PREVALENCE OF INFECTION AND DIAGNOSTIC VALUE OF THE MODIFIED CENTOR SCORE FOR GROUP A STREPTOCOCCAL PHARYNGITIS IN CHILDREN AT CAN THO CHILDREN’S HOSPITAL IN 2025-2026
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Abstract
Background: Group A Streptococcus (Streptococcus pyogenes) is a Gram-positive bacterium responsible for approximately 15-30% of acute pharyngitis cases in children aged 5-15 years and may lead to serious complications such as rheumatic fever, rheumatic heart disease, and acute glomerulonephritis… The modified Centor (McIsaac) score is a clinical prediction tool used to estimate the probability of Group A streptococcal infection based on clinical criteria, thereby supporting appropriate antibiotic prescribing and helping to limit the development of antimicrobial resistance. Objectives: To describe the clinical characteristics, prevalence of infection, antimicrobial resistance patterns, and the diagnostic value of the modified Centor score in diagnosing Group A streptococcal infection among children with acute pharyngitis at Can Tho City Children’s Hospital during 2025-2026. Subjects and Methods: A cross-sectional descriptive study was conducted on 170 children diagnosed with acute pharyngitis who presented to Can Tho City Children’s Hospital from September 2025 to March 2026. Results: The mean age of the study participants was 5.50 ± 3.05 years, with a positive culture rate of 12.9%. Clinical manifestations including fever >38°C (48.2%) and tonsillar swelling/exudates (26.5%) were significantly associated with positive bacterial culture results (p < 0.05). In contrast, sex (55.3% female), anterior cervical lymphadenopathy (27.1%), and symptoms of dry cough/clear rhinorrhea (45.9%) showed no statistically significant association (p > 0.05). The modified Centor score demonstrated good predictive performance with an area under the curve (AUC) of 0.774. A cutoff value of ≥3 yielded a sensitivity of 77.3% and a specificity of 73.0%. Conclusions: Streptococcal acute pharyngitis was significantly associated with clinical features such as fever >38°C and tonsillar swelling/exudates. A modified Centor score cutoff of 3 provided the highest predictive value for Group A streptococcal pharyngitis, with a sensitivity of 77.3% and a specificity of 73.0%.
Keywords
Group A Streptococcus, modified Centor score, McIssac, acute pharyngitis
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References
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