EVALUATING THE EFFECTIVENESS OF THE RAPID TEST AND CENTOR SCALE FOR DETERMINING THE CAUSE OF ACUTE TONSILLITIS

Kravets N. Ya., Klymnyuk S. I.

EVALUATING THE EFFECTIVENESS OF THE RAPID TEST AND CENTOR SCALE FOR DETERMINING THE CAUSE OF ACUTE TONSILLITIS


Show/Download

About the author:

Kravets N. Ya., Klymnyuk S. I.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Inflammation of the tonsils is one of the most common diseases of the upper respiratory tract and requires timely diagnosis and appropriate treatment. Acute tonsillitis is an inflammatory process in the tonsils that can be caused by both viral and bacterial pathogens. Examination of the patient by a doctor is the best method of diagnosis, but this method rarely provides sufficient evidence to determine the aetiology of the pathogen. The Centor clinical scoring system and its modification, Centor/McIsaac, are also used to determine the likelihood of streptococcal infection in patients. Rapid antigen tests are a diagnostic tool that allows testing at the point of care. The aim of our study is to determine the bacterial etiology of tonsillitis using criteria of the patient's clinical condition and the results of the antigen-express test for group A streptococcus. To investigate the bacterial aetiology of tonsillitis, namely the detection of Group A Streptococcus. A rapid lateral flow immunochromatographic test was used to detect the carbohydrate antigen of Group A Streptococcus in a throat swab. In order to differentiate the bacteriological or viral etiology of the infection according to the anamnestic and clinical symptoms in the value of the sum of points, doctors used the Centor scale, for patients >15 years. The results of these tests showed that a rapid diagnostic test using the Centor criterion ≥ 3 has a high sensitivity and a good negative predictive value, making it useful for detecting upper respiratory tract infections and ruling them out in their absence.

Tags:

clinical symptoms, immunochromatographic test, inflammation, streptococcal group A, throat

Bibliography:

  1. McIsaac WJ, Kellner JD, Aufricht P, Vanjaka A, Low DE. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA. 2004;291(13):1587-95. DOI: 10.1001/jama.291.13.1587.
  2. Roggen I, van Berlaer G, Gordts F, Pierard D, Hubloue I. Centor criteria in children in a paediatric emergency department: for what it is worth. BMJ Open. 2013;3(4):e002712. DOI: 10.1136/bmjopen-2013-002712.
  3. Di Muzio F, Barucco M, Guerriero F. Diagnosis and treatment of acute pharyngitis/tonsillitis: a preliminary observational study in General Medicine. Eur Rev Med Pharmacol Sci. 2016;20(23):4950-4954.
  4. Basile K, Kok J, Dwyer DE. Point-of-care diagnostics for respiratory viral infections. Expert Rev Mol Diagn. 2018;18(1):75-83. DOI: 10.1080/14737159.2018.1419065.
  5. Rohde J, Himmel W, Hofinger C, Lâm TT, Schrader H, Wallstabe J, et al. Diagnostic accuracy and feasibility of a rapid SARS-CoV-2 antigen test in general practice – a prospective multicenter validation and implementation study. BMC Prim Care. 2022;23(1):149. DOI: 10.1186/s12875-022-01756-1.
  6. Sølvik UØ, Boija EE, Ekvall S, Jabbour A, Breivik AC, Nordin G, et al. Performance and user-friendliness of the rapid antigen detection tests QuickVue Dipstick Strep A test and DIAQUICK Strep A blue dipstick for pharyngotonsillitis caused by Streptococcus pyogenes in primary health care. Eur J Clin Microbiol Infect Dis. 2021;40(3):549-558. DOI: 10.1007/s10096-020-04034-z.
  7. Woldan-Gradalska P, Gradalski W, Gunnarsson RK, Sundvall PD, Rystedt K. Is Streptococcus pyogenes a pathogen or passenger in uncomplicated acute sore throat? A systematic review and meta-analysis. Int J Infect Dis. 2024;145:107100. DOI: 10.1016/j.ijid.2024.107100.
  8. Willis BH, Coomar D, Baragilly M. Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds. Br J Gen Pract. 2020;70(693):e245-e254. DOI: 10.3399/bjgp20X708833.
  9. Stefaniuk E, Bosacka K, Wanke-Rytt M, Hryniewicz W. The use of rapid test QuikRead go® Strep A in bacterial pharyngotonsillitis diagnosing and therapeutic decisions. Eur J Clin Microbiol Infect Dis. 2017;36(10):1733-1738. DOI: 10.1007/s10096-017-2986-8.
  10. Azrad M, Danilov E, Goshen S, Nitzan O, Peretz A. Detection of group a Streptococcus in pharyngitis by two rapid tests: comparison of the BD Veritor™ and the QuikRead go® Strep A. Eur J Clin Microbiol Infect Dis. 2019;38(6):1179-1185. DOI: 10.1007/s10096-019-03527-w.
  11. MOZ Ukrayiny. Unifikovanyy klinichnyy protokol pervynnoyi, vtorynnoyi (spetsializovanoyi) ta tretynnoyi (vysokospetsializovanoyi) medychnoyi dopomohy Tonzylit. Kyyiv: MOZ Ukrayiny; 2021. 28 s. Dostupno: https://www.dec.gov.ua/wp-content/uploads/2021/04/2021_639_ykpmd_ tonzylit_dd.pdf. [in Ukrainian].
  12. ESCMID Sore Throat Guideline Group, Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, et al. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012;18(1):1-28. DOI: 10.1111/j.1469-0691.2012.03766.x.
  13. Cardoso DM, Gilio AE, Hsin SH, Machado BM, de Paulis M, Lotufo JP, et al. Impact of the rapid antigen detection test in diagnosis and treatment of acute pharyngotonsillitis in a pediatric emergency room. Rev Paul Pediatr. 2013;31(1):4-9. DOI: 10.1590/s0103- 05822013000100002.
  14. Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Group A β-hemolytic Streptococcal pharyngitis: an updated review. Curr Pediatr Rev. 2024;21(1):2-17. DOI: 10.2174/1573396320666230726145436.
  15. Nibhanipudi KV. Usefulness of leukocyte esterase test versus rapid strep test for diagnosis of acute strep pharyngitis. Glob Pediatr Health. 2015;2:2333794X15599156. DOI: 10.1177/2333794x15599156.
  16. Shaikh N, Swaminathan N, Hooper EG. Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: a systematic review. J Pediatr. 2012;160:487-493. DOI: 10.1016/j.jpeds.2011.09.011.
  17. Agarwal M, Raghuwanshi SK, Asati DP. Antibiotic use in sore throat: are we judicious? Indian J Otolaryngol Head Neck Surg. 2015;67(3):267- 70. DOI: 10.1007/s12070-015-0864-1.
  18. Mendes N, Miguéis C, Lindo J, Gonçalves T, Miguéis A. Retrospective study of group A Streptococcus oropharyngeal infection diagnosis using a rapid antigenic detection test in a paediatric population from the central region of Portugal. Eur J Clin Microbiol Infect Dis. 2021;40(6):1235-1243. DOI: 10.1007/s10096-021-04157-x.
  19. Araujo Filho BC, Imamura R, Sennes LU, Sakae FA. Role of rapid antigen detection test for the diagnosis of group-A beta-hemolytic streptococcus in patients with pharyngotonsillitis. Braz J Otorhinolaryngol. 2006;72(1):12-5. DOI: 10.1016/s1808-8694(15)30027-6.
  20. Pontin IP, Sanchez DC, Di Francesco R. Asymptomatic Group A Streptococcus carriage in children with recurrent tonsillitis and tonsillar hypertrophy. Int J Pediatr Otorhinolaryngol. 2016;86:57-9. DOI: 10.1016/j.ijporl.2016.03.044.
  21. Maltezou HC, Tsagris V, Antoniadou A, Galani L, Douros C, Katsarolis I, et al. Evaluation of a rapid antigen detection test in the diagnosis of streptococcal pharyngitis in children and its impact on antibiotic prescription. J Antimicrob Chemother. 2008;62(6):1407-12. DOI: 10.1093/ jac/dkn376.
  22. Forward KR, Haldane D, Webster D, Mills C, Brine C, Aylward D. A comparison between the Strep A Rapid Test Device and conventional culture for the diagnosis of streptococcal pharyngitis. Can J Infect Dis Med Microbiol. 2006;17(4):221-3. DOI: 10.1155/2006/696018.

Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 1, 176, 219-226 pages, index UDC 616.322:094

DOI:

10.29254/2077-4214-2025-1-176-219-226

Was this article helpful?

Leave a Reply

Your email address will not be published. Required fields are marked *


The reCAPTCHA verification period has expired. Please reload the page.