Polymerase chain reaction for Streptococcus pyogenes used to evaluate an optical immunoassay for the detection of group A streptococci in children with pharyngitis

Gustavo Kaltwasser, Jorge Diego, Patricia L. Welby-Sellenriek, Rhonda Ferrett, Michael Caparon, Gregory A. Storch

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background. In evaluations of sensitive rapid tests for group A streptococci such as the optical immunoassay (OIA), some samples are positive by the antigen test but negative by culture. A method is needed for resolving these discrepant results. Objective. To develop a PCR-based assay to detect group A streptococci and to use it to establish a reference standard for evaluating an OIA for group A streptococcal antigen. Methods. A PCR assay that detects a segment of the MF gene of Streptococcus pyogenes was developed for the detection of group A streptococci in throat swabs. Paired swabs were obtained from 200 children with symptomatic pharyngitis and used to perform OIA, agar culture, broth-enhanced culture and PCR. As a reference standard any patient with group A streptococci detected by either culture or PCR was considered to be truly positive. Results. In comparison to agar and broth- enhanced culture procedures, OIA had sensitivities of 82 and 80% and specificities of 87 and 89%, respectively. Eight (44%) of 18 samples that were positive by OIA but negative by culture were positive for group A streptococci by PCR. Compared with the reference standard, sensitivities were OIA 76%, agar culture 79%, broth-enhanced culture 86% and PCR 96%. The specificity of OIA was 92%. Conclusions. PCR can be used to establish a reference standard for evaluating rapid tests for group A streptococci. With this reference standard OIA was nearly as sensitive as but less specific than agar culture for detection of group A streptococci. Maximum detection requires use of both tests.

Original languageEnglish
Pages (from-to)748-753
Number of pages6
JournalPediatric Infectious Disease Journal
Volume16
Issue number8
DOIs
StatePublished - Aug 1 1997
Externally publishedYes

Fingerprint

Pharyngitis
Streptococcus pyogenes
Streptococcus
Immunoassay
Polymerase Chain Reaction
Agar
Antigens
Pharynx

Keywords

  • Group A Streptococcus
  • Optical immunoassay
  • Polymerase chain reaction
  • Streptococcus pyogenes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Polymerase chain reaction for Streptococcus pyogenes used to evaluate an optical immunoassay for the detection of group A streptococci in children with pharyngitis. / Kaltwasser, Gustavo; Diego, Jorge; Welby-Sellenriek, Patricia L.; Ferrett, Rhonda; Caparon, Michael; Storch, Gregory A.

In: Pediatric Infectious Disease Journal, Vol. 16, No. 8, 01.08.1997, p. 748-753.

Research output: Contribution to journalArticle

Kaltwasser, Gustavo ; Diego, Jorge ; Welby-Sellenriek, Patricia L. ; Ferrett, Rhonda ; Caparon, Michael ; Storch, Gregory A. / Polymerase chain reaction for Streptococcus pyogenes used to evaluate an optical immunoassay for the detection of group A streptococci in children with pharyngitis. In: Pediatric Infectious Disease Journal. 1997 ; Vol. 16, No. 8. pp. 748-753.
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abstract = "Background. In evaluations of sensitive rapid tests for group A streptococci such as the optical immunoassay (OIA), some samples are positive by the antigen test but negative by culture. A method is needed for resolving these discrepant results. Objective. To develop a PCR-based assay to detect group A streptococci and to use it to establish a reference standard for evaluating an OIA for group A streptococcal antigen. Methods. A PCR assay that detects a segment of the MF gene of Streptococcus pyogenes was developed for the detection of group A streptococci in throat swabs. Paired swabs were obtained from 200 children with symptomatic pharyngitis and used to perform OIA, agar culture, broth-enhanced culture and PCR. As a reference standard any patient with group A streptococci detected by either culture or PCR was considered to be truly positive. Results. In comparison to agar and broth- enhanced culture procedures, OIA had sensitivities of 82 and 80{\%} and specificities of 87 and 89{\%}, respectively. Eight (44{\%}) of 18 samples that were positive by OIA but negative by culture were positive for group A streptococci by PCR. Compared with the reference standard, sensitivities were OIA 76{\%}, agar culture 79{\%}, broth-enhanced culture 86{\%} and PCR 96{\%}. The specificity of OIA was 92{\%}. Conclusions. PCR can be used to establish a reference standard for evaluating rapid tests for group A streptococci. With this reference standard OIA was nearly as sensitive as but less specific than agar culture for detection of group A streptococci. Maximum detection requires use of both tests.",
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