Community pharmacist–directed point-of-care group A Streptococcus testing: Evaluation of a Canadian program

2018 ◽  
Vol 58 (4) ◽  
pp. 450-456 ◽  
Author(s):  
John Papastergiou ◽  
Chantal Rene Trieu ◽  
Deborah Saltmarche ◽  
Artemis Diamantouros
Keyword(s):  
Community Pharmacist ◽  
Group A Streptococcus ◽  
Point Of Care ◽  
Care Group ◽  
Group A

Detection of Group A Streptococcus in the Saliva of Children Presenting With Pharyngitis Using the cobas Liat PCR System

2020 ◽  
Vol 59 (9-10) ◽  
pp. 856-858
Author(s):  
Gregory DeMuri ◽  
Ellen R. Wald
Keyword(s):  
Polymerase Chain Reaction ◽  
Pilot Study ◽  
Group A Streptococcus ◽  
Point Of Care ◽  
Sampling Techniques ◽  
Chain Reaction ◽  
Point Of Care Test ◽  
Group A ◽  
Increased Sensitivity ◽  
Polymerase Chain

Rapid turnaround real-time polymerase chain reaction (PCR) has recently become available as a point-of-care test for group A Streptococcus (GAS) in children presenting with pharyngitis. Our aim in this pilot study was to determine if GAS can be detected in the saliva of children with sore throat using swabs inoculated by children sucking on them as they would a lollipop. Twenty children with positive rapid antigen detection tests for GAS from pharyngeal swabs were enrolled. Pharyngeal and lollipop samples underwent PCR testing using the cobas Liat system. All 20 pharyngeal swabs were positive; 19 of 20 lollipop samples were positive. The increased sensitivity of the new PCR kits for GAS may permit use of less invasive and more comfortable sampling techniques for diagnosis.

scholarly journals Detection of Group A Streptococcus from Pharyngeal Swab Samples by Bacterial Culture Is Challenged by a Novel mariPOC Point-of-Care Test

2015 ◽  
Vol 53 (7) ◽  
pp. 2079-2083 ◽  
Author(s):  
Jukka Vakkila ◽  
Janne O. Koskinen ◽  
Annika Brandt ◽  
Anna Muotiala ◽  
Viivi Liukko ◽  
...  
Keyword(s):  
Bacterial Culture ◽  
Group A Streptococcus ◽  
Point Of Care ◽  
Clinical Importance ◽  
Test System ◽  
Lower Sensitivity ◽  
Patients Âgés ◽  
Point Of Care Test ◽  
Group A ◽  
Tract Infections

mariPOC is a novel point-of-care test system for rapid detection of respiratory tract infections. We compared the performance of the mariPOC test to that of bacterial culture for detecting group A streptococcus (GAS) in 219 pharyngitis patients (ages 1–64 years) and 109 healthy asymptomatic controls (ages 19–69 years). In addition, 42 patient samples were analyzed by quantitative PCR (qPCR). Of the 219 pharyngeal patient samples, 32 were positive in a GAS bacterial culture (prevalence 15%) and 65 (30%) in the mariPOC test. The amount of GAS in samples reported positive by the mariPOC test and negative by culture was, on average, 10-fold less than that of those positive in both methods. This indicated that the negative results in bacterial cultures were due to lower sensitivity. The qPCR results were positive and in line with the mariPOC results in 43% of the discordant samples studied. Two GAS culture-positive samples were negative by the mariPOC test. The prevalences of GAS in the control subjects were 2% and 6% by culture and mariPOC results, respectively. We conclude that the mariPOC antigen detection test is more sensitive than the conventional bacterial culture for the detection of GAS among symptomatic pharyngitis patients. The higher prevalence of GAS by the mariPOC test among symptomatic patients was probably not due to carriership, since among the control patients, the difference in the prevalence of GAS by the mariPOC test and culture was not nearly as high, 15% versus 4%, respectively. Clinical trials are needed to show the clinical importance of our findings.

Point-of-Care Testing for Group A Streptococcus Infection and Influenza

2017 ◽  
Vol 39 (19) ◽  
pp. 151-157 ◽  
Author(s):  
Jennifer Woo ◽  
Valerie Arboleda ◽  
Omai B. Garner
Keyword(s):  
Group A Streptococcus ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Group A

scholarly journals Assessment of Test Performance and Potential for Environmental Contamination Associated with a Point-of-Care Molecular Assay for Group A Streptococcus in an End User Setting

2018 ◽  
Vol 57 (2) ◽  
Author(s):  
Leslie J. Donato ◽  
Nikki K. Myhre ◽  
Martha A. Murray ◽  
Margaret R. McDonah ◽  
Jane F. Myers ◽  
...  
Keyword(s):  
Failure Rate ◽  
Environmental Contamination ◽  
Test Performance ◽  
Group A Streptococcus ◽  
Point Of Care ◽  
End Users ◽  
Test Accuracy ◽  
End User ◽  
Molecular Systems ◽  
Group A

