{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T19:20:43Z","timestamp":1791141643985,"version":"4.1.0"},"reference-count":12,"publisher":"Microbiology Society","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,8,1]]},"abstract":"The inflamed tonsils harbour numerous types of bacteria, alone or in combination with group A \u03b2<\/jats:italic>-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<\/jats:italic>, Haemophilus influenzae<\/jats:italic>, Staphylococcus aureus<\/jats:italic> and Streptococcus pneumoniae<\/jats:italic> 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\u200a%) children with APT. Of the 114 H. influenzae<\/jats:italic> isolates, 32 were recovered in association with GABHS (29\u200a% of all patients who had GABHS) and 82 were isolated without GABHS (19\u200a%) (P<\/jats:italic>=0.0267). Of the 69 M. catarrhalis<\/jats:italic> isolates, 25 were recovered in association with GABHS (22\u200a% of all patients who had GABHS) and 44 were isolated without GABHS (10\u200a%) (P<\/jats:italic>=0.0012). In contrast, there was no association between the isolation of GABHS and the recovery of Staph. aureus<\/jats:italic> or Strep<\/jats:italic>. pneumoniae<\/jats:italic>. GABHS was recovered from 104 (12\u200a%) healthy children. Of the 69 M. catarrhalis<\/jats:italic> isolates, 24 were recovered in association with GABHS (23\u200a% of all patients who had GABHS) and 80 were isolated without GABHS (10\u200a%) (P<\/jats:italic>=0.006). There was no association between the isolation of GABHS and the recovery of H. influenzae<\/jats:italic>, Staph. aureus<\/jats:italic> or Strep<\/jats:italic>. pneumoniae<\/jats:italic>. This study demonstrates an association between the recovery of GABHS and H. influenzae<\/jats:italic> and M. catarrhalis<\/jats:italic> from pharyngo-tonsillar cultures of patients with APT and M. catarrhalis<\/jats:italic> from pharyngo-tonsillar cultures of healthy children.<\/jats:p>","DOI":"10.1099\/jmm.0.46325-0","type":"journal-article","created":{"date-parts":[[2006,7,18]],"date-time":"2006-07-18T23:08:08Z","timestamp":1153264088000},"page":"989-992","source":"Crossref","is-referenced-by-count":33,"title":["Increased recovery of Moraxella catarrhalis and Haemophilus influenzae in association with group A \u03b2-haemolytic streptococci in healthy children and those with pharyngo-tonsillitis"],"prefix":"10.1099","volume":"55","author":[{"given":"Itzhak","family":"Brook","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Georgetown University, School of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan E.","family":"Gober","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Georgetown University, School of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/clinids\/6.5.601","article-title":"The role of beta-lactamase-producing bacteria in the persistence of streptococcal tonsillar infection","volume":"6","author":"Brook","year":"1984","journal-title":"Rev Infect Dis"},{"key":"R2","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1097\/00006454-198509000-00010","article-title":"Role of beta-lactamase-producing bacteria in the failure of penicillin to eradicate group A streptococci","volume":"4","author":"Brook","year":"1985","journal-title":"Pediatr Infect Dis"},{"key":"R3","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1093\/jac\/24.2.227","article-title":"Treatment of patients with acute recurrent tonsillitis due to group A beta-haemolytic streptococci: a prospective randomized study comparing penicillin and amoxycillin\/clavulanate potassium","volume":"24","author":"Brook","year":"1989","journal-title":"J Antimicrob Chemother"},{"key":"R4","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ijporl.2004.08.007","article-title":"The role of anaerobic bacteria in tonsillitis","volume":"69","author":"Brook","year":"2005","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"R5","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1469-0691.1996.tb00550.x","article-title":"Enhancement of growth of group A beta-hemolytic streptococci in mixed infections with aerobic and anaerobic bacteria","volume":"1","author":"Brook","year":"1996","journal-title":"Clin Microbiol Infect"},{"key":"R6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1093\/clinids\/21.1.171","article-title":"Changes in the core tonsillitis bacteriology of recurrent tonsillitis: 1977\u20131980","volume":"21","author":"Brook","year":"1995","journal-title":"Clin Infect Dis"},{"key":"R7","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1086\/392496","article-title":"Meta-analysis of cephalosporins versus penicillin for treatment of group A streptococcal tonsillopharyngitis in adults","volume":"38","author":"Casey","year":"2004","journal-title":"Clin Infect Dis"},{"key":"R8","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/S0022-3476(88)80291-9","article-title":"Eradication of group A streptococcus from the upper respiratory tract by amoxicillin with clavulanate after oral penicillin treatment failure","volume":"113","author":"Kaplan","year":"1988","journal-title":"J Pediatr"},{"key":"R9","doi-asserted-by":"crossref","first-page":"6689","DOI":"10.1128\/IAI.72.11.6689-6693.2004","article-title":"Moraxella catarrhalis coaggregates with Streptococcus pyogenes and modulates interactions of S. pyogenes with human epithelial cells","volume":"72","author":"Lafontaine","year":"2004","journal-title":"Infect Immun"},{"key":"R10","volume-title":"Manual of Clinical Microbiology","author":"Murray","year":"1995"},{"key":"R11","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1128\/AAC.1.4.283","article-title":"Novel method for detection of beta-lactamase by using a chromogenic cephalosporin substrate","volume":"1","author":"O'Callaghan","year":"1972","journal-title":"Antimicrob Agents Chemother"},{"key":"R12","doi-asserted-by":"crossref","first-page":"314","DOI":"10.3109\/00016489009107448","article-title":"Colonization by Haemophilus influenzae and group A streptococci in recurrent acute tonsillitis and in tonsillar hypertrophy","volume":"109","author":"Stjernquist-Desatnik","year":"1990","journal-title":"Acta Otolaryngol"}],"container-title":["Journal of Medical 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