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BACKGROUND: The SD Bioline Strep A Ultra (SD, Yongin, Korea) is a recently developed rapid antigen detection test (RADT) for diagnosing bacterial pharyngitis caused by Group A Streptococcus, We evaluated the performance of SD Bioline Strep A Ultra, using the number of colony forming units and color intensity. METHODS: Three throat swabs each were taken from 343 children with pharyngitis who visited pediatric clinics. We evaluated the performance of SD Bioline Strep A Ultra and compared its positive rate with the number of colony forming units, using the Fisher exact test. RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value (95% confidence interval) were 97.4% (94.0–99.1%), 90.8% (85.0–94.9%), 93.0% (88.5–96.1%), and 96.5% (92.0–98.9%), respectively. Positive rate significantly differed by number of colony forming units (P=0.021). ROC plot for color intensity showed 0.938 of AUC (area under curve). CONCLUSIONS: SD Bioline Strep A Ultra showed excellent performance, and its positive rate differed by the number of colony counts. This RADT could be used as a sensitive and semi-quantitative method detecting bacterial pharyngitis.
Subject(s)
Child , Humans , Area Under Curve , Methods , Pharyngitis , Pharynx , Sensitivity and Specificity , Stem Cells , StreptococcusABSTRACT
Introducción: Las faringitis producidas por el estreptococo beta hemolítico del grupo A no se pueden distinguir clínicamente de las faringitis producidas por otros gérmenes, sin embargo la utilización de los criterios de Centor y el test de detección rápida de antígeno son de gran utilidad para determinar las probabilidades que estos sean causados por el estreptococo beta hemolítico del grupo A. En este estudio se comparó la sensibilidad entre ambos métodos. Objetivos: Se realizó un estudio para determinar la sensibilidad del criterio clínico en el diagnóstico de faringitis causada por Estreptococo en comparación a la sensibilidad del test de detección rápida de antígeno. Metodología: En el Centro de Salud Bárbara, se tomaron a los pacientes pediátricos que consultaron por dolor de garganta durante dos meses. Se puntuó según la escala de Centor y se tomó una muestra para el test de detección rápida de antígeno, luego, se comparó con el cultivo de orofaringe. Resultados: Se comparó la sensibilidad de ambos parámetros. Discusión: Un puntaje ≥ 3 puntos en la escala de Centor tuvo una sensibilidad de 81.8% y especificidad de 50%. Mientras que el RADT presentó una sensibilidad del 83.3% y especificidad de 84.2%.
Introduction: Pharyngitis caused by group A beta-hemolytic streptococci cannot be distinguished clinically from pharyngitis caused by other germs, however the use of the Centor criteria and the rapid antigen detection test are very useful to determine this pathogen. These are likely to be caused by group A beta hemolytic streptococcus. In this study the sensitivity between the two methods were compared. Objectives: A study was conducted to determine the sensitivity of clinical criteria in the diagnosis of pharyngitis caused by Streptococcus in comparison to the sensitivity of the rapid antigen detection test. Methodology: In the Barbara Health Center, pediatric patients who consulted for sore throat for two months were taken. It was scored according to the Centor scale and a sample was taken for the rapid antigen detection test, later these were compared with the oropharynx culture. Results: The sensitivity of both parameters were compared. Discussion: A score ≥ 3 points on the Centor scale had a sensitivity of 81.8% and specificity of 50%. While the RADT presented a sensitivity of 83.3% and specificity of 84.2%.
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Presence of a foreign object embedded in and around a tooth is unusual. Such object may get lodged and become a source of pain and infection, causing the patient to present to the dentist. This paper present two such case reports of foreign body imbedded within or around the tooth. One of the reported cases is the first case in which staple pin is present in primary molar. Present article emphasizes upon maintenance of oral hygiene and regular dental check up can prevent such undesirable situation.
