120:
indistinguishable, but only bacterial pharyngitis can be effectively treated by antibiotics. Since the major cause of bacterial pharyngitis is GAS, the presence of this organism in a person's throat may be seen as a necessary condition for prescribing antibiotics. GAS pharyngitis is a self-limiting infection that will usually resolve within a week without medication. However, antibiotics may reduce the length and severity of the illness and reduce the risk of certain rare but serious complications, including rheumatic heart disease.
447:"Prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics"
166:
presence of GAS in an individual with pharyngitis does not prove that this organism is responsible for the infection. The sensitivity of lateral flow RSTs is somewhat low at 65% to 80%. Therefore, a negative result from such a test cannot be used to exclude GAS pharyngitis, a considerable disadvantage compared with microbial culture, which has a sensitivity of 90% to 95%. However, optical immunoassay RSTs have been found to have a much higher sensitivity of 94%.
42:
169:
Although an RST cannot distinguish GAS infection from asymptomatic carriage of the organism, most authorities recommend antibiotic treatment in the event of a positive RST result from a person with a sore throat. US guidelines recommend following up a negative result with a microbial culture, whereas
123:
RSTs may also have a public health benefit. In addition to undesirable side-effects in individuals, inappropriate antibiotic use is thought to contribute to the development of drug-resistant strains of bacteria. By helping to identify bacterial infection, RSTs may help to limit the use of antibiotics
143:
The person’s throat is first swabbed to collect a sample of mucus. In most RSTs, this mucus sample is then exposed to a reagent containing antibodies that will bind specifically to a GAS antigen. A positive result is signified by a certain visible reaction. There are three major types of RST: First,
127:
Some clinical guidelines recommend the use of RSTs in people with pharyngitis, but others do not. US guidelines are more consistently in favor of their use than their
European equivalents. The use of RSTs may be most beneficial in the third world, where the complications of streptococcal infection
165:
The specificity of RSTs for the presence of GAS is at least 95%, with some studies finding close to 100% specificity. Therefore, if the test result is positive, the presence of GAS is highly likely. However, 5% to 20% of individuals carry GAS in their throats without symptomatic infection, so the
119:
to a person with pharyngitis, a common infection of the throat. Viral infections are responsible for the majority of pharyngitis, but a significant proportion (20% to 40% in children and 5% to 15% in adults) is caused by bacterial infection. The symptoms of viral and bacterial infection may be
134:
from a throat swab is a reliable and affordable alternative to an RST which has high sensitivity and specificity. However, a culture requires special facilities and usually takes 48 hours to give a result, whereas an RST can give a result within several minutes.
152:, which is currently the most widely used RST. The sample is applied to a strip of nitrocellulose film and, if GAS antigens are present, these will migrate along the film to form a visible line of antigen bound to labeled antibodies. Third, optical
409:
Gerber, MA; Tanz, RR; Kabat, W; Dennis, E; Bell, GL; Kaplan, EL; Shulman, ST (Mar 19, 1997). "Optical immunoassay test for group A beta-hemolytic streptococcal pharyngitis. An office-based, multicenter investigation".
103:. There are currently several types of rapid strep test in use, each employing a distinct technology. However, they all work by detecting the presence of GAS in the throat of a person by responding to GAS-specific
156:
is the newest and more expensive test. It involves mixing the sample with labeled antibodies and then with a special substrate on a film which changes colour to signal the presence or absence of GAS antigen.
294:
148:, which was developed in the 1980s and is largely obsolete. It employs latex beads covered with antigens that will visibly agglutinate around GAS antibodies if these are present. Second, a
889:
782:
343:
Cohen, Jeremie; Cohen, Robert; Chalumeau, Martin (2013). Chalumeau, Martin (ed.). "Rapid antigen detection test for group A streptococcus in children with pharyngitis".
544:
370:
Cohen, JF; Cohen, R; Bidet, P; Levy, C; Deberdt, P; d'Humières, C; Liguori, S; Corrard, F; Thollot, F; Mariani-Kurkdjian, P; Chalumeau, M; Bingen, E (Jun 2013).
971:
884:
613:
654:
372:"Rapid-antigen detection tests for group a streptococcal pharyngitis: revisiting false-positive results using polymerase chain reaction testing"
537:
832:
938:
530:
1023:
837:
991:
847:
852:
807:
899:
673:
827:
1081:
894:
857:
842:
71:
17:
777:
928:
879:
695:
587:
562:
727:
1076:
963:
862:
567:
486:
Pelucci, C; Grigoryan, L; Galeone, C; Esposito, S; Huovinen, P; Little, P; Verheij, T (2012).
