Abu-Sabaah A H, Ghazi H O
Department of Medical Microbiology, Faculty of Medicine and Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.
Br J Biomed Sci. 2006;63(4):155-8. doi: 10.1080/09674845.2006.11732740.
This study aims to assess the diagnostic value of a rapid streptococcal antigen test in addition to four clinical features in patients with sore throat, using throat culture and antibody titre as reference tests, and to evaluate the efficacy of the current antibiotics used in the treatment of throat infections caused by group A beta-haemolytic streptococcus (GABHS). Four clinical features (fever [history of] > or = 38 degrees C, lack of cough, tonsillar exudate, and anterior cervical lymphadenopathy) are recorded in 355 patients aged four years to > or =15 years. A rapid antigen diagnostic test (RADT) is performed, as well as a throat culture. Antistreptolysin O (ASO) titre is performed in patients 11 years. GABHS from patients are tested for susceptibility to different antibiotics. Throat cultures were positive for GABHS in 19% patients. Rapid tests were positive in 24%. Compared with throat culture, the rapid test gave a sensitivity of 91%, specificity of 91%, positive predictive value of 73% and a negative predictive value of 98%. For patients with three or four clinical features, however, the sensitivity was considerably higher at 97%. Using the ASO test as a reference, no association was found between RADT and culture results. Zithromax showed the highest prescription rate (25.5%) and produced a high cure rate (91%) in patients with GABHS pharyngitis.
本研究旨在评估除四种临床特征外，快速链球菌抗原检测在咽痛患者中的诊断价值，以咽拭子培养和抗体滴度作为参考检测，并评估当前用于治疗A组β溶血性链球菌（GABHS）引起的咽喉感染的抗生素的疗效。记录了355名4岁至≥15岁患者的四种临床特征（发热[病史]≥38摄氏度、无咳嗽、扁桃体渗出物和颈前淋巴结病）。进行了快速抗原诊断检测（RADT）以及咽拭子培养。对11岁患者进行抗链球菌溶血素O（ASO）滴度检测。对患者的GABHS进行不同抗生素的敏感性检测。19%的患者咽拭子培养GABHS呈阳性。快速检测阳性率为24%。与咽拭子培养相比，快速检测的敏感性为91%，特异性为91%，阳性预测值为73%，阴性预测值为98%。然而，对于具有三种或四种临床特征的患者，敏感性显著更高，为97%。以ASO检测作为参考，未发现RADT与培养结果之间存在关联。阿奇霉素的处方率最高（25.5%），在GABHS咽炎患者中治愈率较高（91%）。
