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Should Culture Be Replaced?

Theresa A. Schlager, MD; Gregory A. Hayden, MD; William A. Woods, MD; Sharon M. Dudley, MT; J. Owen Hendley, MD

Arch Pediatr Adolesc Med. 1996;150(3):245-248.

Abstract
Objective
To evaluate an optical immunoassay rapid antigen test to detect group A β-hemolytic streptococci directly from throat swab specimens.

Design
Criterion standard with "blinded" comparison. Double-swab pharyngeal samples were obtained; one swab was cultured and the other was used for the rapid antigen test.

Setting
Microbiology laboratory in a primary care center at a university teaching hospital.

Patients
Two hundred sixty-two outpatients with pharyngitis.

Main Outcome Measure
The results of the optical immunoassay rapid antigen test were compared with results of standard aerobic culture.

Results
Sixty-two (24%) of 262 samples were culture-positive; 48 of these 62 were positive by the optical immunoassay rapid test (sensitivity, 77%). Of the 200 culture-negative samples, seven (4%) were positive by the rapid test (specificity, 96%).

Conclusion
The optical immunoassay performed well, but like other rapid tests, is not sensitive enough to replace standard culture for detection of group A β-hemolytic streptococci.

(Arch Pediatr Adolesc Med. 1996;150:245-248)

Author Affiliations
From the Department of Pediatrics, University of Virginia Medical Center, Charlottesville.

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