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Strep throat

Rune Aabenhus, Volkert Siersma, Håkon Sandholdt, Rasmus Køster-Rasmussen, Malene Plejdrup Hansen, Lars Bjerrum
Objectives: In Denmark, general practice is responsible for 75% of antibiotic prescribing in the primary care sector. We aimed to identify practice-related factors associated with high prescribers, including prescribers of critically important antibiotics as defined by WHO, after accounting for case mix by practice. Methods: We performed a nationwide register-based survey of antibiotic prescribing in Danish general practice from 2012 to 2013. The unit of analysis was the individual practice...
April 19, 2017: Journal of Antimicrobial Chemotherapy
E Stefaniuk, K Bosacka, M Wanke-Rytt, W Hryniewicz
Group A Streptococci (GAS) are the main causative agents of bacterial pharyngitis, which require antibiotic therapy. Rapid diagnostic tests detecting GAS combined with Centor/McIsaac score enable accurate differential diagnosis (viral vs. bacterial) and prompt commencement of targeted treatment. The aim of this study was to assess the specificity, sensitivity, PPV and NPV of QuikRead go® Strep A (Orion Diagnostica Oy, Finland) recommended for the detection of GAS in pharyngeal swabs. Quick diagnostic test results were compared with physical examination findings, Centor/McIsaac score and results of reference testing (conventional microbial cultures)...
April 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
Michael R Pranzatelli, Elizabeth D Tate, Tyler J Allison
A longstanding question is whether neuroinflammation is present in children symptomatic for Tourette syndrome (TS) with positive streptococcal serology and throat cultures. The objective was to directly test for it using modern hypothesis-driven approaches. Profiling studies for 14 immune cell types (flow cytometry), 7 chemokines/cytokines (ELISA), oligoclonal bands, and other immunoglobulins were performed in this IRB-approved study of 5 children with TS and streptococcal markers compared to data from 26 non-inflammatory pediatric neurological controls...
March 10, 2017: Cytokine
Ayşe Barış, Nur Anlıaçık, Mehmet Emin Bulut, Rıdvan Deniz, Elif Yücel, Elif Aktaş
Pharyngitis in most cases is due to viral microorganisms however drug therapy without the detection of etiological agent leads to unnecessary use of antibiotics. On the other hand, when the etiologic agent is group A beta-hemolytic streptococci (GAS) it is important to identify the etiologic agent rapidly which will guide the treatment with appropriate antibiotics. The use of highly sensitive rapid tests will contribute significantly to early diagnosis and appropriate therapy. The aim of this study is to evaluate the efficacy of Mascia Brunelli rapid antigen test for the detection of GAS in throat swab samples...
January 2017: Mikrobiyoloji Bülteni
Saisindhu Narala, Tissa R Hata
INTRODUCTION: Atopic dermatitis (AD) is related to other atopic diseases asthma and allergic rhinitis. It is known that those with asthma or allergic rhinitis have impaired immune responses that may predispose them to infections. This study sought to determine whether adult AD is associated with systemic infections, and whether association is strengthened in those with AD plus another atopic disease. METHODS: This cross-sectional study obtained information from adults in the 2010 and the 2012 National Health Interview Survey (NHIS)...
March 2017: Dermatology and Therapy
Fangnian Wang, Yu Tian, Lingjun Chen, Robert Luo, Joanna Sickler, Oliver Liesenfeld, Shuqi Chen
The performance of a polymerase chain reaction-based point-of-care assay, the cobas Strep A Nucleic Acid Test for use on the cobas Liat System (cobas Liat Strep A assay), for the detection of group A Streptococcus bacteria was evaluated in primary care settings. Throat swab specimens from 427 patients were tested with the cobas Liat Strep A assay and a rapid antigen detection test (RADT) by existing medical staff at 5 primary care clinics, and results were compared with bacterial culture. The cobas Liat Strep A assay demonstrated equivalent sensitivity (97...
