109:
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.
436:"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"
155:
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%.
31:
158:
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
112:
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
132:
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,
116:
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
154:
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
108:
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
123:
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.
141:, 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
398:
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".
92:. 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
145:
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.
283:
533:
137:, 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
332:
Cohen, Jeremie; Cohen, Robert; Chalumeau, Martin (2013). Chalumeau, Martin (ed.). "Rapid antigen detection test for group A streptococcus in children with pharyngitis".
526:
359:
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).
519:
361:"Rapid-antigen detection tests for group a streptococcal pharyngitis: revisiting false-positive results using polymerase chain reaction testing"
1012:
826:
980:
888:
662:
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883:
846:
831:
878:
771:
927:
868:
917:
684:
576:
551:
716:
841:
836:
816:
796:
766:
1065:
952:
851:
556:
960:
873:
909:
543:
60:
776:
602:
168:
85:
643:
1034:
975:
965:
893:
679:
134:
1044:
691:
311:
77:
821:
1029:
861:
638:
498:
475:
Pelucci, C; Grigoryan, L; Galeone, C; Esposito, S; Huovinen, P; Little, P; Verheij, T (2012).
457:
416:
380:
303:
255:
138:
120:
1039:
488:
447:
408:
372:
341:
295:
245:
237:
811:
711:
701:
581:
193:
173:
791:
612:
607:
435:
299:
250:
225:
511:
452:
1059:
1005:
942:
736:
648:
622:
617:
597:
493:
476:
786:
731:
706:
315:
284:"Treatment of sore throat in light of the Cochrane verdict: is the jury still out?"
89:
47:
1024:
741:
376:
142:
81:
41:
1000:
696:
345:
282:
Danchin, Margaret; Curtis, Nigel; Carapetis, Jonathan; Nolan, Terence (2002).
117:
are most prevalent, but their use in these regions has not been well studied.
105:
104:
A rapid strep test may assist a clinician in deciding whether to prescribe an
80:(RADT) that is widely used in clinics to assist in the diagnosis of bacterial
922:
781:
434:
Gerber, M; Baltimore, R; Eaton, C; Gewitz, M; Rowley, A; Shulman, S (2009).
412:
30:
502:
461:
384:
360:
307:
259:
226:"Differences among international pharyngitis guidelines: not just academic"
420:
898:
806:
746:
723:
93:
1017:
571:
224:
Matthys, J; De Meyere, M; van Driel, ML; De Sutter, A (Sep–Oct 2007).
856:
241:
970:
932:
801:
55:
515:
159:
European guidelines suggest relying on the negative RST.
401:
JAMA: The
Journal of the American Medical Association
993:
951:
907:
757:
672:
661:
631:
590:
564:
550:
477:"Guideline for the management of acute sore throat"
113:in viral illnesses, where they are not beneficial.
54:
40:
23:
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527:
8:
669:
561:
534:
520:
512:
29:
492:
451:
249:
334:Cochrane Database of Systematic Reviews
184:
20:
7:
827:Oxidative/fermentation glucose test
481:Clinical Microbiology and Infection
300:10.5694/j.1326-5377.2002.tb04925.x
14:
953:Antibiotic susceptibility testing
760:biochemical and immunologic tests
453:10.1161/CIRCULATIONAHA.109.191959
192:Mersch, John (20 February 2015).
981:Minimum inhibitory concentration
673:Manual testing: basic techniques
494:10.1111/j.1469-0691.2012.03766.x
889:Novobiocin susceptibility test
879:Bacitracin susceptibility test
1:
772:Amino acid decarboxylase test
884:Optochin susceptibility test
847:Sulfide indole motility test
832:Phenylalanine deaminase test
288:Medical Journal of Australia
78:rapid antigen detection test
377:10.1016/j.jpeds.2013.01.050
1087:
928:Polymerase chain reaction
365:The Journal of Pediatrics
346:10.1002/14651858.CD010502
230:Annals of Family Medicine
28:
918:Analytical profile index
88:(GAS), sometimes termed
413:10.1001/jama.277.11.899
852:Triple sugar iron test
371:(6): 1282–4, 1284.e1.
910:point-of-care testing
591:Cultures by body site
544:clinical microbiology
16:Test for strep throat
869:Voges–Proskauer test
777:Bile solubility test
632:Cultures by organism
565:Isolation techniques
169:Screening (medicine)
86:group A streptococci
35:Rapid strep test kit
1071:Medical terminology
976:McFarland standards
966:Disk diffusion test
961:Beta-lactamase test
894:Lancefield grouping
874:X and V factor test
842:Salt tolerance test
717:Ziehl–Neelsen stain
680:Colonial morphology
135:latex fixation test
1045:Inoculation needle
194:"Rapid strep test"
96:on a throat swab.
1053:
1052:
1030:Biosafety cabinet
989:
988:
837:Reverse CAMP test
657:
656:
639:Bacterial culture
487:(Suppl 1): 1–28.
196:. MedicineNet.com
139:lateral flow test
121:Microbial culture
66:
65:
1078:
1040:Inoculation loop
938:Rapid strep test
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562:
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221:
206:
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201:
189:
70:rapid strep test
50:
33:
24:Rapid strep test
21:
1086:
1085:
1081:
1080:
1079:
1077:
1076:
1075:
1056:
1055:
1054:
1049:
985:
947:
903:
812:Methyl red test
759:
758:Manual testing:
753:
712:India ink stain
702:Acid-fast stain
665:
653:
627:
603:Genital culture
586:
582:Selective media
554:
546:
540:
510:
474:
473:
469:
446:(11): 1541–51.
