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 Effect of Using 2 Throat Swabs vs 1 Throat Swab on Detection of Group A Streptococcus by a Rapid Antigen Detection Test

2005 ◽  
Vol 159 (5) ◽  
pp. 486 ◽  
Author(s):  
Elias N. Ezike ◽  
Chokechai Rongkavilit ◽  
Marilynn R. Fairfax ◽  
Ronald L. Thomas ◽  
Basim I. Asmar
Keyword(s):  
Throat Swab ◽  
Group A Streptococcus ◽  
Antigen Detection ◽  
Rapid Antigen Detection Test ◽  
Group A

Antibiotic Prescribing in Adults Presenting with Pharyngitis Pre- and Post-Implementation of a Rapid Group A Streptococcus Test

2021 ◽  
pp. 001857872110323
Author(s):  
Preeyaporn Sarangarm ◽  
Timothy A. Huerena ◽  
Tatsuya Norii ◽  
Carla J. Walraven
Keyword(s):  
Group A Streptococcus ◽  
Intervention Group ◽  
Urgent Care ◽  
Antibiotic Prescribing ◽  
Care Clinic ◽  
Rapid Antigen Detection Test ◽  
Appropriate Prescribing ◽  
Icd 10 ◽  
Group A

Background: Group A Streptococcus (GAS) pharyngitis is the most common bacterial cause of acute pharyngitis and is often over treated with unnecessary antibiotics. The purpose was to evaluate if implementation of a rapid antigen detection test (RADT) for GAS would reduce the number of inappropriately prescribed antibiotics for adult patients presenting with symptoms of pharyngitis. Methods: This was a retrospective cohort study of adult urgent care clinic patients pre- and post-implementation of a GAS RADT. We included patients who had a diagnosis of GAS identified via ICD-10 codes and either a throat culture, GAS RADT, or antibiotic prescribed for GAS. Antibiotic prescribing was assessed as appropriate or inappropriate based on testing and IDSA guideline recommendations. Thirty-day follow-up visits related to pharyngitis or the prescribed antibiotics was also evaluated. Results: A total of 1734 patients were included; 912 and 822 in the pre- and post-implementation groups, respectively. Following implementation of the GAS RADT, there was an increase in the number of antibiotics prescribed for GAS (43.4% vs 59.1%, P < .001) as well as an increase in appropriate prescribing (67.6% vs 77.5%, P < .001). More 30-day pharyngitis-related follow-up visits were seen in the pre-intervention group (12.5% vs 9.3%, P = .03). Conclusion: Implementation of a RADT for GAS pharyngitis was associated with an increase in both the overall number of antibiotic prescriptions for GAS and the proportion of appropriately prescribed antibiotics. There was also a reduction in follow up visits related to GAS pharyngitis, however educational efforts to further increase appropriate prescribing is needed.

scholarly journals Positive Rate of Tests for Group a Streptococcus and Viral Features in Children with Acute Pharyngitis

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 599
Author(s):  
Dasom Wi ◽  
Soo-Han Choi
Keyword(s):  
Laboratory Testing ◽  
Older Patients ◽  
Group A Streptococcus ◽  
Throat Culture ◽  
Acute Pharyngitis ◽  
Rapid Antigen Detection Test ◽  
Positive Rate ◽  
Group A ◽  
Centor Score ◽  
Low Prevalence

Group A streptococcus (GAS) is an important cause of acute pharyngitis. We investigated the positive rate of GAS tests and clinical viral features in children with acute pharyngitis. A retrospective review was conducted for patients <15 years old with both rapid antigen detection test (RADT) and throat culture results. Patients were excluded if they were diagnosed with influenza or had received antibiotics within two weeks before these tests. A total of 377 patients were eligible. The median age of patients was 3.5 years, and 45.4% of total patients were <3 years old. Among all patients, 68.7% had at least one viral feature, and 39% had more than two. The overall positiv rate for GAS was 11.4%. The GAS positive rate was significantly lower in patients <3 years old than in older patients (1.8% vs. 19.4%, p < 0.0001). The overall sensitivity and specificity of RADT were 75.0% (95% CI: 57.8–87.9) and 97.9% (95% CI: 95.8–99.2), respectively. The GAS positive rate was not significantly different between patients with and without viral features (12.4% vs. 9.3%, p = 0.4854). In patients aged 3–14 years, the GAS positive rate was not associated with the modified Centor score or the frequency of clinical viral features. Despite a low prevalence of GAS pharyngitis, testing for GAS was frequently performed in children <3 years old in this study. Appropriate use of laboratory testing for GAS pharyngitis and judicious prescription of antibiotics were imperative.

