Performance of the Xpert Xpress Strep A for detection of <i>Streptococcus pyogenes</i> from pediatric pleural fluids

than culture from pleural fluid. Faster turnaround time shortened the window to optimal therapy, supporting its diagnostic utility.IMPORTANCEGroup A streptococcal (GAS) pneumonia, a predominant pathogen in pediatric complicated pneumonia and a severe form of invasive GAS infection, requires prompt diagnosis, both for clinical patient management and identification of close contacts for public health evaluation. Pleural effusion is a common complication. Recovery of GAS from a sterile site like pleural fluid is a key criterion to categorize disease as invasive. However, microbiological yield is often low and may be improved by applying molecular diagnostic techniques. In our study, we demonstrate the utility of Xpert Xpress Strep A for Cepheid GeneXpert for rapid detection of GAS in pediatric pleural fluids. We demonstrated excellent sensitivity with Xpert detecting all 21/21 (100%) positive specimens, compared to culture alone, which was only positive for 8/21 (38%).