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Usefulness and Description of the Test Puncture Method for Necrotizing Fasciitis Caused by Group A β-Hemolytic
Marina Tsukahara1, Shinobu Ayabe1, Chikashi Morikawa1
1Department of Plastic and Reconstructive Surgery, Yao Tokushukai General Hospital, Osaka, Japan.
Objectives:
Necrotizing soft tissue infections (NSTIs) caused by group A streptococcus (GAS) are life-threatening diseases with high morbidity and mortality rates. Early diagnosis is of paramount importance because a delay in diagnosis results in a significant reduction in survival rates. Recent studies have shown that the use of a rapid antigen detection test for GAS (GAS-RADT) at the time of NSTI diagnosis facilitates timely identification and simplifies surgical decision-making through small incision-based interventions. This study aimed to evaluate the accuracy of rapid diagnosis using a puncture method and to describe the associated procedure.
Methods:
We evaluated the accuracy and reproducibility of GAS-RADT performed using a less invasive and simpler puncture method compared to conventional sampling from small incision wounds and outlined the diagnostic procedure. The study population included 19 patients who underwent GAS-RADT using the puncture method at our hospital between 2019 and 2023.
Results:
The concordance rate between GAS-RADT and wound culture was 100%; Cohen's kappa coefficient was 1.0, indicating extremely high concordance.
Conclusions:
As GAS-RADT performed with puncture sampling is a minimally invasive and rapid testing method that helps determine treatment strategies, it can be considered an extremely useful diagnostic method for detecting GAS-NSTI, which has been on the rise in recent years.
Insights
Rapid antigen detection tests for group A Streptococcus (GAS) using a puncture method accurately diagnose life-threatening necrotizing soft tissue infections (NSTIs). This minimally invasive approach aids timely treatment decisions for GAS-NSTIs.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgical Pathology
Background:
- Necrotizing soft tissue infections (NSTIs) caused by group A Streptococcus (GAS) are severe, life-threatening conditions.
- Early diagnosis of GAS-NSTIs is critical for improving patient survival rates.
- Current diagnostic methods can be invasive and time-consuming, delaying crucial treatment.
Purpose of the Study:
- To evaluate the accuracy and reproducibility of a rapid antigen detection test for GAS (GAS-RADT) using a less invasive puncture method.
- To compare the puncture method with conventional wound sampling techniques.
- To describe the diagnostic procedure for GAS-RADT via puncture sampling.
Main Methods:
- GAS-RADT was performed using a puncture method on 19 patients diagnosed with NSTI between 2019 and 2023.
- The accuracy of GAS-RADT was assessed by comparing its results with wound cultures.
- The diagnostic procedure for the puncture method was outlined.
Main Results:
- The study achieved 100% concordance between GAS-RADT results and wound cultures.
- Cohen's kappa coefficient was 1.0, signifying extremely high agreement.
- The puncture sampling method proved accurate and reproducible.
Conclusions:
- GAS-RADT with puncture sampling is a minimally invasive and rapid diagnostic tool for GAS-NSTI.
- This method facilitates prompt treatment strategy determination.
- The technique is highly valuable for the increasing incidence of GAS-NSTIs.
