D'Heilly Sarah J, Janoff Edward N, Nichol Paul, Nichol Kristin L
VA Medical Center, Minneapolis, MN, USA.
J Clin Virol. 2008 Jun;42(2):124-8. doi: 10.1016/j.jcv.2007.12.014. Epub 2008 Mar 4.
Laboratory diagnosis of influenza has previously relied on viral isolation in culture. Rapid antigen tests (RATs) are now available but few studies have examined their use in older adults under routine clinical conditions.
To determine the utility of the RAT in older adults presenting to a large medical center and how test results impacted clinical care.
Retrospective chart review of patients tested for influenza during the 2003--2004 and 2004--2005 influenza seasons. Clinical data were correlated with the results of laboratory testing.
Eighty-four adults tested positive for influenza. Adding the results of the RAT to symptom complexes predictive of influenza significantly enhanced the ability to diagnose influenza in the acute setting. The positive predictive value of fever plus cough increased from 32% to 92% with a positive RAT. The RAT also directed appropriate antiviral therapy. 20/22 (91%) patients with a positive RAT and symptoms < or =48 h received antiviral treatment compared to only 1/12 (8%) patients with a negative RAT and a positive culture.
Under routine clinical conditions rapid influenza testing enhances the ability to quickly diagnose influenza and can be used to guide early treatment decisions in older adults.
流感的实验室诊断以前依赖于病毒培养分离。快速抗原检测（RATs）现已可用，但很少有研究在常规临床条件下考察其在老年人中的应用。
确定RAT在一家大型医疗中心就诊的老年人中的效用，以及检测结果如何影响临床护理。
对2003 - 2004年和2004 - 2005年流感季节接受流感检测的患者进行回顾性图表审查。临床数据与实验室检测结果相关联。
84名成年人流感检测呈阳性。将RAT结果添加到预测流感的症状组合中，显著提高了在急性情况下诊断流感的能力。RAT呈阳性时，发热加咳嗽的阳性预测值从32%提高到92%。RAT还指导了适当的抗病毒治疗。RAT呈阳性且症状≤48小时的患者中有20/22（91%）接受了抗病毒治疗，而RAT呈阴性但培养结果呈阳性的患者中只有1/12（8%）接受了治疗。
在常规临床条件下，快速流感检测提高了快速诊断流感的能力，可用于指导老年人的早期治疗决策。
