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Rapid Antigen Test for the Detection of Group A Β-Hemolytic Streptococcus in Children

Yıl 2024, Cilt: 19 Sayı: 2, 1 - 4, 22.07.2024
https://doi.org/10.17517/ksutfd.1231824

Öz

Objective: Group A beta-hemolytic streptococci (GGBHS) are an important cause of upper respiratory tract infections in children. Since the symptoms of upper respiratory tract infection due to GGBHS are similar to the symptoms due to other infectious agents, laboratory tests are very important in their differentiation. In our study, the positivity of the Rapid antigen test (RAT) used in the diagnosis of GGBHS in children according to age and season was investi-gated.
Material and methods: In our study, throat swab samples from 1490 pediatric patients who were requested to have RAT for the determination of GGBHS between 01.01.2020-01.01.2022 from our hospital's outpatient clinic, emergency service, and inpatient services to our laboratory were evaluated retrospectively according to age and season. Throat swab samp-les were evaluated as GGBHS positive or GGBHS negative by microcult strep A rapid test (Biotech, China).
Results: 145 (9.73%) of 1490 throat swab samples included in the study were found to be positive for GGBHS with HAT.31 (5.76%) of 538 patients aged 3 years and younger, 53 (11.20%) of 473 patients aged 4-6 years, 39 (14.55%) of 268 patients aged 7-9 years, 10-12 years old GGBHS positivity was detected in 13 (11.50%) of 113 patients and 9 (9.18%) of 98 patients over 12 years of age. When RAT positivity was analyzed according to the sea-sons, both the number of patients in whom RAT was studied (58.79%) and RAT positivity (13.58%) were found to be the highest in winter. The second highest positivity following the winter season was determined as spring (6.16%). According to age range, RAT positivity was found to be highest in the 7-9 age range in winter, while it was found in children over 12 years of age in all other seasons.
Conclusion: GGBHS has an important place among the agents of acute upper respiratory tract infections. In our study, GGBHS was found more frequently in winter than in other seasons, and it was found to be more common in children aged 7-9 years in winter.
It was concluded that the use of rapid antigen tests in the diagnosis of GGBHS will contribu-te to both the prevention of antibiotic resistance due to unnecessary antibiotic use and the pre-vention of increasing costs.