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This was a cross sectional study to estimate the prevalence of Group AStreptococcal (GAS) infection among children with acute sore throat and to compare results of Rapid antigen detection test (RADT) with throat culture. Children aged 3-15 years who presented with acute sore throat (throat pain ± redness of pharynx, palate, tonsils), whose parents were willing to participate in the study by giving a written consent were included. Two sterile throat swabs were taken by vigorously rubbing the tonsils or posterior pharyngeal wall, one for RADT (cerTEST Strep Acard test) and 2nd for bacterial culture. The samples were sent to the in-hospital NABLcertified laboratory (SRLLtd). The results of RADT were obtained within 15 minutes while the culture report was available after 72 hours. During the 7 months study period we took 90 throat samples from 86 children. Of these 26 were RADT positive and 22 were culture positive. The prevalence of GAS by RADT was 28.88% and by culture was 25.56%. The sensitivity and specificity of RADTwas 95.65% and 94.02 % respectively. Since the RADThad high sensitivity and specificity and the results were available within 15 minutes, the need for throat swab culture (with additional cost and delay in results) could be avoided. Appropriate antibiotic may be started on the basis of RADT. If RADTis negative culture should be sent.
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BACKGROUND AND OBJECTIVES: This study aims to verify the usefulness of Centor scores to diagnose the Group A Streptococcal pharyngitis. SUBJECTS AND METHOD: The subjects of this study were 379 patients who had been examined by the rapid antigen detection test (RADT) for Group A Streptococcus. We analyzed their medical records and laboratory test results retrospectively and compared the results of Centor symptom scores with those of RADT. Then we analyzed the association of RADT, the Centor score and the laboratory test results statistically. RESULTS: There were no correlation between the RADT results and fever, cough, tonsillar enlargement, nasal symptoms, myalgia or chilling (p>0.05). In the RADT positive group, there were more patients with tonsillar exudate, neck lymph node enlargement, tenderness and pharyngeal abscess formation significantly (p<0.05). The Centor score and C-reactive protein were significantly higher in the RADT positive group (p<0.05). CONCLUSION: The results of this study suggest that Centor symptom scores can be used to determine which antibiotics to use. The Centor score system can help reduce medical costs and detect the problematic Group A Streptococcal pharyngitis.
Subject(s)
Humans , Abscess , Anti-Bacterial Agents , C-Reactive Protein , Cough , Decision Making , Diagnosis , Exudates and Transudates , Fever , Lymph Nodes , Medical Records , Methods , Myalgia , Neck , Pharyngitis , Retrospective Studies , Streptococcus , Streptococcus pyogenesABSTRACT
Abstract Objective: The aim of this study was to evaluate the QuickVue® RSV Test Kit (QUIDEL Corp, CA, USA) as a screening tool for respiratory syncytial virus in children with acute respiratory disease in comparison with the indirect immunofluorescence assay as gold standard. In Brazil, rapid antigen detection tests for respiratory syncytial virus are not routinely utilized as a diagnostic tool, except for the diagnosis of dengue and influenza. Methods: The authors retrospectively analyzed 486 nasopharyngeal aspirate samples from children under age 5 with acute respiratory infection, between December 2013 and August 2014, the samples were analyzed by indirect immunofluorescence assay and QuickVue® RSV Test kit. Samples with discordant results were analyzed by real time PCR and nucleotide sequencing. Results: From 313 positive samples by immunofluorescence assays, 282 (90%) were also positive by the rapid antigen detection test, two were positive only by rapid antigen detection test, 33 were positive only by immunofluorescence assays, and 171 were positive by both methods. The 35 samples with discordant results were analyzed by real time PCR; the two samples positive only by rapid antigen detection test and the five positive only by immunofluorescence assays were also positive by real time PCR. There was no relation between the negativity by QuickVue® RSV Test and viral load or specific strain. The QuickVue® RSV Test showed sensitivity of 90%, specificity of 98.8%, predictive positive value of 99.3%, and negative predictive value of 94.6%, with accuracy of 93.2% and agreement κ index of 0.85 in comparison to immunofluorescence assay. Conclusions: This study demonstrated that the QuickVue® RSV Test Kit can be effective in early detection of Respiratory syncytial virus in nasopharyngeal aspirate and is reliable for use as a diagnostic tool in pediatrics.
