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.

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.

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.

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

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 Use of the McIsaac Score to Predict Group A Streptococcal Pharyngitis in Outpatient Nurse Phone Triage and Electronic Visits Compared With In-Person Visits: Retrospective Observational Study (Preprint)

2020 ◽  
Author(s):  
Jennifer L Pecina ◽  
Leah M Nigon ◽  
Kristine S Penza ◽  
Martha A Murray ◽  
Beckie J Kronebusch ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Observational Study ◽  
Sore Throat ◽  
Scoring System ◽  
Group A Streptococcus ◽  
Streptococcal Pharyngitis ◽  
Future Studies ◽  
Face To Face ◽  
Geographic Barriers ◽  
Group A

BACKGROUND The McIsaac criteria are a validated scoring system used to determine the likelihood of an acute sore throat being caused by group A streptococcus (GAS) to stratify patients who need strep testing. OBJECTIVE We aim to compare McIsaac criteria obtained during face-to-face (f2f) and non-f2f encounters. METHODS This retrospective study compared the percentage of positive GAS tests by McIsaac score for scores calculated during nurse protocol phone encounters, e-visits (electronic visits), and in person f2f clinic visits. RESULTS There was no difference in percentages of positive strep tests between encounter types for any of the McIsaac scores. There were significantly more phone and e-visit encounters with any missing score components compared with f2f visits. For individual score components, there were significantly fewer e-visits missing fever and cough information compared with phone encounters and f2f encounters. F2f encounters were significantly less likely to be missing descriptions of tonsils and lymphadenopathy compared with phone and e-visit encounters. McIsaac scores of 4 had positive GAS rates of 55% to 68% across encounter types. There were 4 encounters not missing any score components with a McIsaac score of 0. None of these 4 encounters had a positive GAS test. CONCLUSIONS McIsaac scores of 4 collected during non-f2f care could be used to consider empiric treatment for GAS without testing if significant barriers to testing exist such as the COVID-19 pandemic or geographic barriers. Future studies should evaluate further whether non-f2f encounters with McIsaac scores of 0 can be safely excluded from GAS testing.

scholarly journals Evaluation of Rapid Antigen Detection Test for Group A Streptococci Pharyngitis among Children in an Out-Patient Clinic in Malaysia

2021 ◽  
Vol 50 (11) ◽  
pp. 3345-3354
Author(s):  
Zaili Zaki ◽  
Asrul Abdul Wahab ◽  
Ramliza Ramli ◽  
Afaaf Esa ◽  
Ezura Madiana Md. Monoto
Keyword(s):  
Sore Throat ◽  
Sensitivity And Specificity ◽  
Throat Swab ◽  
Group A Streptococcus ◽  
Antigen Detection ◽  
Preschool Age ◽  
Throat Culture ◽  
Care Clinic ◽  
Rapid Antigen Detection Test ◽  
Group A

One of the most common conditions encountered in the out-patient setting is acute pharyngitis. Group A Streptococcus (GAS) accounts for 15%-30% of cases of sore throat particularly in children under 15 years old. Rapid antigen testing (RADT) is an alternative diagnostic method to detect GAS pharyngitis. This study was done to evaluate the agreement between RADT whereby BIONEXIA® Strep A Plus (BioMérieux, France) kit was used and throat culture in the diagnosis of GAS pharyngitis in children presented with a sore throat. One hundred and ten children from a primary health care clinic with sore throat were included in this study. All children were evaluated based on McIsaac scoring and throat swab samples were taken for both throat culture and RADT testing. The prevalence of GAS pharyngitis by RADT in this study was 7.3% over one year. A higher incidence of GAS pharyngitis was noted in the school-aged children than the preschool-age children. There was no correlation between cough, lymph node enlargement, and tonsillar enlargement in predicting GAS pharyngitis. The sensitivity and specificity of RADT were 100% and 98%, respectively, when taking throat culture as a gold standard. A good agreement between RADT and throat culture was achieved (k=0.848). McIsaac scoring was noted to have good predictability for GAS pharyngitis with AUC=0.82. In conclusion, the rapid streptococcal antigen detection test showed excellent sensitivity and specificity and detecting GAS from the throat swab samples. Thus, it can be used to aid in the diagnosis of group A Streptococcal pharyngitis and could reduce the overuse of antibiotics. McIsaac score has also proven to be useful as a screening tool for bacterial pharyngitis.

scholarly journals Diagnostic methods for group A Streptococcus associated with sore throat in Cameroon

2014 ◽  
Vol 21 ◽  
pp. 378
Author(s):  
H. Gonsu Kamga ◽  
F. Djomou ◽  
C. Mbimenyuy B ◽  
M. Toukam ◽  
F.-X. Mbopi-Keou ◽  
...  
Keyword(s):  
Sore Throat ◽  
Group A Streptococcus ◽  
Diagnostic Methods ◽  
Group A

scholarly journals Use of the McIsaac Score to Predict Group A Streptococcal Pharyngitis in Outpatient Nurse Phone Triage and Electronic Visits Compared With In-Person Visits: Retrospective Observational Study

10.2196/25899 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e25899
Author(s):  
Jennifer L Pecina ◽  
Leah M Nigon ◽  
Kristine S Penza ◽  
Martha A Murray ◽  
Beckie J Kronebusch ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Observational Study ◽  
Sore Throat ◽  
Scoring System ◽  
Group A Streptococcus ◽  
Streptococcal Pharyngitis ◽  
Future Studies ◽  
Face To Face ◽  
Geographic Barriers ◽  
Group A

Background The McIsaac criteria are a validated scoring system used to determine the likelihood of an acute sore throat being caused by group A streptococcus (GAS) to stratify patients who need strep testing. Objective We aim to compare McIsaac criteria obtained during face-to-face (f2f) and non-f2f encounters. Methods This retrospective study compared the percentage of positive GAS tests by McIsaac score for scores calculated during nurse protocol phone encounters, e-visits (electronic visits), and in person f2f clinic visits. Results There was no difference in percentages of positive strep tests between encounter types for any of the McIsaac scores. There were significantly more phone and e-visit encounters with any missing score components compared with f2f visits. For individual score components, there were significantly fewer e-visits missing fever and cough information compared with phone encounters and f2f encounters. F2f encounters were significantly less likely to be missing descriptions of tonsils and lymphadenopathy compared with phone and e-visit encounters. McIsaac scores of 4 had positive GAS rates of 55% to 68% across encounter types. There were 4 encounters not missing any score components with a McIsaac score of 0. None of these 4 encounters had a positive GAS test. Conclusions McIsaac scores of 4 collected during non-f2f care could be used to consider empiric treatment for GAS without testing if significant barriers to testing exist such as the COVID-19 pandemic or geographic barriers. Future studies should evaluate further whether non-f2f encounters with McIsaac scores of 0 can be safely excluded from GAS testing.

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