngitis.