The test for determining the Streptatest Angina - "Streptatest for the identification of streptococcus group A saved my son from the third course of antibiotics! Streptatest express diagnostic system for determining in vitro B-hemolytic streptococcus group A (Strept.
Last update of description by the manufacturer 13.09.2019
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Pharmacological group
Nonological Classification (ICD-10)
Structure
Purpose
β-hemolytic streptococcus group A is one of the main causative agents of the upper infections respiratory tract, in particular, angina, pharyngitis and scarletins (from 10 to 20% of the angino in adults and from 20 to 40%, the angins in children are caused by the β-hemolytic streptococcus group A). It is important to differentiate infections caused by streptococcus Group A, from other types of infections (for example, viral) to assign the necessary therapy.
The preliminary diagnosis and treatment of infections caused by Streptococcus Group A has reduced the severity of symptoms and the number of such complications such as glomerulonephritis and acute articular rheumatism.
To identify and determine the causative agent traditional methods Requires from 24 to 48 hours.
The immunochromatography method allows you to directly detect the specific antigen of streptococcus group A with a single smear, which, in turn, allows the doctor to immediately diagnose and assign the necessary course of treatment.
Equipment
1. 20, 5 or 2 pack. From aluminum foil with test strips, bag with desiccant.
2. 20, 5 or 2 tampon for taking a smear with marking "CE".
3. 20, 5 or 2 extraction tubes.
4. 20, 5 or 2 lodules with marking "CE".
5. A jar with an extraction reagent A (sodium nitrite 2 m), 10 ml.
6. A jar with extraction reagent B (acetic acid 0.4 m), 10 ml.
7. Annotation.
8. Stand for extraction test tubes *.
9. Control Positive Sample Streptococcus Group A Inactivated, 1 ml **.
10. Controlled negative sample streptococcal group A inactivated, 1 ml **.
* None in products No. 2 and No. 5. For sets No. 2 and No. 5, a special hole on the front side of the package is used as a stand under the tube (simply to swing the designated test tube).
** None in products No. 2 and No. 5 are provided on request.
Operating principle
Streptatest is an immunochromatographic test with a membrane that works on a sandwich principle.
Antibody to the antigen streptococcus group A is fixed in the measured membrane region. The second antibody to the antigen of the streptococcus group A is connected to the purple latex particles and is placed above the membrane immersion zone. Pre-specific antigen streptococcus group A is extracted from a smear with the help of extracting reagents.
Then bottom part Test strips falls into the extraction solution. Specific antigens Streptococcus group A is connected to the antibody marked with latex particles. The mixture moves through the chromatographic system along the membrane, and the complex is fixed in the test zone.
The appearance of a purple strip in this zone indicates a positive result, while its absence is about the negative result. The presence of a purple strip in the control zone means that the test is performed correctly. The absence of this band indicates the unsuitability of the test and improper analysis.
Procedure for analyzing
1. Using the Language Press the language so that saliva does not hit the special tampon. Take a smear with almonds, grooves and all inflamed, ulcerative or exudative zones.
2. It is recommended to test immediately after taking a smear. If it is impossible to implement it immediately, the smear samples can be stored for 4 hours at room temperature (15-30 ° C) in a dry, sterile and hermetically closed container or within 24 hours in the refrigerator (2-8 ° C). If you need to tested another culture at the same time, you should use a new tampon.
3. Immediately before carrying out the test, get a test strip from the bag.
4. Pour 4 drops of an extraction reagent A pink in the extraction tube and add 4 drops of a colorless extracting reagent V. Slightly shake the test tube to mix two solutions. The mixture will change the color with pink to colorless.
5. Lower the tampon in the test tube. About 10 times turn the tampon in the extracting solution. Leave it for 1 min.
6. Press the tampon about the walls of the test tube to remove all the excess liquid. Throw tampon.
7. Lower the test strip into the extraction tube so that the arrows are directed to the extracting solution. Leave a test strip in a test tube.
8. After 5 minutes, you can count the result.
If the concentration of the causative agent of infection is high, then a positive result can manifest itself at the very first minute. Nevertheless, to make sure in the negative result, it is necessary to wait 5 minutes.
Do not take into account the result obtained after 10 minutes.
results
Positive: In the control and test zone there are two colored stripes of purple color.
Negative: In the control zone, only one magenta strip is displayed.
Note. If not a single band manifested in the control and test zones, then the analysis is incorrect. It is necessary to repeat the procedure again.
