scholarly journals Streptococcal group A, C and G pharyngitis in school children: a prospective cohort study in Southern India

2018 ◽  
Vol 146 (7) ◽  
pp. 848-853
Author(s):  
J. John Melbin Jose ◽  
Kootallur N. Brahmadathan ◽  
Vinod J. Abraham ◽  
Chiung-Yu Huang ◽  
David Morens ◽  
...  
Keyword(s):  
School Children ◽  
Diagnostic Tests ◽  
Point Of Care ◽  
Streptococcal Pharyngitis ◽  
Throat Culture ◽  
Clinical Appearance ◽  
Culture Positivity ◽  
Similar Disease ◽  
Group A ◽  
Lancefield Group

AbstractDiagnosing streptococcal pharyngitis in children on the basis of clinical appearance and throat culture is complicated by high colonisation rates and by the ability of other pathogens to cause clinically similar disease. To characterise the epidemiology of Lancefield Group A, C and G β-haemolytic streptococcus (GAS, GCS and GGS, respectively) in children, we conducted a 2-year prospective study of 307 school children between 7 and 11 years old. GGS and GAS were commonly identified organisms both for silent streptococcal colonisation and symptomatic sore throat, while GCS was uncommonly found. Streptococcal culture positivity at the time of clinical pharyngitis was estimated to reflect true streptococcal pharyngitis in only 26% of instances, with the frequency varying from 54% for children rarely colonised to 1% for children frequently colonised. Numerous GAS emm types were identified, including several types previously associated with severe pharyngitis (e.g. emm types 1, 3 and 28). No severe complications were seen in any child. These data suggest that the clinical diagnosis of streptococcal pharyngitis is likely to remain difficult and that treatment decisions will remain clouded by uncertainty. There remains a need for organism-specific rapid point-of-care streptococcal diagnostic tests and tests that can distinguish between streptococcal colonisation and disease.

New Colorimetric Test for Rapid Diagnosis of Streptococcal Pharyngitis: A Warning

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 457-459
Author(s):  
Michael A. Gerber ◽  
Richard R. Facklam ◽  
Martin F. Randolph ◽  
Kathleen K. DeMeo
Keyword(s):  
Drug Administration ◽  
Diagnostic Tests ◽  
Streptococcal Pharyngitis ◽  
Rapid Diagnosis ◽  
Group A Streptococci ◽  
Pharmacologic Agent ◽  
The Past ◽  
Colorimetric Test ◽  
Group A ◽  
Rapid Tests

During the last few years there has been a dramatic proliferation of rapid tests for the diagnosis of group A β-hemolytic streptococcal pharyngitis.1 It is important for physicians to realize that the Food and Drug Administration does not approve these diagnostic tests as it would approve a pharmacologic agent, but simply permits a manufacturer to sell the test. Consequently, unacceptably inaccurate rapid tests for group A streptococci have been marketed in the past and could potentially appear again at anytime. In 1986, we studied a new enzyme fluorescence procedure (Strep-A-Fluor, Bio-Spec Inc, Dublin, CA) for the rapid diagnosis of group A β-hemolytic streptococcal pharyngitis.2

scholarly journals Group A Streptococcus Testing in Pediatrics: the Move to Point-of-Care Molecular Testing

2020 ◽  
Vol 58 (6) ◽  
Author(s):  
Thomas Z. Thompson ◽  
Allison R. McMullen
Keyword(s):  
Point Of Care ◽  
Streptococcal Pharyngitis ◽  
Molecular Methods ◽  
Multiple Point ◽  
Molecular Testing ◽  
Point Of Care Testing ◽  
Culture Methods ◽  
Content Type ◽  
Molecular Group ◽  
Group A

ABSTRACT Each year, there are an estimated 11 million visits to ambulatory care centers for pharyngitis in children between the ages of 3 and 18 years. While there are many causes of pediatric pharyngitis, group A streptococcal pharyngitis represents 15 to 30% of infections and is the only cause for which treatment is recommended. Unfortunately, clinical suspicion is insufficient for the accurate diagnosis of group A streptococcal pharyngitis, and laboratory testing for confirmation of Streptococcus pyogenes infection is required to prevent complications of infection. Traditionally, throat swabs are inoculated onto agar plates for isolation of the large-zone beta-hemolytic streptococcus. However, traditional culture methods present a potential delay in treatment due to turnaround times of 18 to 48 h. In order to improve turnaround times and enhance antimicrobial stewardship, multiple point-of-care assays have been developed. This review describes current point-of-care testing for group A streptococcal pharyngitis, including rapid antigen detection tests and more recent molecular methods. Additional attention is given to the diagnostic considerations when choosing a method for group A streptococcal point-of-care testing, implementation of molecular group A streptococcal testing, and the institutional cost of immunoassays compared to those of newer molecular methods.

