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close this bookBasic Laboratory Procedures in Clinical Bacteriology (WHO; 1991; 128 pages)
View the documentPreface
View the documentIntroduction
open this folder and view contentsQuality assurance in microbiology
close this folderPart I. Bacteriological investigations
open this folder and view contentsBlood
open this folder and view contentsCerebrospinal fluid
open this folder and view contentsUrine
open this folder and view contentsStool
open this folder and view contentsLower respiratory tract infections
close this folderUpper respiratory tract infections
View the documentIntroduction
View the documentThe normal flora of the pharynx
View the documentBacterial agents of pharyngitis
View the documentCollection and dispatch of specimens
View the documentDirect microscopy
View the documentCulture and identification
View the documentSusceptibility testing
open this folder and view contentsSexually transmitted diseases
open this folder and view contentsPurulent exudates, wounds, and abscesses
open this folder and view contentsAnaerobic bacteriology
open this folder and view contentsAntimicrobial susceptibility testing
open this folder and view contentsPart II. Essential media and reagents for isolation and identification of clinical pathogens
View the documentSelected further reading
View the documentSelected WHO publications of related interest
View the documentBack Cover
 

The normal flora of the pharynx

The normal flora of the pharynx includes a large number of species that should be neither fully identified nor reported when observed in throat cultures:

 

• viridans (alpha-haemolytic) streptococci and pneumococci
• nonpathogenic Neisseria spp
Branhamella (formerly Neisseria) catarrhalis (this can also be a respiratory pathogen)
• staphylococci (S. aureus, S. epidermidis)
• diphtheroids
Haemophilus spp
• yeasts (Candida spp) in limited quantity
• various strictly anaerobic Gram-positive cocci and Gram-negative rods, spirochaetes and filamentous forms.

The throats of elderly, immunodeficient, or malnourished patients, particularly when they have received antibiotics, may be colonized by Enterobacteriaceae (Escherichia coli, Klebsiella spp, etc.) and by the nonfermentative Gram-negative groups (Acinetobacter spp and Pseudomonas spp). Such patients may also have in their pharynx a proliferation of S. aureus or of Candida spp, or other yeast-like fungi. Although these microorganisms do not cause pharyngitis, except in association with granulocytopenia, it is advisable to report such isolates to the clinician, as they occasionally indicate the existence of (or may sometimes give rise to) a lower respiratory tract infection (e.g., pneumonia) or bacteraemia. However, an antibiogram should not be performed routinely on these colonizing microorganisms.

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