ABSTRACT Although U.S. Food and Drug Administration-approved and CLIA-waived point-of-care (POC) molecular systems are being implemented in routine clinical practice, instrument reliability, test performance in the hands of end users, and the potential for environmental contamination resulting from use of POC molecular systems have not been extensively evaluated. We performed a prospective evaluation of the Roche cobas Liat group A streptococcus (GAS) assay compared to routine real-time PCR. We evaluated test accuracy, instrument failure rate, and monitored for environmental contamination when testing was performed by minimally trained end users in an Express Care Clinic environment. The overall concordance of the Liat GAS assay with routine testing was 97.2% (455/468). The average Liat failure rate across three analyzers was 6.6% (33/501) (range, 3.7 to 11.6%), and no environmental contamination was detected during the course of the study. The cobas Liat platform and GAS assay demonstrated reliable performance in the end user setting and may serve as a rapid, POC option for routine diagnostic testing for certain infectious diseases, including GAS.

scholarly journals 2179. Detection of Group A Streptococcus in the Saliva of Children Presenting With Pharyngitis Using the cobas®LIAT® PCR System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S739-S740
Author(s):  
Gregory P DeMuri ◽  
Ellen R Wald
Keyword(s):  
Sore Throat ◽  
Group A Streptococcus ◽  
Point Of Care ◽  
Poor Quality ◽  
Small Pilot Study ◽  
Point Of Care Test ◽  
Group A ◽  
Pharynx Swab ◽  
Scientific System ◽  
Posterior Pharynx

Abstract Background CLIA waived polymerase chain reaction (PCR) has recently become available as a point of care test for Group A Streptococci (GAS) in individuals presenting with pharyngitis, enabling rapid and accurate diagnosis. However, swabbing the pharynx results in discomfort and is often dreaded by young children which may result in poor quality sampling. Objective In order to assess the viability of saliva as a sample specimen for GAS, this study compared saliva samples with pharynx swabs of children with sore throat, using swabs inoculated by children sucking on them as they would a lollipop in the context of newly available very sensitive techniques. Methods We enrolled children ages 5–15 years presenting with sore throat and known to have a positive rapid streptococcal antigen detection test (RADT) performed on a posterior pharyngeal swab, at the discretion of the primary care provider. The RADT used was the SureVue® (Fisher Scientific) system. A second swab was obtained by having the child suck on the swab in the anterior mouth for 30 seconds and a third swab was obtained from the posterior pharynx. PCR was performed on these two additional swabs using the cobas®LIAT® (Roche) system according to the manufacturer’s instructions. Results Seventeen children were enrolled in the study between January and April 2019. The mean age of enrollment was 9.6 years (range 6–15). By design all children were known to have a positive RADT for GAS. The LIAT posterior pharynx swab was positive in all 17 subjects. In addition, the LIAT saliva swab was positive in all 17 subjects. Conclusion In this small pilot study, there was 100% concordance between the RADT for GAS and both the posterior pharyngeal and saliva swab using the cobas®LIAT® PCR system. Performing saliva swabs will result in less discomfort and distress to children who are tested for GAS. Further study is needed to determine the sensitivity and specificity of saliva swabs for the detection of GAS in children presenting with acute pharyngitis. Disclosures All authors: No reported disclosures.

Observation of a Pharmacist-Conducted Group A Streptococcal Pharyngitis Point-of-Care Test: A Time and Motion Study

2017 ◽  
Vol 31 (3) ◽  
pp. 284-291 ◽  
Author(s):  
Carolyn E. Corn ◽  
Donald G. Klepser ◽  
Allison M. Dering-Anderson ◽  
Terrence G. Brown ◽  
Michael E. Klepser ◽  
...  
Keyword(s):  
Group A Streptococcus ◽  
Point Of Care ◽  
The United States ◽  
Streptococcal Pharyngitis ◽  
Point Of Care Test ◽  
Time And Motion ◽  
Need To Evaluate ◽  
Group A ◽  
Time Required ◽  
Encounter Time

Background: Acute pharyngitis is among the most common infectious diseases encountered in the United States, resulting in 13 million patient visits annually, with group A streptococcus (GAS) being a common causative pathogen. It is estimated that annual expenditures for the treatment of adult pharyngitis will exceed US$1.2 billion annually. This substantial projection reinforces the need to evaluate diagnosis and treatment of adult pharyngitis in nontraditional settings. Objective: The objective of this research is to quantify the amount of pharmacist time required to complete a point-of-care (POC) test for a patient presenting with pharyngitis symptoms. Methods: A standardized patient with pharyngitis symptoms visited 11 pharmacies for POC testing services for a total of 33 patient encounters. An observer was present at each encounter and recorded the total encounter time, divided into 9 categories. Pharmacists conducted POC testing in 1 of 2 ways: sequence 1—pharmacists performed all service-related tasks; sequence 2—both pharmacists and pharmacist interns performed service-related tasks. Results: The average time for completion of a POC test for GAS pharyngitis was 25.3 ± 4.8 minutes. The average pharmacist participation time per encounter was 12.7 ± 3.0 minutes (sequence 1), which decreased to 2.6 ± 1.1 minutes when pharmacist interns were involved in the testing (sequence 2). Conclusion: Although additional studies are required to further assess service feasibility, this study indicates that a GAS POC testing service could be implemented in a community pharmacy with limited disruption or change to workflow and staff.

