ABSTRACT

Background

Acute tonsillitis is a very common medical condition. Despite different methods of detection, all tests are based on GAS sampling using a throat swab. However, obtaining the swab can elicit vomiting and is often accompanied by fear and apprehension in children. The aim of this study was to find a non-invasive method for the detection of GAS pharyngitis.

Methods

A classic throat swab was obtained for culture, and a saliva sample was taken from 100 subjects recruited from Meuhedet Health Care Organization clinic. Real time PCR was performed to detect GAS dnaseB specific gene in the saliva samples.

Results

56% of the throat cultures and 48% of the PCR samples were positive for GAS. The overall sensitivity and specificity of the saliva PCR method was 79% and 91% respectively; NPV and PPV were 77% and 92% respectively. When excluding patients who presented on the first day of fever, sensitivity and specificity increased to 90% and 100% respectively. No other anamnestic or clinical findings increased the yield of the test.

Conclusion

Saliva-based PCR amplification of GAS DNA method is effective in detection of GAS pharyngitis. Further studies are needed to achieve detection rates to replace the traditional throat swab-based approach.

中文翻译：

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唾液细菌DNA检测GAS咽炎的应用

摘要

背景

急性扁桃体炎是一种非常常见的疾病。尽管检测方法不同，但所有测试均基于使用咽拭子进行的 GAS 采样。然而，获得拭子会引起呕吐，并且通常伴随着儿童的恐惧和忧虑。本研究的目的是寻找一种非侵入性的方法来检测 GAS 咽炎。

方法

获得用于培养的经典咽拭子，并从从 Meuhedet 卫生保健组织诊所招募的 100 名受试者中采集唾液样本。进行实时 PCR 以检测唾液样品中的 GAS dnaseB 特异性基因。

结果

56% 的咽喉培养物和 48% 的 PCR 样本对 GAS 呈阳性。唾液PCR方法的总体敏感性和特异性分别为79%和91%；NPV 和 PPV 分别为 77% 和 92%。当排除在发热第一天就诊的患者时，敏感性和特异性分别增加到 90% 和 100%。没有其他记忆或临床发现增加测试的产量。

结论

基于唾液的PCR扩增GAS DNA法对检测GAS咽炎有效。需要进一步研究以实现检测率，以取代传统的基于咽拭子的方法。