ABSTRACT
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Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pharyngitis/diagnosis , Rapid Assessment of Environmental Integrity/methods , Family Practice/methods , Family Practice/trends , Anti-Bacterial Agents/therapeutic use , Diagnostic Techniques and Procedures/instrumentation , Diagnostic Techniques and Procedures/trends , Primary Health Care/methods , Primary Health Care/trends , Agar , Colony Count, Microbial , Reproducibility of Results/standards , Diagnostic Techniques and Procedures/standards , Diagnostic Techniques and ProceduresSubject(s)
Pharyngitis/diagnosis , Pharyngitis/microbiology , Streptococcal Infections/diagnosis , Adult , Bacteriological Techniques , Female , Humans , Male , Time FactorsABSTRACT
OBJECTIVE: To determine the validity of the rapid antigen test (RAT) OSOM StrepA Genzyme for the diagnosis of acute pharyngitis caused by group A beta-haemolytic strep (GABHS). DESIGN: Diagnostic techniques survey. SETTING: Urban primary care centre, Spain. PARTICIPANTS: All patients over 14 years old seen in 6 surgeries with sore throat and 2 or more Centor criteria: pharyngotonsillar exudate, tender laterocervical nodes, absence of coughing, and/or history or presence of fever. PRINCIPAL MEASUREMENTS: Pharyngeal swabs were taken from all the patients, one for RAT and another to send for culture in the microbiology department. RESULTS: A total of 182 patients were evaluable, with a mean age of 30.6 (12.1) years of which 116 were women (63.7%); 63 patients had 2 Centor criteria; 83 had 3 and 36, the 4 criteria. The culture was positive in 102 patients (56%), with GABHS showing infection in forty (22%; 95% confidence interval [CI], 21.2-22.8). Group C Streptococcus was isolated in 26 patients (14.3%). GABHS was higher among patients with four Centor criteria (38.9% vs 25.3% observed among those with 3 criteria and 7.9% with 2 criteria; P<.001). Sensitivity of RAT was 95%, with a specificity of 93%, a positive predictive value of 79.2% and a negative predictive value of 98.5%. CONCLUSIONS: These results show the usefulness of RAT for diagnosing streptococcal pharyngitis. Its use should be spread to all primary care practices.
Subject(s)
Pharyngitis/diagnosis , Pharyngitis/microbiology , Streptococcal Infections/diagnosis , Streptococcus pyogenes , Adult , Female , Humans , Immunologic Tests , Male , Pharyngitis/immunology , Prospective Studies , Streptococcal Infections/immunology , Time FactorsABSTRACT
Objetivo. Determinamos la validez de latécnica antigénica rápida (TAR) OSOMStrepA Genzyme en el diagnóstico de lafaringitis aguda causada por estreptococobetahemolítico del grupo A (EBHGA).Diseño. Estudio de pruebas diagnósticas.Emplazamiento. Equipo urbano de atenciónprimaria.Participantes. Todos los pacientes mayoresde 14 años atendidos en 6 consultas consíntomas de odinofagia y 2 o más de loscriterios de Centor (exudado faringoamigdalar,adenopatías laterocervicales dolorosas,ausencia de tos y/o historia o presenciade fiebre).Mediciones principales. A todos los pacientesse les tomó una muestra faringoamigdalarcon 2 hisopos, uno para TAR y otro que fueremitido al servicio de microbiología pararealizar cultivo.Resultados. Fueron evaluables 182 sujetos,con una edad media de 30,6 ± 12,1 años,116 mujeres (63,7%). Presentaron 2, 3y 4 criterios de Centor 63, 83 y 36 sujetos,respectivamente. El cultivo fue positivo en102 casos (56%), observándose infección porEBHGA en 40 pacientes (22%; intervalode confianza [IC] del 95%, 21,2-22,8); en26 casos se aisló estreptococo del grupo C(14,3%). La infección por EBHGA presentóuna mayor prevalencia entre los pacientescon 4 criterios (un 38,9% frente a un 25,3%observado con 3 criterios y frente al 7,9%con 2 criterios; p < 0,001). La TAR tuvo unasensibilidad del 95%, una especificidad del93%, un valor predictivo positivo del 79,2%y un valor predictivo negativo del 98,5%.Conclusiones. Estos resultados demuestranla utilidad de la TAR para el diagnósticode la faringitis estreptocócica. Su uso deberíaextenderse a todas las consultas de atenciónprimaria
Objective. To determine the validity of therapid antigen test (RAT) OSOM StrepAGenzyme for the diagnosis of acutepharyngitis caused by group Abeta-haemolytic strep (GABHS).Design. Diagnostic techniques survey.Setting. Urban primary care centre, Spain.Participants. All patients over 14 years oldseen in 6 surgeries with sore throat and 2or more Centor criteria: pharyngotonsillarexudate, tender laterocervical nodes, absenceof coughing, and/or history or presence offever.Principal measurements. Pharyngeal swabswere taken from all the patients, one forRAT and another to send for culture inthe microbiology department.Results. A total of 182 patients wereevaluable, with a mean age of 30.6 (12.1)years of which 116 were women (63.7%); 63patients had 2 Centor criteria; 83 had 3 and36, the 4 criteria. The culture was positive in102 patients (56%), with GABHS showinginfection in forty (22%; 95% confidenceinterval [CI], 21.2-22.8). Group CStreptococcus was isolated in 26 patients(14.3%). GABHS was higher amongpatients with four Centor criteria (38.9% vs25.3% observed among those with 3 criteriaand 7.9% with 2 criteria; P<.001). Sensitivityof RAT was 95%, with a specificity of 93%,a positive predictive value of 79.2%and a negative predictive value of 98.5%.Conclusions. These results show theusefulness of RAT for diagnosingstreptococcal pharyngitis. Its use shouldbe spread to all primary care practices
Subject(s)
Humans , Male , Female , Adult , Pharyngitis/blood , Pharyngitis/diagnosis , Predictive Value of Tests , Streptococcus pyogenes/isolation & purification , Streptococcus pyogenes/pathogenicity , Signs and Symptoms , Sensitivity and Specificity , Primary Health Care/methods , Primary Health Care/trends , Prospective StudiesABSTRACT
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