Objective: To assess the effect of using 2 throat swabs vs 1 on rapid detectio n of group A streptococcus by the STREP A OIA MAX (hereafter, OIAMAX) test. Meth ods: Children aged 5 to 18 years with acute pharyngitis w...Objective: To assess the effect of using 2 throat swabs vs 1 on rapid detectio n of group A streptococcus by the STREP A OIA MAX (hereafter, OIAMAX) test. Meth ods: Children aged 5 to 18 years with acute pharyngitis were randomizedto 1 of 2 study groups. In group 1, one throat swab was obtained, streaked first on sheep blood agar, and then used for OIA MAX testing. In group 2, two throat swabs wer e obtained simultaneously. One swab was streaked first on sheep blood agar and t hen joined with the other swab for OIA MAX testing. In both groups, the pledgets in the collection-transport tube were incubated in Todd-Hewitt broth. A posit ive group A streptococcus culture either by sheep blood agar or Todd-Hewitt bro th was confirmed by a latex agglutination test. Results: Three hundred sixtythre e patients were enrolled, 177 in group 1 and 186 in group 2. Cultures were posit ive for group A streptococcus in 154 (42.4%) of 363 patients. The sensitivity a nd specificity of OIA MAX testing were 94.7%and 100.0%, respectively, in group 1, and 92.4%and 96.3%, respectively, in group 2. There was no statistical dif ference between the sensitivity, the specificity, and the predictive values of t he OIA MAX test performed with 1 swab compared with those performed with 2 swabs (P>.10). There was no association between OIA MAX test sensitivity and the seve rity of pharyngitis as measured by the modified Centor criterion (history of fev er, absence of cough, presence of pharyngeal or tonsillar exudates, and presence of cervical lymphadenopathy) scores. Conclusions: The OIA MAX test yielded comp arable sensitivity and specificity in both study groups. The use of 2 throat swa bs instead of 1 swab did not increase the sensitivity of the OIA MAX test. The p erformance of the OIA MAX test did not depend on the severity of pharyngitis.展开更多
文摘Objective: To assess the effect of using 2 throat swabs vs 1 on rapid detectio n of group A streptococcus by the STREP A OIA MAX (hereafter, OIAMAX) test. Meth ods: Children aged 5 to 18 years with acute pharyngitis were randomizedto 1 of 2 study groups. In group 1, one throat swab was obtained, streaked first on sheep blood agar, and then used for OIA MAX testing. In group 2, two throat swabs wer e obtained simultaneously. One swab was streaked first on sheep blood agar and t hen joined with the other swab for OIA MAX testing. In both groups, the pledgets in the collection-transport tube were incubated in Todd-Hewitt broth. A posit ive group A streptococcus culture either by sheep blood agar or Todd-Hewitt bro th was confirmed by a latex agglutination test. Results: Three hundred sixtythre e patients were enrolled, 177 in group 1 and 186 in group 2. Cultures were posit ive for group A streptococcus in 154 (42.4%) of 363 patients. The sensitivity a nd specificity of OIA MAX testing were 94.7%and 100.0%, respectively, in group 1, and 92.4%and 96.3%, respectively, in group 2. There was no statistical dif ference between the sensitivity, the specificity, and the predictive values of t he OIA MAX test performed with 1 swab compared with those performed with 2 swabs (P>.10). There was no association between OIA MAX test sensitivity and the seve rity of pharyngitis as measured by the modified Centor criterion (history of fev er, absence of cough, presence of pharyngeal or tonsillar exudates, and presence of cervical lymphadenopathy) scores. Conclusions: The OIA MAX test yielded comp arable sensitivity and specificity in both study groups. The use of 2 throat swa bs instead of 1 swab did not increase the sensitivity of the OIA MAX test. The p erformance of the OIA MAX test did not depend on the severity of pharyngitis.