433:
432:
428:
407:(11): 899–903.
397:
396:
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358:
357:
353:
331:
330:
323:
281:
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242:10.1370/afm.741
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174:Diagnostic test
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36:
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5:
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986:
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983:
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973:
968:
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955:
949:
948:
946:
945:
940:
935:
930:
925:
920:
914:
912:
908:Automated and
905:
904:
902:
901:
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891:
886:
881:
876:
871:
866:
865:
864:
854:
849:
844:
839:
834:
829:
824:
819:
814:
809:
804:
799:
794:
792:Coagulase test
789:
784:
779:
774:
769:
763:
761:
755:
754:
752:
751:
750:
749:
744:
739:
734:
726:
721:
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719:
714:
709:
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699:
689:
688:
687:
676:
674:
667:
663:Identification
659:
658:
655:
654:
652:
651:
646:
644:Fungal culture
641:
635:
633:
629:
628:
626:
625:
620:
615:
613:Throat culture
610:
608:Sputum culture
605:
600:
594:
592:
588:
587:
585:
584:
579:
574:
568:
566:
559:
548:
547:
542:Techniques in
541:
539:
538:
531:
524:
516:
509:
508:
467:
426:
390:
351:
321:
265:
207:
183:
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150:Interpretation
148:
129:
126:
101:
98:
64:
63:
58:
52:
51:
44:
38:
37:
34:
26:
25:
15:
13:
10:
9:
6:
4:
3:
2:
1083:
1072:
1069:
1067:
1066:Medical tests
1064:
1063:
1061:
1046:
1043:
1041:
1038:
1036:
1033:
1031:
1028:
1026:
1023:
1019:
1016:
1015:
1014:
1013:Anaerobic jar
1011:
1007:
1006:Growth medium
1004:
1003:
1002:
999:
998:
996:
992:
982:
979:
977:
974:
972:
969:
967:
964:
962:
959:
958:
956:
954:
950:
944:
943:Monospot test
941:
939:
936:
934:
931:
929:
926:
924:
921:
919:
916:
915:
913:
911:
906:
900:
897:
895:
892:
890:
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880:
877:
875:
872:
870:
867:
863:
860:
859:
858:
855:
853:
850:
848:
845:
843:
840:
838:
835:
833:
830:
828:
825:
823:
820:
818:
815:
813:
810:
808:
805:
803:
800:
798:
795:
793:
790:
788:
785:
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778:
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773:
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765:
764:
762:
756:
748:
745:
743:
740:
738:
735:
733:
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729:
727:
725:
722:
718:
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713:
710:
708:
705:
703:
700:
698:
695:
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693:
690:
686:
683:
682:
681:
678:
677:
675:
671:
668:
664:
660:
650:
649:Viral culture
647:
645:
642:
640:
637:
636:
634:
630:
624:
623:Wound culture
621:
619:
618:Urine culture
616:
614:
611:
609:
606:
604:
601:
599:
598:Blood culture
596:
595:
593:
589:
583:
580:
578:
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573:
570:
569:
567:
563:
560:
558:
553:
549:
545:
537:
532:
530:
525:
523:
518:
517:
514:
504:
500:
495:
490:
486:
482:
478:
471:
468:
463:
459:
454:
449:
445:
441:
437:
430:
427:
422:
418:
414:
410:
406:
402:
394:
391:
386:
382:
378:
374:
370:
366:
362:
355:
352:
347:
343:
339:
335:
328:
326:
322:
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309:
305:
301:
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293:
289:
285:
278:
276:
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272:
270:
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261:
257:
252:
247:
243:
239:
236:(5): 436–43.
235:
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220:
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195:
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71:
62:
59:
57:
53:
49:
45:
43:
39:
32:
27:
22:
19:
937:
817:Nitrite test
787:Citrate test
728:Rapid tests
707:Giemsa stain
577:Streak plate
484:
480:
470:
443:
439:
429:
404:
400:
393:
368:
364:
354:
337:
333:
294:(9): 512–5.
291:
287:
233:
229:
198:. Retrieved
187:
157:
153:
131:
119:
115:
111:
103:
90:strep throat
73:
69:
67:
18:
1025:Durham tube
857:Urease test
666:and testing
440:Circulation
143:immunoassay
100:Medical use
82:pharyngitis
42:MedlinePlus
1060:Categories
1001:Agar plate
797:DNAse test
697:Gram stain
200:4 November
180:References
106:antibiotic
84:caused by
1035:Incubator
994:Equipment
923:MALDI-TOF
822:ONPG test
782:CAMP test
685:Hemolysis
552:Isolation
128:Procedure
899:RPR test
807:KOH test
767:ALA test
737:Catalase
724:Wet prep
692:Staining
503:22432746
462:19246689
385:23465407
308:12405896
260:17893386
163:See also
94:antigens
1018:Gas-pak
732:Oxidase
572:Asepsis
557:culture
421:9062328
316:1957427
251:2000301
76:) is a
61:78012-2
742:Indole
501:
460:
419:
383:
314:
306:
258:
248:
48:003745
971:Etest
933:VITEK
862:rapid
802:IMViC
312:S2CID
56:LOINC
555:and
499:PMID
458:PMID
417:PMID
381:PMID
304:PMID
256:PMID
202:2015
68:The
747:PYR
489:doi
448:doi
444:119
409:doi
405:277
373:doi
369:162
342:doi
296:doi
292:177
246:PMC
238:doi
74:RST
1062::
497:.
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324:^
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210:^
133:a
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375::
348:.
344::
338:4
318:.
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72:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
