Updated 21 September 2015

Throat swab culture

This is a laboratory test to isolate and identify organisms which may cause infections in the throat or tonsils.


Throat swab culture is a laboratory test to isolate and identify organisms which may cause infections in the throat or tonsils.

Why is it done?

Sore throats are common, may be caused by a variety of organisms (including viruses), and are usually uncomplicated and self-limiting. However, those caused by group A beta-heamolytic streptococcus (GAS) may have serious consequences, such as acute rheumatic fever (causing damage to heart valves), toxic shock syndrome and acute glomerulonephritis.

In a patient suspected of having a GAS pharyngitis (also known as strep throat), throat swab culture can confirm the diagnosis. Swift antibiotic treatment can prevent the consequences listed above.

How is the test done?

Throat swab specimens must be taken before antibiotics are started.

Sterile swabs which look like giant earbuds are used. The patient opens his mouth wide, and the swab is rubbed against the back of the throat, near to and on the tonsils. The swab is replaced in its container and immediately sent to the laboratory for incubation and culture.

Apart from identifying a bacterium, the laboratory also does an 'antibiogram': the bug is exposed to several different antibiotics to see which ones it is sensitive/resistant to. In this way, the correct antibiotic can be recommended, rather than using a trial and error method in this important condition.

Identifying an organism may take 24-48 hours, and a complete antibiogram up to four days.

Risks of the test

The only serious risk is that of gagging, or vomiting, induced by the swab touching the back of the throat.

Interpretation of results

The throat is not a sterile are, and is normally inhabited by a number of bacteria. Finding any one of these on swab culture does not necessarily mean it is responsible for the clinical condition of the patient. Some people are GAS carriers (meaning that the GAS lives in their throats all the time), and may have a viral throat causing the symptoms.

The commonest cause of sore throat is a virus, which is not detected on this test, and for which there is no curative treatment anyway. Several other bacteria are known to cause pharyngitis:

  • Neisseria gonorrhoea ( gonorrhoea bug),
  • Bordatella pertussis (whooping cough bug),
  • Corynebacterium diphtheriae ( diphtheria bug), and
  • Chlamydia and mycoplasma.

The relevance of the throat swab is therefore as an added diagnostic tool in a patient who is already suspected of having a strep throat, using a 9-point scoring system.

Once the swab has been taken, the patient may be given an antibiotic. If the lab report later shows the bug insensitive to the treatment, a different one can be started. If the bug is sensitive to the treatment chosen, then valuable days will not have been lost while waiting for the result

(Dr A G Hall)


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