Comparison of Alere i Strep A Rapid Molecular Assay With Rapid Antigen Testing and Culture in a Pediatric Outpatient Setting

Elizabeth P Weinzierl; Robert C Jerris; Mark D Gonzalez; Julie A Piccini; Beverly B Rogers

doi:10.1093/ajcp/aqy038

Comparison of Alere i Strep A Rapid Molecular Assay With Rapid Antigen Testing and Culture in a Pediatric Outpatient Setting

Am J Clin Pathol. 2018 Jul 31;150(3):235-239. doi: 10.1093/ajcp/aqy038.

Authors

Elizabeth P Weinzierl^{1

2

3}, Robert C Jerris^{1

2

3}, Mark D Gonzalez^{1

2

3}, Julie A Piccini^{1

2}, Beverly B Rogers^{1

2

3}

Affiliations

¹ Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA.
² Department of Laboratory Medicine, Children's Healthcare of Atlanta, Atlanta, GA.
³ Emory University School of Medicine, Atlanta, GA.

PMID: 29931106
DOI: 10.1093/ajcp/aqy038

Abstract

Objectives: Group A Streptococcus (GAS) is the most common bacterial cause of pediatric acute pharyngitis, and its quick identification is important for subsequent treatment. We sought to determine whether molecular GAS-based testing can successfully replace GAS antigen testing and subsequent culture in a pediatric urgent care center.

Methods: We tested 160 patient oropharyngeal samples by a rapid antigen GAS test, the Alere i Strep A test, and throat culture in a pediatric urgent care setting and calculated basic statistical metrics.

Results: The sensitivity and specificity of the molecular test were 98% and 100%, respectively, compared with culture. There was a 9% false-positive rate with the rapid antigen-based testing.

Conclusions: The Alere test is sufficiently sensitive and specific for definitive GAS testing in a pediatric urgent care setting. This implementation has enabled us to provide definitive patient results at the time of each patient encounter.

Keywords: Alere; Culture; GAS; Group A Streptococcus; Molecular; Pediatric; Pharyngitis; Rapid antigen.