scholarly journals Spectrum and Inoculum Size Effect of a Rapid Antigen Detection Test for Group A Streptococcus in Children with Pharyngitis

PLoS ONE ◽  
2012 ◽  
Vol 7 (6) ◽  
pp. e39085 ◽  
Author(s):  
Jérémie F. Cohen ◽  
Martin Chalumeau ◽  
Corinne Levy ◽  
Philippe Bidet ◽  
Franck Thollot ◽  
...  
Keyword(s):  
Size Effect ◽  
Group A Streptococcus ◽  
Inoculum Size ◽  
Antigen Detection ◽  
Rapid Antigen Detection Test ◽  
Group A

scholarly journals Avoiding Over-indication for Surgical Debridement Using a Rapid Antigen Detection Test of Group A Streptococcus

2021 ◽  
Vol 9 (4) ◽  
pp. e3548
Author(s):  
Itaru Tsuge ◽  
Hiroki Yamanaka ◽  
Motoki Katsube ◽  
Michiharu Sakamoto ◽  
Naoki Morimoto
Keyword(s):  
Group A Streptococcus ◽  
Antigen Detection ◽  
Surgical Debridement ◽  
Rapid Antigen Detection Test ◽  
Group A

scholarly journals Rapid Group a Streptococcus Antigen Test (Radt) Usage and Expediency in Diagnosis and Treatment of Pharyngotonsillitis in Family Physician Practice

2015 ◽  
Vol 25 (2) ◽  
pp. 54-60
Author(s):  
Agnė Augulytė ◽  
Povilas Čepanauskas ◽  
Kazys Simanauskas
Keyword(s):  
Family Physician ◽  
Clinical Symptoms ◽  
Group A Streptococcus ◽  
Antigen Detection ◽  
Empiric Antibiotic Therapy ◽  
Physician Practice ◽  
Antigen Test ◽  
Throat Culture ◽  
Acute Pharyngitis ◽  
Group A

Background. Group A streptococcus (S. pyogenes) is responsi- ble for 5 – 20% of cases of pharyngitis in adults and 15 to 20% of cases in children. Most common diagnostic tests are throat culture and rapid antigen detection testing (RADT). The modified Centor criteria can be used to help physicians decide which patients need no testing, throat culture/rapid antigen detection testing or empiric antibiotic therapy. Objective. Evaluate the rapid group A streptococcus antigen test (RADT) usage and expediency in family physician practice. Goals. To analyze children aged between 3 - 15 who suffers from acute pharyngitis ≥ 3 times per year and have ≥ 3 modified Centor criteria; to evaluate the ease of use of RADT in family phy- sician practice; to identify the correlation between RADT and the clinical symptoms of the acute pharyngitis and between the RADT and the blood test results; to evaluate the importance of RADT in diagnosing the acute pharyngitis and choosing treatment strategy. Methods. The study was accomplished in 2011-2013. 108 children aged between 3 and 15 and who suffers from acute pha- ryngitis > 2 times per year, plus have ≥ 3 modified Centor criteria were investigated. Prospectively all patients were tested by RADT. Also, the prescribed treatment and its effectiveness were analyzed. Statistical facts analysis was performed by using „SPSS 17.0“ and „MS Excel“ programs. Results. Girls suffer more often than boys from acute pha- ryngotonsillitis. The age average of patients was 7,22 ± 3,532. On average, patients appealed to doctor after 2-3 days of illness. RADT was positive in 32 (29.6%) children. Moreover, RADT was more often positive (42%) for children in 7-10 years old group, also for children who had 5 modified Centor criteria (62% of all positive cases). Conclusion. No statistically significant difference was obtained between the clinical symptoms and treatment effectiveness for children with a positive or negative result in RADT. However, all patients with positive RADT and who were taking Phenoxymethyl- penicillin recovered in 10 days. Moreover, obtained data shows that RADT test will facilitate the correct diagnosis and the tactics of selecting the treatment.

scholarly journals Ketepatan Skoring McIsaac untuk Mengidentifikasi Faringitis Group A Streptococcus pada Anak

Sari Pediatri ◽  
2016 ◽  
Vol 15 (5) ◽  
pp. 301
Author(s):  
Emalia Damayanti ◽  
Yulia Iriani ◽  
Yuwono Yuwono
Keyword(s):  
Group A Streptococcus ◽  
Antigen Detection ◽  
Rapid Antigen Detection Test ◽  
Group A