Throat Cultures

PEDIATRICS ◽  
1994 ◽  
Vol 93 (3) ◽  
pp. 539-539
Author(s):  
Ellen R. Wald
Keyword(s):  
Antibiotic Therapy ◽  
Streptococcal Pharyngitis ◽  
Group A Streptococci ◽  
Throat Culture ◽  
Group A ◽  
To Receive

I read with great interest the article entitled "Duration of Positive Throat Cultures for Group A Streptococci After Initiation of Antibiotic Therapy" by Snellman et al.1 The study involved 47 patients in whom streptococcal pharyngitis was diagnosed, who were randomly selected to receive three different antimicrobial regimens with a varying number of doses before the performance of a repeat throat culture. The degree of positivity of the persistently positive cultures (1+, 2+, or 3+) was not shown.

scholarly journals A clinical decision rule for streptococcal pharyngitis management: An update

2017 ◽  
Vol 9 (02) ◽  
pp. 116-120 ◽  
Author(s):  
Hosain Nasirian ◽  
Saeedeh TarvijEslami ◽  
Esfandiar Matini ◽  
Seyedehsara Bayesh ◽  
Yasaman Omaraee
Keyword(s):  
Decision Rule ◽  
Positive Culture ◽  
Clinical Decision ◽  
Streptococcal Pharyngitis ◽  
Clinical Findings ◽  
Common Disease ◽  
Clinical Decision Rule ◽  
Throat Culture ◽  
Group A ◽  
Culture Negative

Abstract PURPOSE: Group A streptococcal (GAS) pharyngitis is a common disease worldwide. We aimed to establish a pragmatic program as a clinical decision rule for GAS pharyngitis diagnosis. MATERIALS AND METHODS: This article derived from a research project on children aged 6–15 years. Five hundred and seventy-one children met the enrollment criteria on whom throat culture and validities of clinical findings were assessed in positive and negative throat culture groups. RESULTS: Positive GAS throat culture group included 99 (17.3%) patients with a positive culture. Negative GAS throat culture group included 472 (82.6%) patients. Exudate or enlarged tender nodes each one had 63% and 68% sensitivity and 31.5% and 37.5% specificity with a high percentage of negative predictive value (NPV) 80.54% and 85.09%, respectively. Sequence test revealed validities of exudate plus enlarged nodes at 43.62% sensitivity and 57.19% specificity with 83% NPV. CONCLUSIONS: High NPV of 83% indicated that similar prevalence in the absence of either exudate or enlarged tender lymph nodes. Probability of GAS negative throat cultures among children suspected of GAS pharyngitis was 83% and would correctly not receive inopportune antibiotics.

scholarly journals Operator Influence on Blinded Diagnostic Accuracy of Point-of-Care Antigen Testing for Group A Streptococcal Pharyngitis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Carla Penney ◽  
Robert Porter ◽  
Mary O’Brien ◽  
Peter Daley
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Microbiology ◽  
Point Of Care ◽  
Streptococcal Pharyngitis ◽  
Significant Loss ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Acute Pharyngitis ◽  
Conventional Culture ◽  
Group A

