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Rapid streptococcal tests

Erin Shanker, Donald A Morrison, Antoine Talagas, Sylvie Nessler, Michael J Federle, Gerd Prehna
Natural transformation, or competence, is an ability inherent to bacteria for the uptake of extracellular DNA. This process is central to bacterial evolution and allows for the rapid acquirement of new traits, such as antibiotic resistance in pathogenic microorganisms. For the Gram-positive bacteria genus Streptococcus, genes required for competence are under the regulation of quorum sensing (QS) mediated by peptide pheromones. One such system, ComRS, consists of a peptide (ComS) that is processed (XIP), secreted, and later imported into the cytoplasm, where it binds and activates the transcription factor ComR...
December 2016: PLoS Pathogens
Salaheldin M Elhamamsy, Mazen O Al-Qadi, Taro Minami, Marguerite Neill
INTRODUCTION: Toxic shock syndrome occurs from dysregulation of host inflammatory responses. Toxin- producing strains of Group A streptococcus cause TSS. Ischemic optic neuropathy rarely complicates septic shock. We present a rare case of streptococcal pharyngitis complicated by septic arthritis and TSS with reversible blindness due to non-arteritic ischemic optic neuropathy. CASE: A 28-year-old man drove to our ED with exudative pharyngitis. A rapid streptococcal test was positive...
December 1, 2016: Rhode Island Medical Journal
Si Cheng, Jie Sun, Junxing Yang, Jianqiang Lv, Feng Wu, Yanxing Lin, Lishan Liao, Yiyou Ye, Chenfu Cao, Liurong Fang, Qunyi Hua
A fast and ultrasensitive test-strip system combining quantum dots (QDs) with a lateral-flow immunoassay strip (LFIAS) was established for detection of Peste des petits ruminants virus (PPRV) antibody. The highly luminescent water-soluble carboxyl-functionalized QDs were used as the signal output and were conjugated to streptococcal protein G (SPG), which was capable of binding to immunoglobulin G (IgG) from many species through an amide bond to capture the target PPRV IgGs. The PPRV N protein, which was immobilized on the detection zone of the test strip, was expressed by transfecting recombinant Bacmid-PPRV-N with Lipofect into Sf9 insect cells...
October 25, 2016: Analytical and Bioanalytical Chemistry
Christina Clarke, Louise O'Connor, Heather Carré-Skinner, Olaf Piepenburg, Terry J Smith
BACKGROUND: Despite the implementation of prevention guidelines, group B Streptococcal (GBS) infection remains a leading cause of sepsis, pneumonia, and meningitis, resulting in significant neonatal morbidity and mortality. Preventive approaches that identify women at risk of transmitting GBS have reduced the incidence of neonatal GBS disease, and dramatically decreased the associated mortality rates. However, there is an on-going requirement for a near-patient diagnostic test for GBS that can be carried out at the time of delivery, ideally in the labour ward setting, particularly for women of unknown GBS colonisation status at the time of delivery...
2016: BMC Microbiology
Connie Zhang, Richard M Haber
Perineal streptococcal dermatitis (PSD) is largely known to be caused by group A β-hemolytic Streptococcus (GAS). We would like to bring cases of non-GAS PSD to the attention of dermatologists, as there are implications for workup and therapy. We report 3 pediatric cases of PSD: 1 caused by GAS, 1 caused by group B β-hemolytic Streptococcus (GBS), and 1 associated with group C β-hemolytic Streptococcus (GCS). GBS and GCS are very rarely reported in pediatric cases of PSD. The literature on non-GAS PSD is reviewed, which additionally revealed several instances of PSD caused by group G β-hemolytic Streptococcus (GGS) and Staphylococcus aureus GBS, GCS, GGS, and S aureus are significant causes of PSD to consider, particularly among adult patients, based on our encountered cases and the literature...