Quality control
Internal control
The control strip serves to internal control of the proper functioning of the test strip and reagents.
External control
1. Pour 4 drops of reagent A and 4 drops of reagent in the extraction tube V. Mix well.
2. Add a drop of a test positive or negative sample to the test tube.
3. Lower the pure tampon into the test tube and perform all test operations, as when taking a smear from the mouth. It is recommended to test the control positive and negative samples every time you receive a new group of sets and when changing the user. Also, if doubts occur on the accuracy of the tests carried out (storage, directly testing process), it is recommended to check the control samples. If the results of the test tests do not correspond to the declared, it is necessary to contact representatives of the company Dectra Pharm..
Specifications
1. The quality of the test depends on the quality of the sample taken. The false negative result may be a consequence of a bad sample or improper storage of smear. A negative result can also be obtained in patients who are at the initial stage of the disease and having an insufficient concentration of antigens. Thus, if the infection caused by the streptococcus group A, and receiving a negative test result, it is necessary to take a new smear and test it with traditional sowing methods.
2. Use tampons supplied in the set.
3. In rare cases, samples with lots Staphylococcus aureus. May give false positive results. If clinical signs do not comply with the test results, it is recommended to carry out a traditional bacteriological study.
4. Respiratory infections, such as pharyngitis, can be caused by streptococcus, excellent and from the serogroup A, as well as other pathogenic pathogens.
5. Streptatest does not allow a quantitative assessment of the concentration of streptococcus group A.
6. As with any diagnosis in vitro.The clinical diagnosis should be based not only on the results of the test, but also at the conclusion of a specialist made after all clinical and biological research.
pharmachologic effect
pharmachologic effect - Diagnostic.Precautions
Since the extraction reagents A and B represent a potential danger in the case of improper use and / or entering the body should immediately consult a doctor.
Immediately after use, it is necessary to close jars with reagents A and B, to store them in an inaccessible place for patients.
Inform patients O. possible riskswhich are carrying reagents A and V. Do not use after the expiration date. Do not change the covers from jars with reagents (samples can be infected infectious pathogens).
The material that was in direct contact with the samples is considered infected. It is necessary to follow the instructions, observing precautions. The product is intended exclusively for diagnosis. in vitro!
special instructions
As a result of a comparative study conducted with the participation of 525 patients with symptoms of angina or pharyngitis, it was revealed that the Streptatest test threshold varies depending on the study and analyzed strains. Its range is equal to 5 · 10 3 bacteria / test to 5 · 10 5 bacteria / test.
Streptatest Test Sensitivity Threshold
Accuracy
Intrate accuracy It was confirmed on the basis of 15 replications using 3 samples: negative, weakly-bed and high positive. All 3 samples were correctly revealed in 99% of cases.
Intertest accuracy It was confirmed on the basis of 15 independent studies of 3 samples (negative, weakly-bed and high positive). 3 sets of Streptatest were used. All samples were correctly revealed in 99% of cases.
Instructions for use
Streptattes express test for the diagnosis of in-hemolytic streptococcus group A N5 instructions for use
Structure
1.5 Schemes made of aluminum foil with test stripes, bag with desiccant.
2.5 Tampons for taking a smear with marking CE.
3.5 extraction tubes.
4.5 Lowers with CE marking.
5.Bank with extraction reagent A (sodium nitrite 2M), 10 ml.
6.Bank with extraction reagent B (acetic acid 0.4 m), 10 ml.
7.annation.
Description
STREPTATEST - a universal express test for a doctor and a patient, which allows for 5 minutes to diagnose the presence or absence of a hazardous beta-hemolytic streptococcus group A. Such timely express diagnosis of streptococcus will help protect against unreasonable treatment, will not allow streptococcal angina missing, and The most important thing is to prevent the development of the hardest complications!
Streptatest is an immunochromatographic test with a membrane that works on the Senvich principle.
Streptattes express test for the diagnosis of beta hemolytic streptococcus group A No. 5
Features of sale
Without a license
Special conditions
Do not use after the expiration date.
Do not change the lids from jars with reagents. Samples can be infected with infectious pathogens. The material in direct contact with the samples is considered infected. Follow the instructions, observing precautions.
Indications
With inflammation of the mucous membrane and lymphoid tissue of the pharynx.
With suspicion of angina, pharyngitis, Scarlatin.
