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[Early diagnosis of streptococcal pharyngitis in paediatric practice: Validity of a rapid antigen detection test]

Gemma Flores Mateo1, Jaume Conejero, Elisabet Grenzner Martinel

  • 1Centro de Atención Primaria Can Bou, Castelldefels, Barcelona, España. gflores@idiapjgol.org

Atencion Primaria
|March 30, 2010
PubMed

Insights

The rapid antigen test for group A beta-haemolytic Streptococcus (GABHS) pharyngitis in children shows high diagnostic value but requires culture confirmation due to significant false positives and negatives. Further testing is recommended, especially for patients with fewer symptoms.

Area of Science:

  • Pediatric infectious diseases
  • Diagnostic test evaluation
  • Microbiology

Background:

  • Acute pharyngitis is common in children.
  • Group A beta-haemolytic Streptococcus (GABHS) is a primary bacterial cause.
  • Accurate diagnosis is crucial for appropriate treatment.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of a rapid antigen test for GABHS pharyngitis.
  • To compare the rapid antigen test against throat culture in pediatric patients.
  • To assess the test's sensitivity, specificity, and predictive values.

Main Methods:

  • Observational study in two Barcelona primary care centers.
  • Included 211 pediatric patients (1-14 years) with sore throat.
  • Oropharyngeal samples analyzed by rapid antigen test and throat culture.

Main Results:

  • Prevalence of GABHS pharyngitis was 34.1%.
  • Rapid antigen test sensitivity: 90.3%; specificity: 78.4% compared to culture.
  • Higher sensitivity observed with increased Centor scores; notable false negatives (9.7%) and false positives (21.6%).

Conclusions:

  • The rapid antigen test has high diagnostic value for GABHS pharyngitis in children.
  • However, false positive and negative rates are substantial.
  • Culture confirmation is recommended due to limitations, particularly in patients with milder symptoms.
Abstract

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