September 14, 2016: Journal of Cutaneous Medicine and Surgery
Carla Penney, Robert Porter, Mary O'Brien, Peter Daley
Background. Acute pharyngitis caused by Group A Streptococcus (GAS) is a common presentation to pediatric emergency departments (ED). Diagnosis with conventional throat culture requires 18-24 hours, which prevents point-of-care treatment decisions. Rapid antigen detection tests (RADT) are faster, but previous reports demonstrate significant operator influence on performance. Objective. To measure operator influence on the diagnostic accuracy of a RADT when performed by pediatric ED nurses and clinical microbiology laboratory technologists, using conventional culture as the reference standard...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
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
Bobbi S Pritt, Robin Patel, Thomas J Kirn, Richard B Thomson
Nucleic acid amplification tests (NAATs) have frequently been the standard diagnostic approach when specific infectious agents are sought in a clinic specimen. They can be applied for specific agents such as S. pyogenes, or commercial multiplex NAATs for detection of a variety of pathogens in gastrointestinal, bloodstream, and respiratory infections may be used. NAATs are both rapid and sensitive. For many years, S. pyogenes testing algorithms used a rapid and specific group A streptococcal antigen test to screen throat specimens, followed, in some clinical settings, by a throat culture for S...
October 2016: Journal of Clinical Microbiology
Monica G Kalra, Kim E Higgins, Evan D Perez
Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and early spring. The strongest independent predictors of GABHS pharyngitis are patient age of five to 15 years, absence of cough, tender anterior cervical adenopathy, tonsillar exudates, and fever. To diagnose GABHS pharyngitis, a rapid antigen detection test should be ordered in patients with a modified Centor or FeverPAIN score of 2 or 3. First-line treatment for GABHS pharyngitis includes a 10-day course of penicillin or amoxicillin...
July 1, 2016: American Family Physician
Anna L Kenchington, Ronald F Lamont
INTRODUCTION: Early onset neonatal Group B streptococcal disease is preventable. Intrapartum antibiotic prophylaxis has resulted in a significant reduction in neonatal mortality and morbidity. National guidelines for the selection of women eligible for intrapartum antibiotic prophylaxis, whether screening-based or risk-based, differ according to the local burden of disease. Despite the introduction of intrapartum antibiotic prophylaxis, there remains a significant burden of disease, which can be resolved by better adherence to guidelines, rapid identification of maternal colonization or in the future, vaccination...
July 6, 2016: Expert Review of Vaccines
Abdul Namugongo, Joel Bazira, Yarine Fajardot, Ngonzi Joseph
Objectives. This study sought to determine the prevalence and factors associated with group B streptococcal anogenital colonization among pregnant women attending antenatal care at Mbarara Regional Referral Hospital, a tertiary hospital. Methods. Cross-sectional study where 309 pregnant women ≥ thirty-five weeks of gestation attending antenatal clinic were consecutively recruited between January and March 2015. Anovaginal swabs were collected and tested qualitatively using rapid visual immunoassay GBS test kits for presence of GBS antigens...
2016: International Journal of Microbiology
Donald G Klepser, Michael E Klepser, Allison M Dering-Anderson, Jacqueline A Morse, Jaclyn K Smith, Stephanie A Klepser
OBJECTIVES: To describe patient outcomes associated with a community pharmacy-based, collaborative physician-pharmacist group A Streptococcus (GAS) management program. SETTING: Fifty-five chain and independent community pharmacies in Michigan, Minnesota, and Nebraska. PRACTICE INNOVATION: Pharmacists screened clinically stable adult patients who presented with signs and symptoms consistent with GAS pharyngitis from October 1, 2013, to August 1, 2014, by means of Centor criteria, and performed a physical assessment followed by a rapid antigen detection test (RADT) for eligible patients...