- Buy Streptattes express test for the diagnosis of in-hemolytic streptococcus group A N5 in Moscow, in Moscow, in a convenient pharmacy for you, making an order to the site.
- We have a low price for the express test for the diagnosis of B-hemolytic streptococcus group A N5 in Moscow.
You can see you next shipping points in Moscow.
Mode of application
Dosage
1. Preparation of the reagent (pour 4 drops from the red bottle into the extraction tube).2. Preparation of the reagent (pour 4 drops from a yellow bottle to extraction).
3. The material of the material (take the smear from the surface of the almonds and the rear wall of the throat without touching the gum, language, sky).
4. Assign a tampon with a material in a test tube, twist 10 times and leave for 1 minute.
5. Suggest a cotton part of the stick in the solution.
6. Test strip arrows down into the solution for 5 minutes, count results.
All good!
Unfortunately, I recently had suspicions that my child Scarlatina. This is an old disease, which now almost no one is sick.
Despite the fact that in the header of this topic, the test is called express-tested angina. In fact, there is no word angina in his title.
And it is applied to the diagnosis of the steamococcus group A, which is in the oral cavity.
💉As a child fell ill scarlet💉
On the first day she had typical signs of ORZ. High temperature and red throat, in which I then noticed some white raids. I thought the usual illness, but on the second day the whole body, and especially its side surfaces were covered with shallow red rash. I did not even immediately realize that it was a rash. Thought she just red from high temperatures. But in bright light, I realized that the red was not homogeneous, but small specks.
Here I was very frightened. We have the frequent cases of measles in the area.
And then I noticed that the child's tongue became in the patch.
Sparkling, I called an ambulance. The doctor soon reported that we have either rubella, or Scarlatina. But the symptoms are not expressed and the observation is required.
The situation is complex, because rubella is a virus, and when scarletina requires an immediate taking antibiotics.
I asked a doctor to tell what methods of diagnostics exist and she proposed to purchase an express test to the definition of Streptococcus A. The fact is that streptococcus of this group causes Scarlatin, angina and other diseases in children.
And in the presence of some signs of scarlet, and if the test confirms, it will be possible to make a unambiguous conclusion.
Although, as far as I know, this language happens only with Scarlantine.
But the test I decided to buy and spend not to think later that I giving a child a shock dose of antibiotics.
💉Method of use of dough💉
Sheptotest is sold in two different versions: 2pcs. in packing and 5pcs. I acquired 2pcs.
The kit includes:
The test method is described in detail in the instructions. Required mini-laboratory work. I even laughed at me.
There is still a more visual image.
First you need to take a stroke of the throat. I pushed the tongue and with several attempts I managed to make the child open the throat and anointed with a cotton wand on the almonds. Of course, it's not easy to do with unusual.
Then he took a test tube and pin first 4 drops of one reagent A.
Which according to the instructions had to be pink. But for some reason was absolutely transparent.
Then 4 drops of reagent V. drip needed with caution, you can easily pour out easily.
Then shake it all and lay back a cotton wand.
The wand carefully immersed into the liquid, tested there and left for a minute.
Then in the test tube immersed the test strip. It looks like a pregnancy test.
My result was visible almost immediately.
Two strips began to manifest, after 5 minutes you can estimate the final result.
Thus, we were confirmed by the diagnosis of Scarlatina.
Instructions for use
Streptattes express test for the diagnosis of in-hemolytic streptococcus group A N5 instructions for use
Structure
1.5 Schemes made of aluminum foil with test stripes, bag with desiccant.
2.5 Tampons for taking a smear with marking CE.
3.5 extraction tubes.
4.5 Lowers with CE marking.
5.Bank with extraction reagent A (sodium nitrite 2M), 10 ml.
6.Bank with extraction reagent B (acetic acid 0.4 m), 10 ml.
7.annation.
Description
STREPTATEST - a universal express test for a doctor and a patient, which allows for 5 minutes to diagnose the presence or absence of a hazardous beta-hemolytic streptococcus group A. Such timely express diagnosis of streptococcus will help protect against unreasonable treatment, will not allow streptococcal angina missing, and The most important thing is to prevent the development of the hardest complications!
Streptatest is an immunochromatographic test with a membrane that works on the Senvich principle.
Streptattes express test for the diagnosis of beta hemolytic streptococcus group A No. 5
Features of sale
Without a license
Special conditions
Do not use after the expiration date.
