Group A Streptococcal Tonsillopharyngitis: Cost-Effective Diagnosis and Treatment

Pichichero, Michael E.

doi:10.1016/s0196-0644(95)70300-4

Cited by 107 publications

(85 citation statements)

References 120 publications

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“…Group A streptococcus (GAS) is a common cause of pharyngitis, resulting in more than 10 million physician visits each year (6) and accounting for 15 to 30% of sore throats in children (3,11,18,29). Accurate diagnosis is necessary to permit targeted administration of antimicrobial therapy to prevent suppurative (peritonsillar and retropharyngeal abscesses) and nonsuppurative (rheumatic heart disease and acute glomerulonephritis) complications, to hasten symptom resolution, and to reduce the transmission of GAS in the community while limiting the use of antibiotics in virus-mediated infections (10,22,26,32,36).…”

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confidence: 99%

Performance of Rapid Streptococcal Antigen Testing Varies by Personnel

Fox

Cohen

Marcon³

et al. 2006

J Clin Microbiol

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Rapid carbohydrate antigen tests are frequently used to diagnose group A streptococcal (GAS) pharyngitis. Despite evidence of modest sensitivity in medical settings, rapid antigen tests are available to the public for self-testing. We sought to determine if the personnel performing a rapid streptococcal antigen test influence the test's performance characteristics. Throat swabs of pediatric patients performed for GAS pharyngitis in a tertiary-care children's hospital network were included during two study periods in 2004 and 2005. The performance characteristics of a rapid carbohydrate antigen test were evaluated in three clinical settings against a nucleic acid probe test method according to the personnel performing the test (laboratory technologist versus nonlaboratory personnel). Between the study periods, nonlaboratory personnel from one site underwent retraining. Subsequently, the performance characteristics of the rapid antigen test were reassessed. The sensitivity of the rapid antigen test varied widely among the different testing sites (56 to 90%). Notably, test sensitivity was consistently greater when the test was performed by laboratory technologists than when it was performed by nonlaboratory personnel (P < 0.0001). Although the rapid antigen test sensitivity significantly improved after nonlaboratory personnel at one testing site were retrained (sensitivity before versus after retraining; P < 0.0001), the sensitivity remained greater in the laboratory technologist cohort (P < 0.0001). These data confirm the important relationship of the operator performing a rapid streptococcal antigen test with the test's accuracy, even in a clinical setting, where operator training is mandated. Therefore, its use outside the medical setting by lay persons cannot be recommended without culture backup.

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confidence: 99%

Performance of Rapid Streptococcal Antigen Testing Varies by Personnel

Fox

Cohen

Marcon³

et al. 2006

J Clin Microbiol

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“…GAS infection is a common cause of pharyngitis in children (36), but it can also be a rare cause of IE (5% of all cases) (37). Moreover, pharyngeal infection can sometimes be asymptomatic (38).…”

Section: Discussionmentioning

confidence: 99%

<i>Pasteurella multocida</i> Infective Endocarditis: A Possible Link with Primary Upper Respiratory Tract Infection

et al. 2015

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A 50-year-old Japanese man presented with fever and upper respiratory tract symptoms that required urgent inpatient admission. A physical examination revealed conjunctival hemorrhages and peripheral embolic phenomena. Blood cultures grew Pasteurella multocida, and an echocardiography revealed a mitral valve vegetation suggestive of infective endocarditis (IE), which was confirmed using the Modified Duke Criteria. After several antibiotic regimens proved ineffective, valve replacement was performed, with a good eventual outcome. P. multocida IE is rare and may sometimes have no preceding risk factors. P. multocida infections of the upper respiratory tract are unusual but may be an inciting event for IE. It is essential to check blood cultures and to repeat the performance of physical examinations to appreciate the developing features of IE.

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“…Group A streptococcus [GAS] is considered the most prevalent and important bacteria that causes pediatric acute pharyngitis due to its serious complications (1,2). It causes a considerable economic burden to the community due to the cost of medical care.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the use of dedicated swab for rapid antigen detection testing in group a streptococcal pharyngitis in children

Sultan¹,

Seliem²

2017

Af J Clin Exp Micro

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Background: Group A streptococcus (GAS) is the most common and fearful bacterial cause in pediatric acute pharyngitis due to its serious complications. Several generations of rapid antigen detection tests (RADTs) have been developed to facilitate rapid detection of GAS pharyngitis. We assessed the value of using a dedicated swab for RADT rather than using the same swab for throat culture and RADT.

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Group A Streptococcal Tonsillopharyngitis: Cost-Effective Diagnosis and Treatment

Cited by 107 publications

References 120 publications

Performance of Rapid Streptococcal Antigen Testing Varies by Personnel

Performance of Rapid Streptococcal Antigen Testing Varies by Personnel

<i>Pasteurella multocida</i> Infective Endocarditis: A Possible Link with Primary Upper Respiratory Tract Infection

Evaluating the use of dedicated swab for rapid antigen detection testing in group a streptococcal pharyngitis in children

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