Kaynakça

  • ESCMID Sore Throat Guideline Group; Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, Verheij T. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012 Apr;18 Suppl 1:1-28. doi: 10.1111/j.1469-0691.2012.03766.x. PMID: 22432746.
  • Pallon J, Sundqvist M, Hedin KA. 2‐year follow‐up study of patients with pharyngotonsillitis. BMC Infect Dis 2018;18:3.
  • Lean WL, Arnup S, Danchin M, Steer AC. Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis. Pediatrics. 2014;134(4):771-781.
  • Cohen JF, Bertille N, Cohen R, Chalumeau M. Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Database Syst Rev. 2016;7(7):CD010502. Published 2016 Jul 4.
  • Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. 2012. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis 55:1279–1282.
  • Medscape [Internet]. New York (NY): WebMD, LLC. Group A Streptococcal (GAS) infections; 2017 Aug 8 [cited 2018 Apr 20].
  • Diseases caused by Group A strep [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. 2016 Sep 16 [cited 2018 Apr 20].
  • Point of care testing for streptococcal sore throat: A review of diagnostic accuracy, cost-effectiveness, and guidelines [Internet]. Ottawa: CADTH; 2009 Apr 24. [cited 2018 Apr 20]. (CADTH Health Technology Inquiry Service).
  • Abraham T, Sistla S. Identification of Streptococcus pyogenes - Phenotypic tests vs molecular assay (spy1258PCR): A comparative study. J Clin Diagn Res [Internet]. 2016 Jul [cited 2018 Apr 20];10(7):DC01–DC03.
  • Sims Sanyahumbi A, Colquhoun S, Wyber R, Carapetis JR. Global Disease Burden of Group A Streptococcus. In: Ferretti JJ, Stevens DL, Fischetti VA, eds. Streptococcus pyogenes: Basic Biology to Clinical Manifestations. Oklahoma City (OK): University of Oklahoma Health Sciences Center;2016; February 10.
  • Breese BB, Disney FA. 1954. The accuracy of diagnosis of beta streptococcal infections on clinical grounds. J Pediatr 44:670–673.
  • Van Brusselen D, Vlieghe E, Schelstraete P, De Meulder F, Vandeputte C, Garmyn K, et al. Streptococcal pharyngitis in children: to treat or not to treat? Eur J Pediatr. 2014 Oct;173(10):1275–83.
  • Kucuk O, Bicer S, Giray T, Col D, Erdag GC, Gurol Y, et al. Validity of rapid antigen detection testing in group A beta-hemolytic streptococcal tonsillopharyngitis. Indian J Pediatr. 2014 Feb;81(2):138–42.
  • Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis. Pediatrics. 2010;126(3):e557-e564.
  • Stürenburg E, Junker R. The Advantages and Disadvantages of Immunochromatographic Test Strips. Dtsch Arztebl Int 2009;106(4): 48-54.
  • Milletli-Sezgin F, Ünlü E. Evaluation of rapid antigen test in child patients with group A streptococcal tonsillopharyngitis. Turk Hij Den Biyol Derg, 2019; 76(3): 329-334
  • Barış A, Anlıaçık N , Bulut ME, Deniz R, Yücel E, Elif Aktaş E. A Grubu Beta-Hemolitik Streptokok Farenjiti Tanısında Mascia Brunelli Hızlı Antijen Testinin Değerlendirilmesi. Mikrobiyol Bul 2017; 51(1): 73-78.
  • Davies HD, McGeer A, Schwartz B, Green K, Cann D, Simor AE, Low DE. Invasive group A streptococcal infections in Ontario, Canada. Ontario Group A Streptococcal Study Group. N Engl J Med. 1996 Aug 22;335(8):547-54. doi: 10.1056/NEJM199608223350803. PMID: 8684408.
  • Wheeler MC, Roe MH, Kaplan EL, Schlievert PM, Todd JK. Outbreak of group A streptococcus septicemia in children. Clinical, epidemiologic, and microbiological correlates. JAMA. 1991 Jul 24-31;266(4):533-7. PMID: 2061980.
  • Akar A, Kuyucu N. Üç yaşından küçük çocuklarda A Grubu Β-Hemolitik Streptokok tonsillofarenjiti sıklığı. Mersin Univ Saglık Bilim Derg 2018;11(3).
  • Arıkan K, Biten Güven G. Çocuklarda A grubu beta hemolitik streptokok enfeksiyonları; yıllara ve yaş gruplarına göre değişimi. J Pediatr Inf 2021;15(3):135- 140.
  • Hervás D, Hervás-Masip J, Ferrés L, Ramírez A, Pérez JL, Hervás JA. Efects of meteorologic factors and schooling on the seasonality of group A streptococcal pharyngitis. Int J Biometeorol. 2016;60(5):763–9.
  • Klug TE. Incidence and microbiology of peritonsillar abscess: the infuence of season, age, and gender. Eur J Clin Microbiol Infect Dis. 2014;33(7):1163–7.
  • Andersson M, Pallon J, Olof Cronberg O, Sundqvist M, Hedin K. Seasonal variations in use and outcome of rapid antigen detection tests and cultures in pharyngotonsillitis: a register study in primary care. BMC Infect Dis 2021; 21:1104

Çocuklarda A Grubu Β-Hemolitik Streptokok Tespitinde Hızlı Antijen Testi.

Yıl 2024, Cilt: 19 Sayı: 2, 1 - 4, 22.07.2024
https://doi.org/10.17517/ksutfd.1231824

