Molecular Dx Significance 6/10

Revogene Strep A Molecular Assay Delivers 98% Sensitivity in Multicenter Evaluation

A seven-site prospective study validated the Revogene Strep A real-time PCR assay for Group A Streptococcus detection from throat swabs, reporting 98.1% sensitivity and 94.7% specificity against bacterial culture. The cartridge-based system delivers results in approximately 70 minutes, offering a faster molecular alternative to culture-based diagnosis in clinical microbiology labs.

The original study

Multicenter Clinical Evaluation of the Revogene Strep A Molecular Assay for Detection of Streptococcus pyogenes from Throat Swab Specimens.

Authors
Banerjee D, Michael J, Schmitt B, Salimnia H, Mhaissen N, Goldfarb DM, et al.
Journal
Journal of clinical microbiology
Type
Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
PMID
32321780
Read the original study →

Original abstract

Group A streptococcus (GAS) species cause bacterial pharyngitis in both adults and children. Early and accurate diagnosis of GAS is important for appropriate antibiotic therapy to prevent GAS sequalae. The Revogene Strep A molecular assay (Meridian Bioscience Canada Inc, Quebec City, QC, Canada) is an automated real-time PCR assay for GAS detection from throat swab specimens within approximately 70 min. This multicenter prospective study evaluated the performance of the Revogene Strep A molecular assay compared to that of bacterial culture. Dual throat swab specimens in either liquid Amies or Stuart medium were collected from eligible subjects (pediatric population and adults) enrolled across 7 sites (USA and Canada). Revogene Strep A and reference testing was performed within 7 days and 48 h of sample collection, respectively. Of the 604 evaluable specimens, GAS was detected in 154 (25.5%) samples by the reference method and in 175 (29%) samples by the Revogene Strep A assay. Revogene Strep A assay sensitivity and specificity were reported to be 98.1% (95% confidence interval [CI], 94.4 to 99.3) and 94.7% (95% CI, 92.2 to 96.4), respectively. The positive predictive value was 86.3% (95% CI, 80.4 to 90.6), negative predictive value was 99.3% (95% CI, 98.0 to 99.8) with a 1.0% invalid rate. Discrepant analysis with alternative PCR/bidirectional sequencing was performed for 24 false-positive (FP) and 3 false-negative (FN) specimens. Concordant results were reported for 17 (FP only) of 27 discordant specimens. The Revogene Strep A assay had high sensitivity and specificity for GAS detection and provides a faster alternative for GAS diagnosis.