Investigation of the Prevalence of Group A Beta-haemolytic Streptococcus and Efficiency of Streptococcus Rapid Antigen Test in Patients Prediagnosed with Acute Tonsillopharyngitis in a University Hospital

Abstract

Introduction: Acute tonsillopharyngitis is the most important infectious cause of hospital admission in pediatric age groups. The aim of this study was to investigate the prevalence of group A beta-hemolytic streptococci in patients prediagnosed with acute tonsillopharyngitis in a university hospital in Northern Cyprus and determine the effectiveness of Streptococcus rapid antigen test (SRAT) in diagnosis. Materials and Methods: Patients with acute tonsillopharyngitis prediagnosis and admitted to our hospital between September 1, 2015 and December 31, 2017 were retrospectively screened from physical and electronic records. Patients with a throat culture and/or SRAT result were included in the study. Culture method was used as the golden standard. Statistical analysis was performed with SPSS version 13.0 (SPSS Inc., Chicago, IL, USA) programme and p<0.05 was considered statistically significant. Results: The study group included 1,023 patients with acute tonsillopharyngitis prediagnosis and throat culture test. For 508 (49.7%) of patients, both culture and SRAT results were reported. Mean age was 14.5 years (age range 0-89) and there were 506 (49.5%) females and 517 (50.5%) males. Prevalence of disease was detected to be 22.8% in the 5-15 age group and 14.9% in all age groups. Positivity of both SRAT and throat culture tests was statistically significant in the 5-15 age range (p<0.001, p<0.001 respectively). SRAT had a sensitivity of 58% and a specificity of 91%. Positive predictive value and negative predictive value were detected as 54% and 93%, respectively. Conclusion: Our study results represent the first dataset investigating streptococcal tonsillophayngitis and SRAT efficiency in Northern Cyprus. Despite its relatively low sensitivity, due to the high specificity of SRAT, we conclude that it will be beneficial for clinicians in prompt diagnosis and treatment, and will prevent inappropriate antibiotic use.

Keywords

• streprococcus pyogenes
• tonsillitis
• prevalence
• epidemiology
• upper respiratory tract infection