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Strep Screen

Rapid antigen tests for group A Streptococcal pharyngitis are available. The major advantage of rapid diagnosis is that a patient can be diagnosed and treated at the same time. Early treatment is beneficial because it promptly relieves symptoms, decreases the likelihood of serious sequelae, and limits the spread of infection to others.

The sensitivities of these techniques depend not only on the methodology used but also on the numbers of streptococci present in the sample. A recent College of American Pathologists survey summarized results from several commonly used kits:

Methodology

# Tested

% Correct

Abbott Testpack

222

99

Abbott Testpack Plus

760

99

BD Culturette 10MN LTX

47

100

BD Directigen

39

98

BD Directigen 123

619

96

BD Q Test Strep

15

83

Biostar Strep A OIA

150

100

DPC DX Strep A

48

98

Hybritech Tandem Icon

365

99

Kodak Surecell

102

100

Wampole Clearview

65

93

Obviously some kits perform better than others. Tests with an efficiency below 99% should be avoided. False negative results may occur with any test method if the specimen contains small numbers of streptococci. Therefore, a good throat swab is crucial. All antigen-negative swabs should have the negative result confirmed by culture.

Specimen requirement is a throat swab placed in clear liquid transport media.

Reference range is negative for group A Streptococcus by antigen detection.

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