920:
554:
787:
179:
96:
204:
8:
1045:
986:
976:
904:
690:
145:
1055:
702:
446:
322:
310:
261:
236:
88:
522:
463:
1040:
872:
649:
509:
504:
487:
468:
427:
391:
314:
266:
149:
131:
1050:
499:
458:
419:
383:
352:
326:
306:
295:"Treatment of sore throat in light of the Cochrane verdict: is the jury still out?"
256:
248:
867:
58:
822:
722:
712:
592:
184:
387:
802:
623:
618:
356:
293:
Danchin, Margaret; Curtis, Nigel; Carapetis, Jonathan; Nolan, Terence (2002).
128:
are most prevalent, but their use in these regions has not been well studied.
115:
A rapid strep test may assist a clinician in deciding whether to prescribe an
91:(RADT) that is widely used in clinics to assist in the diagnosis of bacterial
1070:
1016:
953:
747:
659:
633:
628:
608:
445:
Gerber, M; Baltimore, R; Eaton, C; Gewitz, M; Rowley, A; Shulman, S (2009).
423:
797:
742:
717:
513:
472:
395:
371:
318:
270:
237:"Differences among international pharyngitis guidelines: not just academic"
100:
431:
1035:
752:
153:
92:
52:
1011:
707:
116:
235:
Matthys, J; De Meyere, M; van Driel, ML; De Sutter, A (Sep–Oct 2007).
933:
792:
252:
909:
817:
757:
734:
104:
234:
1028:
582:
41:
485:
981:
943:
812:
66:
292:
444:
170:
European guidelines suggest relying on the negative RST.
552:
412:
JAMA: The
Journal of the American Medical Association
408:
488:"Guideline for the management of acute sore throat"
369:
342:
124:in viral illnesses, where they are not beneficial.
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222:
1068:
338:
336:
277:
219:
538:
333:
202:
545:
531:
40:
503:
462:
260:
345:Cochrane Database of Systematic Reviews
14:
1069:
526:
838:Oxidative/fermentation glucose test
492:Clinical Microbiology and Infection
24:
311:10.5694/j.1326-5377.2002.tb04925.x
25:
1093:
964:Antibiotic susceptibility testing
771:biochemical and immunologic tests
464:10.1161/CIRCULATIONAHA.109.191959
203:Mersch, John (20 February 2015).
160:
992:Minimum inhibitory concentration
684:Manual testing: basic techniques
505:10.1111/j.1469-0691.2012.03766.x
900:Novobiocin susceptibility test
890:Bacitracin susceptibility test
479:
438:
402:
363:
196:
110:
13:
1:
783:Amino acid decarboxylase test
190:
895:Optochin susceptibility test
858:Sulfide indole motility test
843:Phenylalanine deaminase test
299:Medical Journal of Australia
138:
89:rapid antigen detection test
7:
388:10.1016/j.jpeds.2013.01.050
173:
10:
1098:
1004:
962:
939:Polymerase chain reaction
918:
768:
683:
672:
642:
601:
575:
561:
376:The Journal of Pediatrics
357:10.1002/14651858.CD010502
241:Annals of Family Medicine
65:
51:
39:
34:
929:Analytical profile index
99:(GAS), sometimes termed
424:10.1001/jama.277.11.899
863:Triple sugar iron test
382:(6): 1282–4, 1284.e1.
921:point-of-care testing
602:Cultures by body site
555:clinical microbiology
27:Test for strep throat
880:Voges–Proskauer test
788:Bile solubility test
643:Cultures by organism
576:Isolation techniques
180:Screening (medicine)
97:group A streptococci
46:Rapid strep test kit
1082:Medical terminology
987:McFarland standards
977:Disk diffusion test
972:Beta-lactamase test
905:Lancefield grouping
885:X and V factor test
853:Salt tolerance test
728:Ziehl–Neelsen stain
691:Colonial morphology
146:latex fixation test
1056:Inoculation needle
205:"Rapid strep test"
107:on a throat swab.
1064:
1063:
1041:Biosafety cabinet
1000:
999:
848:Reverse CAMP test
668:
667:
650:Bacterial culture
498:(Suppl 1): 1–28.