Do not change the lids from jars with reagents. Samples can be infected with infectious pathogens. The material in direct contact with the samples is considered infected. Follow the instructions, observing precautions.
Indications
With inflammation of the mucous membrane and lymphoid tissue of the pharynx.
With suspicion of angina, pharyngitis, Scarlatin.
- Buy Streptattes express test for the diagnosis of in-hemolytic streptococcus group A N5 in Moscow, in Moscow, in a convenient pharmacy for you, making an order to the site.
- We have a low price for the express test for the diagnosis of B-hemolytic streptococcus group A N5 in Moscow.
You can see you next shipping points in Moscow.
Mode of application
Dosage
1. Preparation of the reagent (pour 4 drops from the red bottle into the extraction tube).2. Preparation of the reagent (pour 4 drops from a yellow bottle to extraction).
3. The material of the material (take the smear from the surface of the almonds and the rear wall of the throat without touching the gum, language, sky).
4. Assign a tampon with a material in a test tube, twist 10 times and leave for 1 minute.
5. Suggest a cotton part of the stick in the solution.
6. Test strip arrows down into the solution for 5 minutes, count results.
Acute tonsillopharygitis in children: description. Cultural study of the material from the sky almonds and its alternative is an express test for BGSA, which allows you to determine the presence of an antigen of this microorganism in the material from the oralogot.
Polyakov Dmitry Petrovich, Candidate of Medical Sciences, doctor of the otolaryngological department of the Federal State Budgetary Institution "NCCSC" RAM
Acute tonsillopharygitis in children is one of the most frequent causes of medical care. It is known that most of the sharp inflammatory diseases of the rotogling have viral etiology. The proportion of bacterial tonsillopharygitis in children, whose main bacterial pathogen is considered □ -Gemolytic streptococcus Group A (BGSA), is small and does not exceed 20-30%. However, 95% of patients are prescribed systemic antibacterial therapy and, thus, in most cases it turns out to be unreasonable. On the other hand, hypodiagnosis of acute streptococcal tonsillopharygitis and the refusal of antibacterial therapy in BSSA infection makes the risk of developing early purulent and late autoimmune complications. As demonstrated in a number of major studies, nor the clinical picture, nor the level of inflammation markers do not have sufficient sensitivity and specificity for differential diagnosis viral and bacterial tonsillitis, and therefore cannot be sufficient ground for appointment antibacterial therapy. The experience of applying indicative clinical scales (McisaAc and others) also showed their relative transference prognostic value. In this regard, the "gold standard" diagnosis of acute streptococcal tonsillopharygitis remains a culture study of the material from the sky almonds. However, the insufficient availability of this method, its relative complexity, high cost and delay in obtaining the result limit its use in routine practice. An alternative to culture research is an express test for BGSA, which allows to determine the presence of the antigen of this microorganism in the material from the oral cell. The accumulated global data indicate the high sensitivity and specificity of modern rates of express diagnostics of BGSA infection.
Keywords: Children, acute tonsillopharygitis, ß-hemolytic streptococcus group A, express test.
Acute tonsillofaringitis is among the most common community-friendly infectious diseases in all countries of the world. The pain in the throat as the main symptom of acute tonsilotlofaringitis, in turn, is the most common cause of appealing for outpatient medical care or self-treatment. According to statistics, in the United States annually doctors common practice And pediatricians are carried out up to 15 million consultations in connection with such a complaint. The overwhelming majority of cases of acute tonsillopharygitis have a viral origin (respiratory and enteroviruses, Epstein-Barr virus) and therefore does not require the appointment of any etiotropic therapy. Among bacterial pathogens, hemolytic streptococcus group A (BGSA) is essential. With this pathogen is associated with 5 to 15% of cases of sharp tonsillopharygitis in an adult population and 20-30% in children. A number of authors point to a certain role of other bacterial pathogens, such as streptococcus groups with and g, Streptococcus Pneumoniae, ArcanobacteriumHaemolyticum, Anaeroba, Mycoplasma Pneumoniae and Chlamydophila Pneumoniae. Nevertheless, the lack of evidence of the participation of these microorganisms in the formation of the plates of acute tonsilotlopharygitis and the practical inability to differentiate the carriage of such a flora from its direct etiological significance is forced to refer to the given data and the need for antibacterial therapy regarding the specified pathogens. Thus, a modern strategy for antibacterial therapy of sharp tonsillopharygitis is determined by the etiological decoding of the diagnosis. As an almost only indication for systemic antimicrobial therapy, the immunocompetent persons are considered streptococcal (BGSA) the genesis of inflammation (with the exception of extremely rare cases of diphtheria and gonococcal tonsillitis). This concept is reflected in International Classification Diseases of the 10th revision, in accordance with which sharp pharyngitis and tonsillites are divided into "streptococcal" ^ 02.0 and J03.0) and "caused by other unspecified pathogens" (J03.8).
