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The feasibility of measuring calprotectin from a throat swab as a marker of infections caused by group A streptococcus: a case–control feasibility study

Schofield, Behnaz, Gregory, Clive, Gal, Micaela, Gillespie, David, Naik, Gurudutt, Hay, Alastair and Francis, Nick 2020. The feasibility of measuring calprotectin from a throat swab as a marker of infections caused by group A streptococcus: a case–control feasibility study. BJGP Open 4 (2) , 20X101006. 10.3399/bjgpopen20X101006

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Background Most people with sore throat do not benefit from antibiotic treatment, but nearly three-quarters of those presenting in primary care are prescribed antibiotics. A test that is predictive of bacterial infection could help guide antibiotic prescribing. Calprotectin is a biomarker of neutrophilic inflammation, and may be a useful marker of bacterial throat infections. Aim To assess the feasibility of measuring calprotectin from throat swabs, and assess whether individuals with sore throats likely to be caused by streptococcal infections have apparently higher throat calprotectin levels than other individuals with sore throat and healthy volunteers. Design & setting A proof of concept case–control study was undertaken, which compared primary care patients with sore throats and healthy volunteers. Method Baseline characteristics and throat swabs were collected from 30 primary care patients with suspected streptococcal sore throat, and throat swabs were taken from 10 volunteers without sore throat. Calprotectin level determination and rapid antigen streptococcal testing were conducted on the throat swab eluents. Calprotectin levels in the following groups were compared: volunteers without a sore throat; all patients with a sore throat; patients with a sore throat testing either negative or positive for streptococcal antigen; and those with lower and higher scores on clinical prediction rules for streptococcal sore throat. Results Calprotectin was detected in all throat swab samples. Mean calprotectin levels were numerically higher in patients with sore throat compared with healthy volunteers, and sore throat patients who had group A streptococci antigen detected compared with those who did not. Conclusion Calprotectin can be measured from throat swab samples and levels are consistent with the hypothesis that streptococcal infection leads to higher throat calprotectin levels. This hypothesis will be tested in a larger study.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Centre for Trials Research (CNTRR)
Additional Information: This article is Open Access: CC BY license (https:// creativecommons. org/ licenses/ by/4.0/)
Publisher: Royal College of General Practitioners
ISSN: 2398-3795
Date of First Compliant Deposit: 9 January 2020
Date of Acceptance: 23 July 2019
Last Modified: 20 Jan 2021 04:15

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