Background. Acute pharyngitis caused by Group AStreptococcus(GAS) is a common presentation to pediatric emergency departments (ED). Diagnosis with conventional throat culture requires 18–24 hours, which prevents point-of-care treatment decisions. Rapid antigen detection tests (RADT) are faster, but previous reports demonstrate significant operator influence on performance.Objective. To measure operator influence on the diagnostic accuracy of a RADT when performed by pediatric ED nurses and clinical microbiology laboratory technologists, using conventional culture as the reference standard.Methods. Children presenting to a pediatric ED with suspected acute pharyngitis were recruited. Three pharyngeal swabs were collected at once. One swab was used to perform the RADT in the ED, and two were sent to the clinical microbiology laboratory for RADT and conventional culture testing.Results. The RADT when performed by technologists compared to nurses had a 5.1% increased sensitivity (81.4% versus 76.3%) (p=0.791) (95% CI for difference between technologists and nurses = −11% to +21%) but similar specificity (97.7% versus 96.6%).Conclusion. The performance of the RADT was similar between technologists and ED nurses, although adequate power was not achieved. RADT may be employed in the ED without clinically significant loss of sensitivity.

Pharyngitis—Principles of Judicious Use of Antimicrobial Agents

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 171-174 ◽  
Author(s):  
Benjamin Schwartz ◽  
S. Michael Marcy ◽  
William R. Phillips ◽  
Michael A. Gerber ◽  
Scott F. Dowell
Keyword(s):  
Antimicrobial Agents ◽  
Low Cost ◽  
Streptococcal Pharyngitis ◽  
Clinical Findings ◽  
Group A Streptococci ◽  
Throat Culture ◽  
Drug Of Choice ◽  
Group A ◽  
Resistant Group ◽  
Test Result

Accurate diagnosis of group A streptococcal pharyngitis and appropriate antimicrobial therapy are important, particularly to prevent nonsuppurative sequelae such as rheumatic fever. Most episodes of sore throat, however, are caused by viral agents. Clinical findings cannot reliably differentiate streptococcal from viral pharyngitis and most physicians tend to overestimate the probability of a streptococcal infection based on history and physical examination alone. Therefore, diagnosis should be based on results of a throat culture or an antigen-detection test with throat culture backup. Presumptively starting therapy pending results of a culture is discouraged because treatment often continues despite a negative test result. Other bacterial causes of pharyngitis are uncommon and often can be diagnosed based on nonpharyngeal findings. Penicillin remains the drug of choice for streptococcal pharyngitis because of its effectiveness, relatively narrow spectrum, and low cost. No group A streptococci are resistant to β-lactam antibiotics. High rates of resistance to macrolides has been documented in several areas; in Finland, decreased national rates of macrolide use led to a decline in the proportion of macrolide-resistant group A streptococci.

scholarly journals β-HEMOLYTIC STREPTOCOCCAL PHARYNGITIS

2018 ◽  
Vol 25 (12) ◽  
pp. 1882-1886
Author(s):  
Waseem Ahmad ◽  
Muhammad Yousaf Saleemi ◽  
Muhammad Iqbal
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Streptococcal Pharyngitis ◽  
Statistical Investigation ◽  
Throat Culture ◽  
Culture Methods ◽  
Cross Sectional ◽  
Group A ◽  
Strep Throat

Background: Strep throat is also known as Streptococcal Pharyngitis. It is an infection in back of the throat including tonsils which reasoned by group A Streptococcus (GAS). General signs like fever, red tonsils, sore throat and grow lymph nodes in the neck. Nausea, headache and vomiting may also happen due to Streptococcal Pharyngitis. Objective: The aim of study is to conclude the correctness in discover Group A β-Hemolytic Streptococci (GABHS) through brisk antigen testing evaluate with throat culture methods which are generally used. Materials and Methods: Study Design: Cross-sectional study. Setting: Sir Ganga Ram Hospital Lahore. Period: 1st July 2016 to 31st December 2016. At first throat culture,Streptococcal select agar or sheep blood agar, performed on 192 patients with severe strep throat and after that brisk antigen detection tests, Directigen Group A Strep, was also executed. Statistical investigation contained sensitivity, specificity, positive predictive value, negative predictive value as well as its prevalence. Results: The prevalence of group A β-hemolytic streptococci is 13.54%. Sensitivity is 96.15%, specificity is 95.18%, positive predictive value is 75.76% along with negative predictive value is 99.37% which shows that a very low percentage of patients with Group A β-Hemolytic Streptococci as <1%. Conclusion: This showed that a very low percentage as <1% of patients with Group A β-Hemolytic Streptococci evade findings by brisk screening test methods.

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