Öz

Amaç: A grubu beta hemolitik streptokok (AGBHS), çocuklarda üst solunum yolu enfeksiyonlarının önemli etkenlerindendir. AGBHS’lara bağlı üst solunum yolu enfeksiyon semptomları diğer enfeksiyon etkenlerine bağlı gelişen semptomlara benzemesinden dolayı ayrımlarında laboratuvar testleri çok önemlidir. Çalışmamızda, çocuklarda AGBHS tanısında kullanılan Hızlı antijen testi (HAT)’nin yaş ve mevsimlere göre pozitifliği araştırıldı.
Gereç ve Yöntemler: Çalışmamız 01.01.2020-01.01.2022 tarihleri arasında hastanemiz poliklinik, acil servis ve yataklı servislerinden laboratuvarımıza AGBHS tayini için HAT istemi yapılan 1490 çocuk hastadan boğaz sürüntüsü örneği, yaş ve mevsimlere göre retrospektif olarak değerlendirildi. Boğaz sürüntü örnekleri microcult strep A rapid testi (Biotech,China) ile AGBHS pozitif veya AGBHS negatif olarak değerlendirildi.
Bulgular: Çalışmaya dahil edilen 1490 boğaz sürüntü örneğinin 145’inde (%9.73) HAT ile AGBHS pozitif olarak saptandı. HAT ile 3 yaş ve altı 538 hastanın 31’i (%5.76), 4-6 yaş aralığında 473 hastanın 53’ü (%11.20), 7-9 yaş aralığında 268 hastanın 39’u (%14.55), 10-12 yaş aralığında 113 hastanın 13’ü (%11.50) ve 12 yaş üstü 98 hastanın 9’unda (%9.18) AGBHS pozitifliği saptandı. Mevsimlere göre HAT pozitifliğine bakıldığında, kış mevsiminde hem HAT çalışılan hasta sayısı (%58.79) hem de HAT pozitifliği (%13.58) en yüksek olarak saptandı. Kış mevsimini takiben ikinci en yüksek pozitiflik ilkbahar mevsimi (%6.16) olarak saptandı. Kış mevsiminde yaş aralığına göre HAT pozitifliği 7-9 yaş aralığında en yüksek saptanırken, diğer tüm mevsimlerde 12 yaş üstü çocuklar olarak saptandı.
Sonuç: AGBHS akut üst solunum yolu enfeksiyon etkenleri içinde önemli bir yere sahiptir. Çalışmamızda, kış mevsiminde AGBHS diğer mevsimlere göre daha sık ve kış mevsiminde 7-9 yaş aralığındaki çocuklarda AGBHS daha fazla saptandı. AGBHS tanısında hızlı antijen testinin kullanımının hem gereksiz antibiyotik kullanımına bağlı antibiyotik direnci gelişmesi hem de artan maliyetin önlenmesine katkı sağlayacağı kanaatine varıldı.