Attempts to systematize and standardize the treatment tactics of acute tonsillopharygitis over the past years, there were many national and international clinical guidelines and systematic reviews, such as: "Analysis of the recommendations of international treatment guidelines. scrolling pharyngitov in adults and children "(overview 12 of the Guides, E. Chiapinni et al., 2011); "Relief pain recommendations" (European Society for Clinical Microbiology and infectious diseases, Under hand-in prof. R. Huovinen, 2012); "Practical guidelines for the diagnosis and treatment of BGSA-Farnigitov" (American Society for Infectious Diseases, IDSA, 2012), etc.
Contrary to this, the systemic antibacterial therapy is carried out by the overwhelming majority of patients with acute tonsillofaring syndrome, which occupies a leading position on the unreasonable imposition of antimicrobial means in the world. According to pharmacoepidemiological studies, the Research Institute of Antimicrobial Chemotherapy (Smolensk, 2004), in the Russian Federation, in 95% of cases, antibiotic is prescribed to patients with a clinical picture of acute tonsilotlopharygitis. Similar data (95%) were obtained in Turkey, and only a bit better - in the USA and Spain (73 and 80.9%, respectively). In this case, the excessive antibacterial load on the population behaves both to the continuation of a significant increase in the resistance of pathogenic microorganisms in general and to the risk of undesirable reactions to antibiotics and an increase in the cost of treatment in each particular case.
On the other hand, the rejection of antimicrobial therapy in streptococcal tonsillitis is in itself the likelihood of the development of early purulent (paraphart, parapharing, purulent lymphadenitis) and late immunologically indirect complications (acute rheumatic fever, post-finishing glomerulo-jade streptococcal toxic shock syndrome, Pandas-syndrome). Despite the decline in the prevalence of acute rheumatic fever and other late complications Over the past 40-60 years, the frequency of their development after acute bgsantonzillofaringitis is 1-2%, and if the doctor has not prescribed adequate treatment, they can be considered as non-herogenous.
Such a scale of the problem is due to the objective difficulties of the differential diagnosis of acute tonsillopharygitis syndrome on the etiological basis. Formed in Russia for many decades of stereotypes of the diagnosis of "Angine", based on the evaluation of the pharyngoscopic picture in accordance with the most common classification I. B. Soldatov, caused frequent diagnostic and tactical errors. An angina unit to catarrhal, lacunar, follicular and ulcer-film has led to identifying the first form with a viral infection, the last three - with bacterial.
Nevertheless, the raids in palatine almonds may be equally the symptom of both streptococcal tonsillopharygitis, and many sharp respiratory viral infections (adenovirus, rhinovyrus, etc.), infectious mononucleosis, orofaring towidiasis. On the contrary, the picture "Catarial Angina" does not contradict the BGSA-etiology of inflammation (Fig. 1 A-E).
Unfortunately, as was convincingly demonstrated in several large domestic (A. S. Darmanyan, V. K. Tastenko, M. D. Bakradze, 2009) and foreign (A.Boccazzi et al., 2011) research nor clinical picture (Including the presence of raids in pacide almonds and fever), nor the level of inflammation markers (leukocytosis, neutrophilee with a shift to the left, concentration of C-ret. an inventory protein and procalcitonin) do not have sufficient sensitivity and specificity for the differential diagnosis of viral and bacterial tonsillitis, and therefore cannot be a sufficient basis for appointing antibacterial therapy.
Understanding the low diagnostic value of individual symptoms and laboratory indicators led to the creation of a number of indicative clinical and clinical and paraklinic scales (Walsh, 1975;BREESE, 1977;Centor, 1981;McLsaac , 1998), which, by a combination of signs allow you to determine the likelihoodstreptococcal (BGSA) of the etiology of tonsillopharygitis, which was based on correlation with bacteriological studies of the material with palatal almonds.
