This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fox, J. W.
Right arrow Articles by Bonsu, B. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fox, J. W.
Right arrow Articles by Bonsu, B. K.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, November 2006, p. 3918-3922, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.01399-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Performance of Rapid Streptococcal Antigen Testing Varies by Personnel{triangledown}

James W. Fox,1* Daniel M. Cohen,2 Mario J. Marcon,3 William H. Cotton,4 and Bema K. Bonsu2

Department of Pediatrics, Division of Emergency Medicine, Children's Hospital of Akron, Akron, Ohio,1 Department of Pediatrics, Divisions of Emergency Medicine,2 Laboratory Medicine,3 Ambulatory Pediatrics, Children's Hospital, Columbus, Ohio4

Received 6 July 2006/ Returned for modification 30 July 2006/ Accepted 30 August 2006

Rapid carbohydrate antigen tests are frequently used to diagnose group A streptococcal (GAS) pharyngitis. Despite evidence of modest sensitivity in medical settings, rapid antigen tests are available to the public for self-testing. We sought to determine if the personnel performing a rapid streptococcal antigen test influence the test's performance characteristics. Throat swabs of pediatric patients performed for GAS pharyngitis in a tertiary-care children's hospital network were included during two study periods in 2004 and 2005. The performance characteristics of a rapid carbohydrate antigen test were evaluated in three clinical settings against a nucleic acid probe test method according to the personnel performing the test (laboratory technologist versus nonlaboratory personnel). Between the study periods, nonlaboratory personnel from one site underwent retraining. Subsequently, the performance characteristics of the rapid antigen test were reassessed. The sensitivity of the rapid antigen test varied widely among the different testing sites (56 to 90%). Notably, test sensitivity was consistently greater when the test was performed by laboratory technologists than when it was performed by nonlaboratory personnel (P < 0.0001). Although the rapid antigen test sensitivity significantly improved after nonlaboratory personnel at one testing site were retrained (sensitivity before versus after retraining; P < 0.0001), the sensitivity remained greater in the laboratory technologist cohort (P < 0.0001). These data confirm the important relationship of the operator performing a rapid streptococcal antigen test with the test's accuracy, even in a clinical setting, where operator training is mandated. Therefore, its use outside the medical setting by lay persons cannot be recommended without culture backup.

* Corresponding author. Mailing address: Children's Hospital of Akron, Division of Emergency Medicine, One Perkins Square, Akron, OH 44308. Phone: (330) 543-8452. Fax: (801) 729-0466. E-mail: jfox{at}chmca.org.

{triangledown} Published ahead of print on 13 September 2006.

Journal of Clinical Microbiology, November 2006, p. 3918-3922, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.01399-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Maltezou, H. C., Tsagris, V., Antoniadou, A., Galani, L., Douros, C., Katsarolis, I., Maragos, A., Raftopoulos, V., Biskini, P., Kanellakopoulou, K., Fretzayas, A., Papadimitriou, T., Nicolaidou, P., Giamarellou, H. (2008). Evaluation of a rapid antigen detection test in the diagnosis of streptococcal pharyngitis in children and its impact on antibiotic prescription. J Antimicrob Chemother 62: 1407-1412 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»