207:. MedicineNet.com
150:lateral flow test
132:Microbial culture
77:
76:
16:(Redirected from
1089:
1051:Inoculation loop
949:Rapid strep test
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680:
573:
572:
547:
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331:
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290:
275:
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264:
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217:
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200:
81:rapid strep test
61:
44:
35:Rapid strep test
32:
31:
21:
1097:
1096:
1092:
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1090:
1088:
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1086:
1067:
1066:
1065:
1060:
996:
958:
914:
823:Methyl red test
770:
769:Manual testing:
764:
723:India ink stain
713:Acid-fast stain
676:
664:
638:
614:Genital culture
597:
593:Selective media
565:
557:
551:
521:
484:
480:
457:(11): 1541–51.
443:
439:
418:(11): 899–903.
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368:
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341:
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278:
253:10.1370/afm.741
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185:Diagnostic test
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5:
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984:
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946:
941:
936:
931:
925:
923:
919:Automated and
916:
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865:
860:
855:
850:
845:
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835:
830:
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820:
815:
810:
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803:Coagulase test
800:
795:
790:
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774:
772:
766:
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760:
755:
750:
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674:Identification
670:
669:
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663:
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655:Fungal culture
652:
646:
644:
640:
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637:
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631:
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624:Throat culture
621:
619:Sputum culture
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611:
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579:
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553:Techniques in
550:
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519:
478:
437:
401:
362:
332:
276:
218:
194:
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175:
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161:Interpretation
159:
140:
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112:
109:
75:
74:
69:
63:
62:
55:
49:
48:
45:
37:
36:
26:
9:
6:
4:
3:
2:
1094:
1083:
1080:
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1077:Medical tests
1075:
1074:
1072:
1057:
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1052:
1049:
1047:
1044:
1042:
1039:
1037:
1034:
1030:
1027:
1026:
1025:
1024:Anaerobic jar
1022:
1018:
1017:Growth medium
1015:
1014:
1013:
1010:
1009:
1007:
1003:
993:
990:
988:
985:
983:
980:
978:
975:
973:
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967:
965:
961:
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954:Monospot test
952:
950:
947:
945:
942:
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937:
935:
932:
930:
927:
926:
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922:
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704:
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697:
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679:
675:
671:
661:
660:Viral culture
658:
656:
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648:
647:
645:
641:
635:
634:Wound culture
632:
630:
629:Urine culture
627:
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617:
615:
612:
610:
609:Blood culture
607:
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541:
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528:
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511:
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501:
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366:
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289:
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247:(5): 436–43.
246:
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73:
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56:
54:
50:
43:
38:
33:
30:
19:
948:
828:Nitrite test
798:Citrate test
739:Rapid tests
718:Giemsa stain
588:Streak plate
495:
491:
481:
454:
450:
440:
415:
411:
404:
379:
375:
365:
348:
344:
305:(9): 512–5.
302:
298:
244:
240:
209:. Retrieved
198:
168:
164:
142:
130:
126:
122:
114:
101:strep throat
84:
80:
78:
29:
1036:Durham tube
868:Urease test
677:and testing
451:Circulation
154:immunoassay
111:Medical use
93:pharyngitis
53:MedlinePlus
1071:Categories
1012:Agar plate
808:DNAse test
708:Gram stain
211:4 November
191:References
117:antibiotic
95:caused by
18:Strep test
1046:Incubator
1005:Equipment
934:MALDI-TOF
833:ONPG test
793:CAMP test
696:Hemolysis
563:Isolation
139:Procedure
910:RPR test
818:KOH test
778:ALA test
748:Catalase
735:Wet prep
703:Staining
514:22432746
473:19246689
396:23465407
319:12405896
271:17893386
174:See also
105:antigens
1029:Gas-pak
743:Oxidase
583:Asepsis
568:culture
432:9062328
327:1957427
262:2000301
87:) is a
72:78012-2
753:Indole
512:
471:
430:
394:
325:
317:
269:
259:
59:003745
982:Etest
944:VITEK
873:rapid
813:IMViC
323:S2CID
67:LOINC
566:and
510:PMID
469:PMID
428:PMID
392:PMID
315:PMID
267:PMID
213:2015
79:The
758:PYR
500:doi
459:doi
455:119
420:doi
416:277
384:doi
380:162
353:doi
307:doi
303:177
257:PMC
249:doi
85:RST
1073::
508:.
496:18
494:.
490:.
467:.
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449:.
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374:.
351:.
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335:^
321:.
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221:^
144:a
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539:t
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422::
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349:4
329:.
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251::
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83:(
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