As can be seen from the McisaAc scale, even when the patient has the highest number of points (4 and 5), the likelihood of BGSA-etiology of toniclofaring is about 50%, i.e., each 2nd patient will receive antibacterial therapy unreasonably. And, on the contrary, the minimum estimate (0-1) does not allow to completely eliminate acute streptococcal tonsillopharygitis, which, with a well-defined refusal of treatment, the risk of complications. All this indicates a relatively low predictive strength of such scales.
The "gold standard" of BSSA is still a culture bacteriological study of the material from the sky almonds, which, while complying with all the conditions for the fence of the material, transportation and incubation, has 100% sensitivity and specificity indicators. However, in real outpatient clinical practice, in most cases, this study it turns out to be impossible, which is associated with a low density of microbiological laboratories that can correctly perform the study, their operation mode, the need to use transport media, as well as with the deferred analysis result (after 24-72 hours ). In reality, the waiting period of the result of a bacteriological study for not quite clear reasons often exceeds these terms, and the material fence is made on the next morning the doctor's visit when the patient has already been assigned an antibiotic. Due to these disadvantages and relatively high cost, the culture study is carried out in Russia only in 2% of cases. Similar trends take place in other countries. Thus, in Croatia, bacteriological analysis is prescribed 54% of patients, and only 4.2% is carried out.
Unfortunately, if it is impossible to perform a culture study, the risk of bacterial etiology of the process "compensated" to the appointment of antibiotics, which in most cases, as mentioned above, is irrational.
The search for new, as informative, but simpler ways to identify BGSA, was implemented in the development of express tests, allowing to identify this microorganism instantly, directly in the material from the rotogling.
Table 1. Scale Mcisaac
As can be seen from the MCLVAS scale, even when the patient is set by the greatest number of points (4 and 5), the probability of the BGSA-etiology of tonsilotlopharygitis is about 50%, that is, each 2-th patient will receive antibacterial therapy unreasonably. And, on the contrary, the minimum estimate (0-1) does not allow to completely eliminate acute streptococcal tonsillopharygitis, which, with a well-defined refusal of treatment, the risk of complications. All this indicates a relatively low predictive strength of such scales.
In this regard, at present, the most reasonable indication for the appointment of an antibacterial drug in acute tonsilotloparing is the Verification of BGSA. The method of determining BGSA in the rotoglotka must simultaneously have a maximum sensitivity to avoid hypodiagnostics and, as a result, the development of complications and extremely high specificity to reduce the unreasonable drug load.
The "gold standard" of BSSA is still a culture bacteriological study of the material from the sky almonds, which, while complying with all the conditions for the fence of the material, transportation and incubation, has 100% sensitivity and specificity indicators. However, in real outpatient clinical practice, in most cases, this study it turns out to be impossible, which is associated with a low density of microbiological laboratories that can correctly perform the study, their operation mode, the need to use transport media, as well as with the deferred analysis result (after 24-72 hours ). In reality, the waiting period of the result of a bacteriological study for not quite clear reasons often exceeds these terms, and the material fence is made on the next morning the doctor's visit when the patient has already been assigned an antibiotic. Due to these disadvantages and relatively high cost, the culture study is carried out in Russia only in 2% of cases. Similar trends take place in other countries. So, in Croatia, bacteriological analysis prescribe 54% of patients, and spend only 4,2% .
Unfortunately, if the risk of bacterial etiology is impossible for the implementation of the culture» The appointment of antibiotics, which in most cases, as mentioned above, is irrational.
The search for new, as informative, but simpler ways to identify BGSA, was implemented in the development of express tests, allowing to identify this microorganism instantly, directly in the material from the rotogling.
Generation tests based on Latex and Coaggl methodsyu tinations, could not fully satisfy the requirements for low sensitivity (55% ). The next generation of tests using the mechanisms of immunoferment analysis, immunochromatography and optical immune analysis, significantly strengthened the position of this method in clinical practice due to the achievement of sensitivity and specificity indicators on average(depending on the manufacturer) to 85 and 96% , respectively. There are also systemsIII generations capable of determining non-surface bacterial antigens, but specific sections of deoxyribonucleic acid (DNA) of BGSA using DNA hybridization and polymerase chain reaction. However, they can hardly be fully attributed to rapid tests, since they require expensive equipment, in connection with which they become low-proof in routine outpatient practice, despite close to10 0 % Sensitivity and specificity.
The experience of using express tests on BGSA during acute tonsillopharygitis in France, Finland and the United States demonstrated a significant reduction in the frequency of unreasonable antibiotic appointment (for example, on 41% In France, 2003) in the absence of an increase in the number of early and late complications.
