Comparison of Directigen Group A Strep Test with a traditional culture technique for detection of group A beta-hemolytic streptococci.

The Directigen Group A Strep Test (DGAST), a new rapid method of detecting group A beta-hemolytic streptococci directly from throat swabs, was compared with a traditional culture technique for the detection of group A beta-hemolytic streptococci. Five hundred oropharyngeal swabs from pediatric and adult patients were cultured and then processed by using the DGAST. Of the 144 specimens positive by culture, 131 were DGAST positive (sensitivity, 90.9%). Of the 356 specimens negative by culture, 353 were DGAST negative (specificity, 99.2%). Twelve of the 13 false-negative DGAST results were from pediatric patients. One hundred isolates of non-group A beta-hemolytic streptococci were recovered, primarily groups C, F, and G. The DGAST is easy to perform, rapid, sensitive, and very specific for detection of group A beta-hemolytic streptococci directly from swabs. Supplementing the DGAST with a culture on a 5% sheep blood agar plate would enhance detection of group A beta-hemolytic streptococci, especially in pediatric patients.