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Clinical Pediatrics
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Streptococcal Pharyngitis

Comparison of Latex Agglutination and Throat Culture

Christopher B. White, MD

Department of Pediatrics William Beaumont Army Medical Center, El Paso, Texas

Richard Harris, MS

Department of Pathology, William Beaumont Army Medical Center, El Paso, Texas

Michael R. Weir, MD

Madigan Army Medical Center, Tacoma, Washington

Inez Gonzales, MD

Department of Pediatrics William Beaumont Army Medical Center, El Paso, Texas

James W. Bass, MD

Department of Pediatrics, Tripler Army Medical Center, Hawaii

Despite its imperfections, the throat culture remains the "gold standard" against which all rapid streptococcal antigen detection tests are compared. Using triple throat swabs, the accuracy of a rapid latex agglutination (LA) test and back up throat culture was determined and compared with a simultaneously obtained additional throat culture in children with suspected streptococcal pharyngitis. Although there was a 95 percent concordancy between throat cultures, the sensitivity of the throat culture was only 87 percent. Despite the LA test's lower sensitivity (78 percent), in this clinical population with a relatively low prevalence of positive throat cultures (19 percent), the predictive value of a negative LA test was only slightly lower than that of the throat culture (94-95 percent vs. 97 percent). Backup throat cultures are commonly recommended for patients with initially negative LA test results, but 10 percent of the patients with group A beta-hemolytic streptococci-positive throat cultures would have been undetected using this approach.

Clinical Pediatrics, Vol. 27, No. 9, 431-434 (1988)
DOI: 10.1177/000992288802700904
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