In accordance with the existing international recommendations, express testing for BGSS is an equivalent alternative to culture study during the primary diagnosis of acute tonsilotlopagitis. At the same time, the positive response of the express system is regarded as highly expensive and does not require the implementation of control bacteriological analysis.
However, there are disagreements to the ratio of the need for a duplicating microbiological analysis with a negative result of express test.
IN " Practical manual According to the diagnosis and treatment of BGSA-Farnigitis, the IDSA (2012) is indicated for the validity of its implementation by children and adolescents and the absence of such a need for adults due to the relatively lower prevalence of BSSantonzilopharygitis at high age. In addition, the routine diagnosis of BGSA infection in children under the age of 3 years, on the contrary, is not recommended due to its rare and minimal likelihood of the development of acute rheumatic fever. The exception is the patients of early children's ageContacting older children with sharp streptococcal tonsillitis.
« National Guide In the treatment of acute pharyngitis in children, the Italian National Health Institute (2012), estimating the specificity and pro-profitability of the negative result of the express test on BGSA as very high, does not recommend a culture study in children. Similar data are also given by Spanish authors (G. ReguerasDelorenzoi et al., 2012), which proved the absolute correlation of negative results of express testing with a lack of growth in parallel microbiological diagnostics.
The rational "intermediate" tactics in these conditions is the re-execution of the express test with an initially negative result in a patient with a high risk of developing acute streptococcal tonsillopharygitis (based on indicative scales and / or epidemiological history).
Such contradictions may be associated with the use of different countries A wide range of express tests on bgs, sensitivity and specificity of which vary within certain limits. Control on control food products And US drugs (FDA) approved about 180 express tests, and there are even more in the world of such systems.
The metaanalysis of studies of the diagnostic value of express tests on BGSA for the period from 2000 to 2009 showed that the sensitivity of the method ranges from 65.6 to 96.4%, specificity - from 68.7 to 99.3%, and the prognosticity of positive and negative Results - within 59.4-97.4 and 87.8-98%, respectively (Table 2).
In Russia, the express test "Streptatest" ("Dectra Pharm", France), distinguished by high reliability: sensitivity - 96.8%, specificity - 94.7%, prognostility of a positive result - 98.9%, prognosticity of a negative result - 98 ,nine%. A total correlation with a culture bacteriological study, according to tests with the participation of 525 patients, was 95.2% (at p \u003d 0.95). When compared with the indicators shown above in the meta-analyze, it is safe to talk about the high quality of this express test.
In British comparative analysis of 5 test systems, one of which was "Streptatest", he took 2nd place, ahead of competitors on the duration of the storage and stability of the readable result. At the same time, the pricing policy is characterized as an excellent (leading position), which is particularly relevant in the development of domestic health care.
Thus, the use of express tests for BGSA during acute tonsillopharygitis in modern clinical practice throughout the world is considered as a routine method for diagnosing and determining the testimony to appoint antibacterial therapy. Unfortunately, in Russia, the introduction of this technique occurs extremely slowly, and the problem of unreasonably widely appreciated by systemic antimicrobial agents during non-attractococcal tonsillopharygitis remains relevant. The accumulated experience allows you to confidently recommend the expressadiagnostics of BGSA infectionc. aI for widespread introduction in everyday work outpatient polyclinic networks and adoptive departments of infectious and multidisciplinary hospitals. Reducing excessive antibacterial load, reducing the cost of diagnosis and treatment- The indisputable advantages of the specified method.
BIBLIOGRAPHY
- Belov B. S. Modern approaches to antibacterial therapy of a-streptococcal tonsillitis. Oopunit Tveb'yit. Infections and antimicrobial therapy. 2000; 2 (2): 164-168.
- SHULMAN S. T., BISNO A. L., CLEGG H. W., Gerber M. A., Kaplan E. L., Lee G., Martin J. M., Van Beneden C. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by The Infectious Diseases Society of America. CLIN. Infect. DIS. Adv. Access Published September 9, 2012.
- Bisno A. L. Acute Pharyngitis: Etiology and Diagnosis. Pediatrics. 1996; 97: 949-954.
- Ebell M. H., Smith M. A., Barry H. C., Ives K., Carey M. The Rational Clinical Examination. Does this Patient Have Strep Throat? Jama. 2000; 284: 2912-2918.
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