Orlando, FL -- The culprit in bacterial streptococcus pharyngitis, or strep throat, can be vicious. Ask a parent who suspects their child has caught the virus, or the family of 29 Texans, including nine children, who died in 1997 after the bacteria manifested itself into a flesh eating disease. This virulent disorder used to cause physicians to order patients to immediately start taking antibiotics even when a bacterial origin had not been established.

But taking antibiotics when not needed reduces the curative effects of antibiotics. That is why physicians applauded the introduction of the Rapid Streptococcal Antigen Test or the "rapid strep" test. Research indicates that this test, which takes about 20 minutes, is just as accurate as the much slower culture analysis. (If the rapid test is not clearly negative and symptoms exist, a doctor may also perform a regular culture.)

Advocates claim the rapid test is 80 to 90 percent sensitive in detecting group A beta-hemolytic streptococcus in throat swabs and 90 to 95 percent specific in eliminating streptococcal infection as a consideration in rapid test-negative patients. Detection of streptococci by rapid antigen tests or throat culture has consistently been shown to be a cost-effective strategy in the management of sore throat, independent of the issues surrounding antibiotic overuse.

But the leader of a team that developed a rapid test for anthrax exposure has completed an assessment of various testing procedures used in the rapid test and found the results wanting. He suggests that rapid antigen testing lacks sensitivity, negative results require a back-up culture and that its sensitivity may be declining. One alternative is rRNA (ribosomal ribonucleic acid) testing which has enhanced sensitivity but is still not as effective as a culture. His conclusion is that assessing PCR (polymerase chain reaction) using the same principle and diagnostic equipment in a proposed test for anthr
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Contact: Donna Krupa
djkrupa1@aol.com
407-685-4215
American Association for Clinical Chemistry
29-Jul-2002

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