scholarly journals Comparison of 3 Nucleic Acid Amplification Tests and a Rapid Antigen Test with Culture for the Detection of Group A Streptococci from Throat Swabs

2019 ◽  
Vol 4 (2) ◽  
pp. 164-169 ◽  
Author(s):  
Kyle G Parker ◽  
Sumanth Gandra ◽  
Scott Matushek ◽  
Kathleen G Beavis ◽  
Vera Tesic ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Predictive Value ◽  
Bacterial Culture ◽  
Group A Streptococcus ◽  
Point Of Care ◽  
High Sensitivity ◽  
Ease Of Use ◽  
Nucleic Acid Amplification ◽  
Gold Standard Method ◽  
Group A

Abstract Background Recently, the US Food and Drug Administration cleared 3 nucleic acid amplification test (NAAT) assays for detection of Streptococcus pyogenes [group A Streptococcus (GAS)] in pharyngeal specimens. However, there are limited studies evaluating the performance of these NAAT assays. Methods We compared the results of 3 NAATs (cobas Liat, Luminex Aries, and Cepheid Xpert Xpress) and a rapid antigen assay (Quidel QuickVue in-line strep A) with the accepted gold standard method, bacterial culture. Results Sixty-eight throat swab specimens collected between August and October 2017 were tested. Compared to bacterial culture, the sensitivities, specificities, positive predictive value, and negative predictive value for detecting GAS were as follows: cobas Liat: 100%, 97.4%, 96.7%, and 100%; Cepheid Xpert: 100%, 97.4%, 96.7%, and 100%; Luminex Aries: 95.2%, 100%, 100%, and 95.5%. The Quidel QuickVue in-line strep A assay showed poor sensitivity, detecting only 5.2% of culture-positive specimens. Conclusion The 3 NAATs have high sensitivity when compared with bacterial culture for detection of GAS. With rapid turnaround time and ease of use, these tests can be considered as reliable point-of-care tests for the diagnosis of GAS, replacing the need for back-up culture.

scholarly journals 444. Better Efficiency, Same Accuracy: Point-of-Care PCR for the Detection of Group A streptococcus in Noninvasive Skin Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S219-S219
Author(s):  
Patrick D Galdun ◽  
Ryan M Close ◽  
Catherine Sutcliffe ◽  
Dennie R Parker ◽  
Angelina Reid ◽  
...  
Keyword(s):  
Predictive Value ◽  
Group A Streptococcus ◽  
Point Of Care ◽  
Antibiotic Use ◽  
The United States ◽  
Diagnostic Techniques ◽  
Antibiotic Prescribing ◽  
Roche Molecular Diagnostics ◽  
Group A ◽  
Culture Positive

Abstract Background Group A streptococcus (GAS) is a common cause of skin and soft-tissue infections (SSTIs). Current diagnostic techniques are culture-based and time intensive, requiring the prescription of empiric antibiotics before results are available. New detection tools are needed to hasten the diagnosis and appropriate treatment of SSTIs. The Cobas® Liat® System is a point of care (POC), real-time PCR system developed by Roche Molecular Diagnostics and is used in the United States and Europe to detect GAS from throat swabs within 15 minutes. We evaluated the feasibility and performance characteristics of POC for the detection of GAS in non-severe SSTIs. Methods Wound swabs collected from patients presenting to the Whiteriver Indian Health Service Hospital with non-severe SSTIs requiring only outpatient treatment were eligible for inclusion. Two swabs were collected: one swab was cultured on sheep’s blood agar, and the other swab was tested using POC. Compared with culture, we determined the sensitivity (SN), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) for POC to detect GAS in wound samples. We performed chart reviews 30-days from eligibility to assess the potential impact of POC systems on antibiotic use and healthcare utilization for SSTIs. Results To date, we have tested 100 (25%) of our target 400 samples (enrollment will be complete in August 2019). Of the 100 samples, 50 (50%) tested positive for GAS by POC, all of which were culture positive for GAS, 49 tested negative by POC (2 after a first invalid result), all of which tested culture negative for GAS (table), and 1 had an invalid POC result even after repeat testing (culture positive for MRSA only) and was excluded from further analysis. Among samples with a valid POC result, POC SN was 100%, SP was 100%, PPV was 100%, and NPV was 100%. The most common mono-infections were MRSA (22%), GAS (18%), and CoNS (6%). Among GAS cases, MSSA (32%) and MRSA (18%) co-infection was common. Conclusion POC PCR is highly sensitive and specific for the detection of GAS in non-severe SSTIs. To our knowledge, this is the first prospective study to use this technology for wound samples. POC PCR methods have the potential to accelerate identification of SSTI pathogens and improve antibiotic prescribing. Disclosures All authors: No reported disclosures.

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