The World Health Organization (WHO) has advised healthcare providers to stay vigilant in diagnosing Streptococcus pyogenes, or group A Streptococcus (GAS), infections due to a global resurgence of invasive GAS (iGAS) cases—particularly among children—following the COVID-19 pandemic [1]. Currently, the microbiological diagnosis of GAS in skin and soft tissue infections (SSTIs) relies on culture-based methods, with results typically available 1–2 days after specimen processing. As a result, empirical antibiotic therapy—critical for the timely prevention and management of iGAS—must often be initiated before microbiological confirmation is obtained.

Although GAS is a well-recognized cause of SSTIs, most GAS infections are pharyngeal and are routinely diagnosed using rapid antigen detection tests (RADTs). Nucleic acid amplification tests (NAATs) suitable for point-of-care (POC) use are also widely employed for the detection of GAS in pharyngeal specimens. While these diagnostic methods are currently validated only for pharyngeal specimens, RADTs have also been successfully applied in the diagnosis of perianal streptococcal dermatitis [2], wound infections [3], and even cases of necrotizing fasciitis caused by GAS [4,5].

Additionally, the cobas® Liat Strep A (Roche Diagnostics) NAAT has demonstrated accurate identification of GAS from SSTI specimens [6]. Among POC compatible NAATs for GAS, the isothermal ID NOW™ Strep A 2 (ID NOW) assay (Abbott Diagnostics) is the fastest available, with a turnaround time of approximately 8–10 min [7]. At our hospital, it has been routinely used in the emergency department since 2021 for the diagnosis of GAS pharyngitis, performed by non-laboratory healthcare personnel.

In this study, we aimed to evaluate the suitability of the ID NOW assay for the rapid detection of GAS in non-pharyngeal specimens from pediatric (<18 years) and adult patients, with a focus on samples derived from skin and soft tissue infections (SSTIs).