Abstract

Background: Group A Streptococcus (GAS) is accountable for 20-40% of pharyngitis in children. Rapid antigen detection test (RADT) provides important information for determining the need for antibiotics for patients presenting with GAS infections. As compared to the throat culture technique, RADT offers a quick diagnosis within 5 to 10 min. The study aims to assess the efficacy of RADT in comparison with conventional throat culture for the detection of GAS using clinical samples from pediatric patients.

Methods: A retrospective study was carried out on pediatric patients of both genders aged up to 14 years, for a duration of five years at a tertiary care hospital of Bahrain. Tests such as RADT and throat culture were used for the analysis of throat swabs from these patients. Diagnostic performance characteristics were evaluated with conventional culture as the reference standard.

Results: A total of 1085 samples were collected from patients belonging to different age groups out of which, 232 were culture-positive and 234 were RADT-positive. Majority of the culture-positive samples came from patients aged 5-9 y. The diagnostic characteristics test for RADT showed 90% sensitivity, 97% specificity, and 96% accuracy. The positive and negative predictive values were 89% and 97.30%.

Conclusion: RADT is an efficient, reliable, highly specific, and sensitive technique which gives rapid results to rule out GAS in pediatric patients in contrast to the conventional throat culture assessment methods, thereby enabling the clinicians to take a better clinical decision and limiting the unnecessary use of antibiotics.

Keywords: Sensitivity; Specificity; Sore Throat; Streptococcus; RADT