December 1, 2016: Clinical Pediatrics
Lisa J Underland, Gerson A Vallencia Villeda, Abhijeet Pal, Leslie Lam
Thyroid storm has a high mortality rate and is often associated with a precipitating factor such as intercurrent illness or infection. It is rare in pediatric patients. Cardiac disease in hyperthyroidism mostly manifests itself as tachycardia but more serious cardiac findings have also been described. A 5-year-old male with recent strep throat infection presented with dilated cardiomyopathy, hematuria, and symptoms and lab findings consistent with severe hyperthyroidism. He was diagnosed with thyroid storm secondary to concurrent Graves' disease and poststreptococcal glomerulonephritis (PSGN)...
2016: Case Reports in Pediatrics
Kumara V Nibhanipudi
Objective. A study to determine if addition of palatal petechiae to Centor criteria adds more value for clinical diagnosis of acute strep pharyngitis in children. Hypothesis. In children, Centor Criteria does not cover all the symptoms and signs of acute strep pharyngitis. We hypothesize that addition of palatal petechiae to Centor Criteria will increase the possibility of clinical diagnosis of group A streptococcal pharyngitis in children. Methods. One hundred patients with a complaint of sore throat were enrolled in the study...
2016: Global Pediatric Health
(no author information available yet)
No abstract text is available yet for this article.
July 1, 2016: American Family Physician
Jérémie F Cohen, Nathalie Bertille, Robert Cohen, Martin Chalumeau
BACKGROUND: Group A streptococcus (GAS) accounts for 20% to 40% of cases of pharyngitis in children; the remaining cases are caused by viruses. Compared with throat culture, rapid antigen detection tests (RADTs) offer diagnosis at the point of care (within five to 10 minutes). OBJECTIVES: To determine the diagnostic accuracy of RADTs for diagnosing GAS in children with pharyngitis. To assess the relative diagnostic accuracy of the two major types of RADTs (enzyme immunoassays (EIA) and optical immunoassays (OIA)) by indirect and direct comparison...
July 4, 2016: Cochrane Database of Systematic Reviews
Dean Follmann, Chiung-Yu Huang, Erin Gabriel
Unmeasured confounding is the fundamental obstacle to drawing causal conclusions about the impact of an intervention from observational data. Typically, covariates are measured to eliminate or ameliorate confounding, but they may be insufficient or unavailable. In the special setting where a transient intervention or exposure varies over time within each individual and confounding is time constant, a different tack is possible. The key idea is to condition on either the overall outcome or the proportion of time in the intervention...
October 30, 2016: Statistics in Medicine
Stephan Brouwer, Timothy C Barnett, Tania Rivera-Hernandez, Manfred Rohde, Mark J Walker
Streptococcus pyogenes (group A Streptococcus, GAS) is a human-adapted pathogen responsible for a wide spectrum of disease. GAS can cause relatively mild illnesses, such as strep throat or impetigo, and less frequent but severe life-threatening diseases such as necrotizing fasciitis and streptococcal toxic shock syndrome. GAS is an important public health problem causing significant morbidity and mortality worldwide. The main route of GAS transmission between humans is through close or direct physical contact, and particularly via respiratory droplets...
November 2016: FEBS Letters
Augustine J Sohn, John M Hickner, Fasika Alem
OBJECTIVE: Point-of-care testing (POCT) has been used in the United States for several decades to diagnose and monitor acute and chronic medical conditions. The aim of this study is to assess the use of POCT and perceived benefits of and concerns regarding POCT among US family physicians. METHODS: A total of 405 US family physicians responded to an electronic survey about their use of POCT for diagnosing and monitoring illnesses and for reducing referrals for specialty care...
