title: Evaluation of the modified Visuwell Strep-A enzyme immunoassay for detection of group-A Streptococcus from throat swabs.
abstract: The modified Visuwell Strep-A enzyme immunoassay (EIA) was compared with culture for detection of group-A Streptococcus from throat swabs. Throat swabs in modified Stuarts medium obtained after culture at two institutions were tested in Visuwell. Cumulative results were n = 417, sensitivity 87.8%, specificity 89.9% predictive value positive (PVP) 67.9%, predictive value negative (PVN) 96.8%, and accuracy 89.5%. At another site, swabs were delivered to the laboratory without transport medium, cultured, and subsequently tested by Visuwell (n = 202, sensitivity 79.6%, specificity 84.5%, PVP 65.2%, PVN 91.9%, accuracy 83.2%). When 1+ culture-positive specimens were considered negative, the sensitivity and PVN increased from 79.6% to 90.2% and 91.9% to 97.1% respectively. Overall performance of the modified Visuwell was comparable with that of the initial assay for throat swabs transported with or without modified Stuarts medium. Cross reaction with organisms other than group-A Streptococcus normally found in the oropharynx was negligible in Visuwell and the limit of detection of group-A Streptococcus was 5 x 10(4) colony-forming units.
authors.affiliation: Department of Clinical Microbiology, Buffalo Children's Hospital, New York.
authors.forename: M
authors.initials: M
authors.lastname: Drulak
authors.forename: W
authors.initials: W
authors.lastname: Bartholomew
authors.forename: L
authors.initials: L
authors.lastname: LaScolea
authors.forename: D
authors.initials: D
authors.lastname: Amsterdam
authors.forename: N
authors.initials: N
authors.lastname: Gunnersen
authors.forename: J
authors.initials: J
authors.lastname: Yong
authors.forename: C
authors.initials: C
authors.lastname: Fijalkowski
authors.forename: S
authors.initials: S
authors.lastname: Winston
mesh_terms: D003429:Cross Reactions; D003470:Culture Media; D006801:Humans; D007124:Immunoenzyme Techniques; D010612:Pharyngitis / Q000175:diagnosis* / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology*; D011237:Predictive Value of Tests; D013048:Specimen Handling; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000302:isolation & purification*
chemical_list: D003470:Culture Media