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. 2023 Nov 10;15(11):e48607.
doi: 10.7759/cureus.48607. eCollection 2023 Nov.

Prevalence of Positive Rapid Antigen Detection Test for Group A Streptococcus Among Patients With Respiratory Symptoms in Eastern Province, Kingdom of Saudi Arabia

Nadira A Al-Baghli  1 , Ahmed Al Saif  2 , Shorok A Al Dorazi  1 , Ammar Y Bukhamseen  3 , Mohammed Al Eithan  4 , Amira R Albannai  5 , Zainab A Buhaliqa  6 , Montaser A Bu-Khamseen  7 , Bothaina Alyousef  6 , Ali A Rabaan  8   9   10
Affiliations

Prevalence of Positive Rapid Antigen Detection Test for Group A Streptococcus Among Patients With Respiratory Symptoms in Eastern Province, Kingdom of Saudi Arabia

Nadira A Al-Baghli et al. Cureus. .

Abstract

Background During the COVID-19 pandemic, there was a dramatic upsurge in the prevalence of respiratory symptoms, which may have altered the usual pattern of bacterial infections and relevant decision-making. Objectives This study aimed to investigate the prevalence of rapid antigen detection test (RADT) positivity for group A Streptococcus (GAS) in patients with respiratory symptoms and signs during the COVID-19 pandemic. In addition, we evaluated the association between a positive test and the modified Centor criteria in a population of children and adults with upper respiratory tract infections (URTIs). Methods A prospective study was conducted in primary health care centres (PHCCs) and the paediatric emergency department (ED) of the Maternity and Children Hospital in Dammam City, Kingdom of Saudi Arabia (KSA). Trained physicians collected data from patients aged three years and older or their guardian(s) regarding URTI symptoms. The modified Centor score was calculated, and RADT was performed for all patients. Results Data were collected from 469 patients. The prevalence of positive RADT was 19 (4.1%), and the setting was associated with RADT positivity, as 14% of ED visitors tested positive compared with 0.6% of PHCC visitors. The RADT results had an area under the curve of 0.856 (95% confidence interval (CI)=0.774-0.939), with Centor scores of 2 and 3 having a sensitivity of 89.5%/78.9% and specificity of 70.6%/80.8%, respectively. Individuals with a score of 5 had the highest rate of positive RADT (33.3%, P<0.001); a score less than 0 excluded the possibility of GAS infection. Conclusion The Centor score can improve effective antibiotic prescribing; however, Centor scores ≥2 should be supplemented with an additional confirmatory test. The high specificity of RADT makes it a useful tool in preventing the prescription of unneeded antibiotics.

Keywords: centor score; group a streptococcal pharyngitis; radt; saudi arabia; urti.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Percentage of positive RADTs according to the Centor score
Figure 2
Figure 2. Performance of the Centor criteria in predicting positive rapid antigen detection tests (RADTs)
ROC: receiver operating characteristic
See this image and copyright information in PMC

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