May 2016: Journal of the American Board of Family Medicine: JABFM
Ulrich Orda, Biswadev Mitra, Sabine Orda, Mark Fitzgerald, Ronny Gunnarsson, Geoff Rofe, Anna Dargan
OBJECTIVE: History, clinical examination and throat culture may be inadequate to rule in or out the presence of group A streptococci (GAS) infection in patients with sore throat in a remote location. We correlated the diagnostic accuracy for guiding antibiotic prescription of clinical decision and physiological scoring systems to a rapid diagnostic point of care (POC) test result in paediatric patients presenting with sore throat. METHODS: Prospective diagnostic accuracy study conducted between 30 June 2014 and 27 February 2015 in a remote Australian ED using a convenience sample...
April 2016: Emergency Medicine Australasia: EMA
Ulrich Orda, Ronny Gunnarsson, Sabine Orda, Mark Fitzgerald, Geoff Rofe, Anna Dargan
BACKGROUND: Clinical reasoning utilizing certain symptoms and scores has not proven to be a reliable decision-making tool to determine whether or not to suspect a group A Streptococcus (GAS) infection in the patient presenting with a sore throat. Culture as the so-called 'gold standard' is impracticable because it takes 1 to 2 days (and even longer in remote locations) for a result, and thus treatment decisions will be made without the result available. Rapid diagnostic antigen tests have demonstrated sufficient sensitivities and specificities in detecting GAS antigens to identify GAS throat infections...
April 2016: International Journal of Infectious Diseases: IJID
Raziye Dut, Sesin Kocagöz
OBJECTIVES: To evaluate clinical manifestations of acute respiratory system infectious diseases and specific tests for causative agents in pediatric patients. METHODS: The authors evaluated children aged 0-16 y with clinical symptoms of acute respiratory tract infections who were administered rapid strep A test and/or throat culture test and/or respiratory viral panel test, from February 2012 through January 2013 at pediatric department of Acıbadem Maslak Hospital, Turkey...
May 2016: Indian Journal of Pediatrics
Michelle M Tabb, Hollis J Batterman
The Simplexa™ Group A Strep Direct assay is intended for use on the Integrated Cycler for detection of Group A Streptococcus (GAS) directly from throat swabs that have not undergone nucleic acid extraction. A prospective study of 1352 samples in 4 geographically diverse sites showed an overall prevalence of GAS of 15.4%. The assay demonstrated 97.4% sensitivity and 95.2% specificity versus culture. The positive predictive value compared to culture was 72.7%. However, 46 out of 57 discrepant samples were Group A Strep positive when tested using a bi-directional sequencing method illustrating the increased sensitivity of the assay compared to culture for detection of GAS...
2016: Expert Review of Molecular Diagnostics
Luchang Zhu, Randall J Olsen, Waleed Nasser, Ivan de la Riva Morales, James M Musser
UNLABELLED: Strains of emm89 Streptococcus pyogenes have become one of the major causes of invasive infections worldwide in the last 10 years. We recently sequenced the genome of 1,125 emm89 strains and identified three major phylogenetic groups, designated clade 1, clade 2, and the epidemic clade 3. Epidemic clade 3 strains, which now cause the great majority of infections, have two distinct genetic features compared to clade 1 and clade 2 strains. First, all clade 3 organisms have a variant 3 nga promoter region pattern, which is associated with increased production of secreted cytolytic toxins SPN (S...
2015: MBio
Katherine McMurray, Matthew Garber
No abstract text is available yet for this article.
October 2015: Hospital Pediatrics
Jeffrey Howard Walden, Bryan Hess, Michael Rigby
A 7-year-old girl with an unremarkable medical history presented to a local paediatric emergency department with a 7-day history of fever, sore throat and vomiting, and a 1-day history of rash. She was admitted to the hospital, with presumed Kawasaki disease. A few hours after admission, the patient had sudden onset of two witnessed tonic-clonic seizures and subsequent decreased mental status. She was transferred to the paediatric intensive care unit and started on broad-spectrum antibiotics. On hospital day 2, cerebral spinal fluid cultures and blood cultures grew Streptococcus pyogenes, and repeat physical examination was consistent with acute streptococcal pharyngitis...
2015: BMJ Case Reports
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