Kaynakça

  • ESCMID Sore Throat Guideline Group; Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, Verheij T. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012 Apr;18 Suppl 1:1-28. doi: 10.1111/j.1469-0691.2012.03766.x. PMID: 22432746.
  • Pallon J, Sundqvist M, Hedin KA. 2‐year follow‐up study of patients with pharyngotonsillitis. BMC Infect Dis 2018;18:3.
  • Lean WL, Arnup S, Danchin M, Steer AC. Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis. Pediatrics. 2014;134(4):771-781.
  • Cohen JF, Bertille N, Cohen R, Chalumeau M. Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Database Syst Rev. 2016;7(7):CD010502. Published 2016 Jul 4.
  • Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, et al. 2012. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis 55:1279–1282.
  • Medscape [Internet]. New York (NY): WebMD, LLC. Group A Streptococcal (GAS) infections; 2017 Aug 8 [cited 2018 Apr 20].
  • Diseases caused by Group A strep [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. 2016 Sep 16 [cited 2018 Apr 20].
  • Point of care testing for streptococcal sore throat: A review of diagnostic accuracy, cost-effectiveness, and guidelines [Internet]. Ottawa: CADTH; 2009 Apr 24. [cited 2018 Apr 20]. (CADTH Health Technology Inquiry Service).
  • Abraham T, Sistla S. Identification of Streptococcus pyogenes - Phenotypic tests vs molecular assay (spy1258PCR): A comparative study. J Clin Diagn Res [Internet]. 2016 Jul [cited 2018 Apr 20];10(7):DC01–DC03.
  • Sims Sanyahumbi A, Colquhoun S, Wyber R, Carapetis JR. Global Disease Burden of Group A Streptococcus. In: Ferretti JJ, Stevens DL, Fischetti VA, eds. Streptococcus pyogenes: Basic Biology to Clinical Manifestations. Oklahoma City (OK): University of Oklahoma Health Sciences Center;2016; February 10.
  • Breese BB, Disney FA. 1954. The accuracy of diagnosis of beta streptococcal infections on clinical grounds. J Pediatr 44:670–673.
  • Van Brusselen D, Vlieghe E, Schelstraete P, De Meulder F, Vandeputte C, Garmyn K, et al. Streptococcal pharyngitis in children: to treat or not to treat? Eur J Pediatr. 2014 Oct;173(10):1275–83.
  • Kucuk O, Bicer S, Giray T, Col D, Erdag GC, Gurol Y, et al. Validity of rapid antigen detection testing in group A beta-hemolytic streptococcal tonsillopharyngitis. Indian J Pediatr. 2014 Feb;81(2):138–42.
  • Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis. Pediatrics. 2010;126(3):e557-e564.
  • Stürenburg E, Junker R. The Advantages and Disadvantages of Immunochromatographic Test Strips. Dtsch Arztebl Int 2009;106(4): 48-54.
  • Milletli-Sezgin F, Ünlü E. Evaluation of rapid antigen test in child patients with group A streptococcal tonsillopharyngitis. Turk Hij Den Biyol Derg, 2019; 76(3): 329-334
  • Barış A, Anlıaçık N , Bulut ME, Deniz R, Yücel E, Elif Aktaş E. A Grubu Beta-Hemolitik Streptokok Farenjiti Tanısında Mascia Brunelli Hızlı Antijen Testinin Değerlendirilmesi. Mikrobiyol Bul 2017; 51(1): 73-78.
  • Davies HD, McGeer A, Schwartz B, Green K, Cann D, Simor AE, Low DE. Invasive group A streptococcal infections in Ontario, Canada. Ontario Group A Streptococcal Study Group. N Engl J Med. 1996 Aug 22;335(8):547-54. doi: 10.1056/NEJM199608223350803. PMID: 8684408.
  • Wheeler MC, Roe MH, Kaplan EL, Schlievert PM, Todd JK. Outbreak of group A streptococcus septicemia in children. Clinical, epidemiologic, and microbiological correlates. JAMA. 1991 Jul 24-31;266(4):533-7. PMID: 2061980.
  • Akar A, Kuyucu N. Üç yaşından küçük çocuklarda A Grubu Β-Hemolitik Streptokok tonsillofarenjiti sıklığı. Mersin Univ Saglık Bilim Derg 2018;11(3).
  • Arıkan K, Biten Güven G. Çocuklarda A grubu beta hemolitik streptokok enfeksiyonları; yıllara ve yaş gruplarına göre değişimi. J Pediatr Inf 2021;15(3):135- 140.
  • Hervás D, Hervás-Masip J, Ferrés L, Ramírez A, Pérez JL, Hervás JA. Efects of meteorologic factors and schooling on the seasonality of group A streptococcal pharyngitis. Int J Biometeorol. 2016;60(5):763–9.
  • Klug TE. Incidence and microbiology of peritonsillar abscess: the infuence of season, age, and gender. Eur J Clin Microbiol Infect Dis. 2014;33(7):1163–7.
  • Andersson M, Pallon J, Olof Cronberg O, Sundqvist M, Hedin K. Seasonal variations in use and outcome of rapid antigen detection tests and cultures in pharyngotonsillitis: a register study in primary care. BMC Infect Dis 2021; 21:1104
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Feray Ferda Şenol 0000-0003-4705-5757

Hasan Çetiner 0000-0002-7218-6217

İlkay Bahçeci 0000-0003-3662-1629

Yüksel Akkaya 0000-0002-3167-8055

Özlem Aytaç 0000-0002-3305-6284

Pinar Öner 0000-0001-9592-5986

Zülal Aşçı Toraman 0000-0001-5202-8564

Erken Görünüm Tarihi 11 Temmuz 2024
Yayımlanma Tarihi 22 Temmuz 2024
Gönderilme Tarihi 16 Ocak 2023
Kabul Tarihi 13 Nisan 2023
Yayımlandığı Sayı Yıl 2024 Cilt: 19 Sayı: 2

Kaynak Göster

AMA Şenol FF, Çetiner H, Bahçeci İ, Akkaya Y, Aytaç Ö, Öner P, Aşçı Toraman Z. Çocuklarda A Grubu Β-Hemolitik Streptokok Tespitinde Hızlı Antijen Testi. KSÜ Tıp Fak Der. Temmuz 2024;19(2):1-4. doi:10.17517/ksutfd.1231824