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J Korean Soc Emerg Med > Volume 19(6); 2008 > Article
Journal of The Korean Society of Emergency Medicine 2008;19(6): 738-742.
Value of a Diagnostic RSS (rapid streptococcal screening) Test for Patients with Sore Throat in the Emergency Department
Young Tae Park, Ok Jun Kim, Sung Wook Choi, Eui Chung Kim, Ta Ei Ko, Ki Hyung Kim, Kyeung Weon Kang, Hyun Soo Kim, Dong Wook Lee
Department of Emergency Medicine, College of Medicine, The Pochon CHA University, Bundang, Korea. ed4749@hanmail.net
This paper compares a RSS (Rapid Streptococcal Screening) detection test with a throat culture. The RSS detection kit is an easier and faster way to identify the infection of Group A beta-hemolytic streptococcus (GABHS), the most common causal agent of acute bacterial pharyngitis. We also examine the clinical symptoms that are associated with bacterial pharyngitis.
A throat culture and a RSS detection test were performed simultaneously to all 239 patients who were suspected of having acute pharyngitis, and visited the emergency department between September 1st, 2002, and June 30th, 2003. Then the values of the RSS detection test were analyzed comparatively on a chi square test. The correlation between Centor criteria clinical features and bacterial pharyngitis was examined through a logic regression test.
Comparative analysis of the results of a throat culture and RSS detection test showed a test sensitivity of 83.6%, specificity was 97.2%, and the kappa coefficient was 0.83 (95% C.I: 0.75~0.91). This suggests that the RSS detection test is valuable statistically.
The RSS detection test is more accurate than the diagnosis of bacterial pharyngitis based on clinical features. Assuming that all patients with acute pharyngitis take antibiotics, an RSS detection test reduce of unnecessary antibiotics use.
Key words: Streptococcal infection, Diagnosis, Reagent kits, Pharyngitis
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