May 2016: Journal of the American Pharmacists Association: JAPhA
Engin Kose, Seda Sirin Kose, Deniz Akca, Kerem Yildiz, Cengizhan Elmas, Mustafa Baris, Murat Anil
We aimed to investigate the effect of rapid antigen detection test (RADT) in the diagnosis of streptococcal pharyngitis, its impact on antibiotic prescription decision of pediatricians and influence on reduction of antibiotic treatment costs in children with pharyngitis. The study group consisted of 223 patients who were diagnosed with pharyngitis by pediatricians. The sensitivity and specificity of RADT were 92.1% (95% Cl: 78.6-98.3%) and 97.3% (95% Cl: 93.8-99.1%), respectively. In the first assessment, before performing RADT, pediatricians decided to prescribe antibiotics for 178 (79...
August 2016: Journal of Tropical Pediatrics
Saloni Katoch, Ravindra Kallappa, Murugesh B Shamanur, Sneha Gandhi
Purpura fulminans (PF) is a descriptive term used to describe a heterogeneous group of disorders characterized by rapidly progressive purpuric lesions that may develop into extensive areas of skin necrosis, and peripheral gangrene. This rare disorder is associated with laboratory evidence of consumptive coagulopathy and is often fatal. PF is usually associated with many infections, most notably with meningococcal, staphylococcal, and streptococcal infections. However, there are very few reports of this entity with spotted fever and scrub typhus from India...
January 2016: Indian Dermatology Online Journal
Rosângela Stadnick Lauth de Almeida Torres, Talita Zajac dos Santos, Robson Antônio de Almeida Torres, Lygia Maria Coimbra de Manuel Petrini, Marion Burger, Andrew C Steer, Pierre R Smeesters
BACKGROUND: Conflicting recommendations regarding antibiotic prophylaxis for contacts of patients with invasive group A streptococcal (GAS) infection exist. Close contacts of patients with such severe and rapidly progressive disease often strongly appeal to the treating clinicians for antimicrobial treatment to prevent additional cases. We aimed to use an approach based on pharyngeal culture testing of contacts and targeted antibiotic prophylaxis. METHODS: A large throat swab survey including 105 contacts was undertaken after a fulminant and fatal case of GAS necrotizing fasciitis...
March 2016: Journal of the Pediatric Infectious Diseases Society
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
Vincent Gazzano, Anne Berger, Yvonne Benito, Anne-Marie Freydiere, Anne Tristan, Sandrine Boisset, Anne Carricajo, Claire Poyart, François Vandenesch, Ghislaine Descours
Rapid antigen detection tests (RADTs) for group A streptococci (GAS) are widely used for diagnosing acute pharyngitis, which has led to a considerable reduction in antibiotic prescriptions over the past decade. Beyond this intended use, their reassessment on invasive samples may be relevant in the management of life-threatening GAS infections. To this end, we evaluated the performances of three RADTs, culture, GAS PCR, and 16S rRNA gene PCR assays, and compared them with a composite gold standard (GAS-PCR assay and/or culture) for the diagnosis of severe GAS infection...
April 2016: Journal of Clinical Microbiology
Aaron M Harris, Lauri A Hicks, Amir Qaseem
BACKGROUND: Acute respiratory tract infection (ARTI) is the most common reason for antibiotic prescription in adults. Antibiotics are often inappropriately prescribed for patients with ARTI. This article presents best practices for antibiotic use in healthy adults (those without chronic lung disease or immunocompromising conditions) presenting with ARTI. METHODS: A narrative literature review of evidence about appropriate antibiotic use for ARTI in adults was conducted...
March 15, 2016: Annals of Internal Medicine
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
César García-Vera, Bárbara de Dios Javierre, Beatriz Castán Larraz, Teresa Arana Navarro, Teresa Cenarro Guerrero, Rafael Ruiz Pastora, Javier Sánchez Gimeno
AIM: To describe the age, signs and clinical symptoms of children with scarlet fever at the present time, and to check whether they are equivalent to those with traditional streptococcal pharyngotonsillitis. STUDY DESIGN: An observational, retrospective study was conducted on the clinical records of 5500 children aged from 0 to 15 years attending a primary health care center. A record was made of the percentage of the cases in which signs and symptoms appear and the Centor score was calculated...
August 2016: Enfermedades Infecciosas y Microbiología Clínica
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