UTILITY OF RAPID ANTIGEN DETECTION TEST FOR DIAGNOSIS OF STREPTOCOCCAL A INFECTION DIRECTLY FROM THE THROAT SWAB OF SUSPECTED PATIENTS OF PHARYNGITIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 13
Abstract
BACKGROUND Beta-haemolytic Group A Streptococcus (GAS), i.e. Streptococcus pyogenes is responsible for a wide range of both invasive and non-invasive infections. Early diagnosis and treatment of Group A streptococcal pharyngitis has been shown to reduce the severity of symptoms and further complications such as rheumatic fever and glomerulonephritis. Infection of GAS may spread through direct contact with mucus or sores on the skin with over 10 million mild infections and > 500,000 deaths per year. With 20% to 40% bacterial infections, which are indistinguishable from viral infections can be effectively treated by antibiotics. The 48 to 72 hours delay in culture conformation is problematic in low-resource settings, where repeated follow-up visits are not feasible for appropriate treatment. Rapid Antigen Detection Tests (RADTs) assist in the diagnosis of bacterial pharyngitis caused by Group A Streptococci and gives a visual qualitative detection of Group A streptococcal antigen directly from throat swabs. These are potentially more feasible alternatives, because of their quick turnaround time. MATERIALS AND METHODS The cross-sectional study was carried out in the Department of Microbiology in college associated with tertiary care hospital, in central India Bhopal during a time period of 2 months from August to September 2016 after obtaining permission from the Institutional Ethics Committee. A total of 38 non-repetitive patients of either gender and of any age clinically suspected to be of pharyngitis attending OPD of Department of ENT in a tertiary care hospital were enrolled after informed consent. Throat swabs collected were transported and processed immediately for the culture and RADT for Streptococcal A. All data was maintained in Microsoft Office Excel and statistical analysis was carried out using Excel with appropriate statistical tools like tests of proportion and significance. RESULTS Out of 38 samples collected, 25 were from male patients and 13 were from females. 35 out of 38 (91.10%) patients were from active age group. All the samples tested were negative for RADT. A total of 16/38 (42.10%) samples grew Beta-haemolytic streptococci, but were negative when again tested for Streptococcal A antigen using RADT. CONCLUSION The sensitivity and specificity of Rapid Antigen detection test by immuno-chromatographic tests have been claimed to be over 90%, but could not be established in our settings. A large scale study with strict inclusion criteria is warranted to establish the utility of RADT.
Authors and Affiliations
Shubham Gupta, Navinchandra M Kaore, Sadat Qureshi, Avinash Laghawe, Arti Jain, Tukaram K Prabhu
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