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Group A Strep The advantages of the rapid Strep screen over traditional throat culture are readily apparent. Culture requires technical expertise, expensive media and equipment, and incubation time. Group A Strep (GAS) direct antigen detection requires a kit, a trained and conscientious staff member, a bit of counter and refrigerator space, and a few minutes per patient sample. The caveat is that a poorly collected culture specimen is likely to show some growth of GAS, if present. If the number of organisms captured for direct antigen testing is insufficient, a false negative result is almost certain. It is wise, then, to collect two swabs. If the rapid test is positive, there is no need to culture. The second swab may be discarded.Quality Control Requirements CLIA requires that two levels of GAS controls be performed and documented each day of patient testing. The regulation does not specify that these must both be external controls, each using a separate testing device. At least one control may be internal, automatically performed with each patient test. Remember that at least one control must be able to detect errors in the extraction phase. Check manufacturer's directions to determine how and when to use external QC. Some systems require each operator to perform external QC on each kit. If three individuals are performing testing, six devices out of a 20-test kit must be used for QC. Only 14 of 20 are available for patient testing. Reduce cost by assigning each operator a kit for his/her exclusive use, leaving 18 devices out of 20 for patient testing. Storage Temperatures and Expiration Dates As always, monitor and record temperatures of testing and storage areas daily. If your GAS kit (or a portion of it) is stored at room temperature, the expiration date printed on the package may not be valid. Check manufacturer's directions regarding various storage scenarios and change the dating to reflect the chosen storage conditions, if necessary. |
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This article may be republished in its entirety on your web site or in your newsletter under the following two conditions: 1) Include the following statement at the beginning or end of the article. "Republished with permission of the author, Margaret A Knapp MT(ASCP) CLS, of KnappˇFrazer Consulting. www.knapp-frazer.com ~ 707.539.6621" 2) Send copy of your publication or URL to KnappˇFrazer Consulting at time of republication. |
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