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Overview:
Isolate and identify group A ß-hemolytic streptococci; establish the diagnosis of strep throat.
Rheumatic fever remains a concern in the United States and serious complications including sepsis, soft tissue invasion, and toxic shock-like syndrome have been reported to be increasing in frequency;1 therefore, timely diagnosis and early institution of appropriate therapy remains important. Timely therapy may reduce the acute symptoms and overall duration of streptococcal pharyngitis. The sequelae of poststreptococcal glomerulonephritis and rheumatic fever are diminished by early therapy.
As group A streptococci are uniformly susceptible to penicillin, there is no indication for monitoring susceptibility to penicillin and the emergence of resistance. Susceptibility testing is not routinely performed.
1. Givner LB, Abramson JS, Wasilauskas B. Apparent increase in the incidence of invasive group A beta-hemolytic streptococcal disease in children. J Pediatr. 1991 Mar; 118(3):341-346. PubMed 1999773
Facklam RR. Specificity study of kits for detection of group A streptococci directly from throat swabs. J Clin Microbiol, 1987; 25(3):504-8. PubMed 3553226
Kaplan EL. The rapid identification of group A beta-hemolytic streptococci in the upper respiratory tract. Current status. Pediatr Clin North Am. 1988 Jun; 35(3):535-542. PubMed 3287313
Nadler HL. Group A strep detection. Diagn Clin Test. 1989; 27(3):35-41 (review of rapid methods). Rapid diagnostic tests for group A streptococcal pharyngitis. Med Lett Drugs Ther. 1991 May 3; 33(843):40-41. PubMed 2014015
Veasy LG, Wiedmeier SE, Orsmond GS, et al. Resurgence of acute rheumatic fever in the intermountain area of the United States. N Engl J Med. 1987; Feb 19; 316(8):421-427. PubMed 3807984
Collection Instructions:
Bacterial swab transport containing Amies gel (preferred) or double dry Dacron swab.
Both tonsillar pillars and the oropharynx should be swabbed. Do not allow the swab to touch the tongue.
Maintain specimen at room temperature.
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