AI Article Synopsis
- The study aimed to determine how likely it is that finding Streptococcus pyogenes in throat swabs indicates it causes sore throats, and how this varies by age, carrier rates, and climate.
- A meta-analysis was performed using data from 15 studies, determining the positive and negative etiologic predictive values (P-EPV and N-EPV) for both children and adults with sore throats.
- Results showed a strong P-EPV for adults (92%) and a significant increase for children (83%) when patients showed 3-4 Centor criteria, while negative swabs effectively ruled out S. pyogenes for both groups.
Article Abstract
Objectives: The objective was to estimate the probability that finding a Streptococcus pyogenes (Group A Streptococcus) in a throat swab in a patient with a sore throat reflects the aetiology. We also investigated to what extent this is influenced by age, carrier rates of S. pyogenes and climate zone.
Methods: We conducted a comprehensive search of Medline and Scopus up until October 2023 for case-control studies reporting the prevalence of S. pyogenes in patients with a sore throat and healthy controls. We only included studies with separate data for children and adults. We used the positive and negative etiologic predictive values (P-EPV and N-EPV) to estimate the probability of a link between a sore throat and a finding of S. pyogenes.
Results: We included 15 studies in our meta-analysis. The overall P-EPV for children and adults were 63% (49-74%) and 92% (87-95%), respectively. The P-EPV rose to 83% (64-93%) for children and 94% (90-97%) for adults when only patients with 3-4 Centor criteria were included. The overall N-EPV was 97% (96-98%) for children and 96% (95-97%) for adults.
Conclusion: Detecting S. pyogenes in adult patients with an uncomplicated acute sore throat is useful to rule in S. pyogenes as the likely aetiologic agent. The P-EPV significantly increased for children when those with 3-4 Centor criteria were selected. A negative throat swab is always useful for both children and adults to rule out S. pyogenes as the cause of sore throat.
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| http://dx.doi.org/10.1016/j.ijid.2024.107100 | DOI Listing |
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