Resumo Objetivo: Avaliar o teste QuickVue® RSV Test Kit (QUIDEL Corp, CA, EUA) para o diagnóstico rápido do vírus sincicial respiratório em crianças com doença respiratória aguda, comparandoo com a imunofluorescência indireta como padrão ouro. Visto que, no Brasil, testes rápidos para detecção de antígenos para vírus sincicial respiratório não são rotineiramente utilizados como ferramenta de diagnóstico, exceto para Dengue e Influenza. Métodos: Um total de 486 amostras de aspirado de nasofaringe de crianças menores de 5 anos com doença respiratória aguda, coletadas entre dezembro de 2013 e agosto de 2014, foram analisadas por imunofluorescência e pelo teste QuickVue®. Amostras com resultados discordantes entre os métodos foram submetidas a PCR em tempo real e sequenciamento. Resultados: Das 313 amostras positivas por IFI, 282 foram positivas no teste rápido (90%), 2 amostras foram positivas apenas no teste rápido (0.6%), 33 apenas na imunofluorescência (10.5%) e 171 foram negativas em ambos os métodos. As 35 amostras com resultados discordantes foram testadas por PCR em tempo real, sendo que duas que foram positivas apenas no teste rápido e 5 apenas na imunofluorescência confirmaram-se positivas. Não houve relação entre a ausência de positividade no teste QuickVue® com a carga ou com a cepa viral. O teste QuickVue® mostrou sensibilidade de 90.1%, especificidade 98.9%, valor preditivo positivo 99.3%, valor preditivo negativo de 94.6%, acurácia de 93.2% e índice de concordância de 0.85 em comparação à imunofluorescência. Conclusões: Nosso estudo demonstrou que o teste QuickVue® RSV pode ser efetivo na detecção precoce do vírus sincicial respiratório em amostras de aspirado de nasofaringe e é confiável como uma ferramenta de diagnósticos em pediatria.
Subject(s)
Humans , Male , Female , Child, Preschool , Respiratory Syncytial Viruses/immunology , Respiratory Syncytial Virus Infections/diagnosis , Reverse Transcriptase Polymerase Chain Reaction , Antigens, Viral/analysis , Reagent Kits, Diagnostic , Respiratory Syncytial Viruses/isolation & purification , Respiratory Tract Infections/virology , Brazil , Retrospective Studies , Sensitivity and Specificity , Respiratory Syncytial Virus Infections/virology , Fluorescent Antibody Technique, IndirectABSTRACT
PURPOSE: The purpose of this study was to evaluate the utility of rapid antigen detection test for group A streptococci in children with acute pharyngitis. METHODS: Seventy children with acute pharyngitis enrolled the study, who visited the Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym Medical Center from September 2004 to August 2005. The presence of clinical features such as tonsillar exudates, fever, scarletiniform rash and previous antibiotic use were evaluated and throat swab culture, rapid antigen detection test for group A Streptococci, CBC, ASO, and CRP were performed. RESULTS: Among 70 children with acute pharyngitis, the prevalence of group A beta-hemolytic Streptococcus by throat swab culture and rapid antigen detection test was 14(20.0 %) and 22(31.4%), respectively. The sensitivity of the rapid antigen detection test was 78.6 %, specificity was 80.4%, the positive predictive value was 50.0% and the negative predictive value was 93.8%. The positivity of the throat swab culture and rapid antigen detection test showed no signigicant differences according to the presence of the clinical symptoms except scarletiniform rash. Laboratory data such as CBC, ASO or CRP proved not valuable to predict the positivity of the throat swab culture and/or rapid antigen detection test for group A Streptococcus. There was a tendency of negative throat swab culture and positive rapid antigen detection test in cases of previous antibiotic use. CONCLUSION: The rapid antigen detection test can be a useful diagnostic tool for early detection of the group A Streptococcus in children with acute pharyngitis and can be helpful for the clinician to reduce the inappropriate use of antibiotics.