尿抗原检测在早发型B族链球菌病中的临床应用
Clinical application of urine antigen detection in early onset group B streptococcal disease.
作者信息
McIntosh E D, Jeffery H E
机构信息
Department of Preventive Medicine, Royal Alexandra Hospital for Children, Camperdown, NSW, Australia.
出版信息
Arch Dis Child. 1992 Oct;67(10 Spec No):1198-200. doi: 10.1136/adc.67.10_spec_no.1198.
The aim of this study was to test the sensitivity and specificity of antigen detection for group B streptococcus (GBS) from the urine of neonates with early onset GBS sepsis. GBS sepsis was defined as early (< 48 hours) signs of sepsis in a neonate colonised with GBS. Neonates of 26 weeks' gestation or more, considered at risk for sepsis, were prospectively investigated for one year. Investigations included culture of superficial swabs to assess colonisation, blood culture, and the Wellcogen Strep B latex particle agglutination test on urine. Of 188 neonates investigated, 17 (9%) had GBS sepsis. The urine antigen test had a sensitivity of 88% and specificity of 98%. The positive predictive value was 79% and the negative predictive value 99%. Blood culture was positive in only five neonates (29%). The annual incidence of GBS sepsis was 4.0 per 1000 and of blood culture positive GBS disease was 1.2 per 1000 live births. Three neonates died. The application of the urine antigen test of clinical neonatal practice is discussed.
本研究的目的是检测用于早期发生B族链球菌（GBS）败血症的新生儿尿液中GBS抗原检测的敏感性和特异性。GBS败血症定义为在定植有GBS的新生儿中出现败血症的早期（<48小时）体征。对妊娠26周或以上、被认为有败血症风险的新生儿进行了为期一年的前瞻性研究。调查包括浅表拭子培养以评估定植情况、血培养以及对尿液进行Wellcogen B族链球菌乳胶颗粒凝集试验。在188名接受调查的新生儿中，17名（9%）发生了GBS败血症。尿液抗原检测的敏感性为88%，特异性为98%。阳性预测值为79%，阴性预测值为99%。仅5名新生儿（29%）血培养呈阳性。GBS败血症的年发病率为每1000例中有4.0例，血培养阳性GBS疾病的年发病率为每1000例活产中有1.2例。3名新生儿死亡。本文讨论了尿液抗原检测在临床新生儿实践中的应用。
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