Latar belakang. Pemberian antibiotik faringitis Group A Streptococcus (GAS) penting untuk mencegah komplikasi demam rematik dan penyakit jantung rematik. Namun, gambaran klinis saja tidak dapat diandalkan untuk memastikan atau menyingkirkan faringitis GAS. Skoring McIsaac merupakan sistem penilaian klinis untuk memprediksi faringitis GAS yang penggunaannya dapat meningkatkan ketepatan identifikasi kasus faringitis GAS serta kebutuhan akan antibiotik.Tujuan. Menguji ketepatan skoring McIsaac dalam mendiagnosis faringitis GAS anak.Metode. Uji diagnostik yang dilakukan dari bulan Januari-Agustus 2012 pada 96 anak usia 3-14 tahun dengan faringitis akut di RSUP Dr Mohammad Hoesin dan Puskesmas Pembina, Palembang. Skoring McIsaac dihitung berdasarkan empat gejala klinis yang hasilnya dibandingkan dengan rapid antigen detection test (RADT) atau biakan usap tenggorok apabila RADT negatif. Analisis data menggunakan piranti lunak SPSS versi 17.0 dan Stata SE 10.0.Hasil. Ditemukan 13,54% faringitis GAS. Titik potong optimal skoring McIsaac ≥4 dengan sensitivitas 84,62% (IK 95% 54,55-98,08%), spesifisitas 68,67% (IK 95% 57,56-78.41%), nilai duga positif 29,73% (IK 95% 15,87-46,98%), dan nilai duga negatif 96,61% (IK 95% 88,29-99,59%). Untuk nilai 5 mempunyai sensitivitas 38,46% (IK 95% 13,86-68,42%), spesifisitas 98,8% (IK 95% 93,47-99,97%), nilai duga positif 83,33% (IK 95% 35,88-99,58%), dan nilai duga negatif 91,11% (IK 95% 83.23-96,08%).Kesimpulan. Diagnosis faringitis GAS dapat disingkirkan apabila hasil skoring McIsaac <4, memerlukan pemeriksaan penunjang lebih lanjut (RADT atau biakan usap tenggorok) pada hasil skoring 4, dan sangat mungkin (98,8%) untuk hasil skoring 5.

scholarly journals The feasibility of measuring calprotectin from a throat swab as a marker of infections caused by group A streptococcus: a case–control feasibility study

BJGP Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. bjgpopen20X101006
Author(s):  
Behnaz Schofield ◽  
Clive Gregory ◽  
Micaela Gal ◽  
David Gillespie ◽  
Gurudutt Naik ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthy Volunteers ◽  
Sore Throat ◽  
Throat Swab ◽  
Group A Streptococcus ◽  
Case Control ◽  
Antibiotic Prescribing ◽  
Group A ◽  
Primary Care Patients ◽  
Streptococcus A

BackgroundMost people with sore throat do not benefit from antibiotic treatment, but nearly three-quarters of those presenting in primary care are prescribed antibiotics. A test that is predictive of bacterial infection could help guide antibiotic prescribing. Calprotectin is a biomarker of neutrophilic inflammation, and may be a useful marker of bacterial throat infections.AimTo assess the feasibility of measuring calprotectin from throat swabs, and assess whether individuals with sore throats likely to be caused by streptococcal infections have apparently higher throat calprotectin levels than other individuals with sore throat and healthy volunteers.Design & settingA proof of concept case–control study was undertaken, which compared primary care patients with sore throats and healthy volunteers.MethodBaseline characteristics and throat swabs were collected from 30 primary care patients with suspected streptococcal sore throat, and throat swabs were taken from 10 volunteers without sore throat. Calprotectin level determination and rapid antigen streptococcal testing were conducted on the throat swab eluents. Calprotectin levels in the following groups were compared: volunteers without a sore throat; all patients with a sore throat; patients with a sore throat testing either negative or positive for streptococcal antigen; and those with lower and higher scores on clinical prediction rules for streptococcal sore throat.ResultsCalprotectin was detected in all throat swab samples. Mean calprotectin levels were numerically higher in patients with sore throat compared with healthy volunteers, and sore throat patients who had group A streptococci antigen detected compared with those who did not.ConclusionCalprotectin can be measured from throat swab samples and levels are consistent with the hypothesis that streptococcal infection leads to higher throat calprotectin levels. This hypothesis will be tested in a larger study.

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