الفهرس 
Streptococcal PharyngitisOnly 14 pages are availabe for public view
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Abstract
T
he goals were to establish performance characteristics of a rapid antigen-detection test and blood agar plate culture performed and interpreted in community pediatric offices and to assess the ability of the test to diagnose group A beta hemolytic streptococcal pharyngitis in comparison with throat culture as reference method standard.
Two throat swabs were collected from 50 children 3 to 13 years of age who were evaluated for acute pharyngitis between May 2010, and November 2010 in Ain Shams Pediatric Outpatient Clinic. One swab was used to perform the rapid antigen-detection test and the other was sent immediately to the central laboratory of Ain Shams university hospitals for blood agar plate culture. Clinical findings were used to calculate the McIsaac score for each patient.
84% of laboratory blood agar plate culture yielded group A streptococcus, the specificity of the RADT was 88.1%, while the sensitivity was 37.5%.
The sensitivity of McIsaac score was 75%, and the specificity was 66.7%.
Among patients with McIsaac score >2, rapid antigen-detection test sensitivity was 87.5%, and the specificity was 69%.
The specificity of the RADT was close to that reported by similar studies; the sensitivity was significant lower than that reported in the same studies. Combined approach (RADT and McIsaac score) has an important impact on limiting unnecessary antibiotic prescription.
This study supports a new approach for the management of pharyngitis in the pediatric population, taking into account the clinical likelihood for streptococcal disease and the application of a targeted rapid diagnostic test. By screening all children with pharyngitis using clinical scoring system and subsequently performing an office RADT, such a strategy has an important impact on limiting throat culture testing and unnecessary antibiotic prescription.