Llor Carles, Hernández Anadón Silvia, Gómez Bertomeu Frederic Francesc, Santamaria Puig Josep Maria, Calviño Domínguez Olga, Fernández Pagés Yvonne
Medicina de Familia, Centro de Salud Jaume I, Tarragona, Spain.
Aten Primaria. 2008 Oct;40(10):489-94. doi: 10.1157/13127228.
To determine the validity of the rapid antigen test (RAT) OSOM StrepA Genzyme for the diagnosis of acute pharyngitis caused by group A beta-haemolytic strep (GABHS).
Diagnostic techniques survey.
Urban primary care centre, Spain.
All patients over 14 years old seen in 6 surgeries with sore throat and 2 or more Centor criteria: pharyngotonsillar exudate, tender laterocervical nodes, absence of coughing, and/or history or presence of fever.
Pharyngeal swabs were taken from all the patients, one for RAT and another to send for culture in the microbiology department.
A total of 182 patients were evaluable, with a mean age of 30.6 (12.1) years of which 116 were women (63.7%); 63 patients had 2 Centor criteria; 83 had 3 and 36, the 4 criteria. The culture was positive in 102 patients (56%), with GABHS showing infection in forty (22%; 95% confidence interval [CI], 21.2-22.8). Group C Streptococcus was isolated in 26 patients (14.3%). GABHS was higher among patients with four Centor criteria (38.9% vs 25.3% observed among those with 3 criteria and 7.9% with 2 criteria; P<.001). Sensitivity of RAT was 95%, with a specificity of 93%, a positive predictive value of 79.2% and a negative predictive value of 98.5%.
These results show the usefulness of RAT for diagnosing streptococcal pharyngitis. Its use should be spread to all primary care practices.
确定OSOM StrepA Genzyme快速抗原检测（RAT）用于诊断A组β溶血性链球菌（GABHS）引起的急性咽炎的有效性。
诊断技术调查。
西班牙城市初级保健中心。
在6家外科诊所就诊的所有14岁以上出现咽痛且有2项或更多项森托标准的患者：咽扁桃体渗出物、颈侧淋巴结压痛、无咳嗽和/或发热史或发热。
从所有患者采集咽拭子，一份用于RAT检测，另一份送至微生物科进行培养。
共有182例患者可进行评估，平均年龄为30.6（12.1）岁，其中116例为女性（63.7%）；63例患者有2项森托标准；83例有3项，36例有4项标准。102例患者培养结果为阳性（56%），GABHS感染40例（22%；95%置信区间[CI]，21.2 - 22.8）。26例患者分离出C组链球菌（14.3%）。有4项森托标准的患者中GABHS感染率更高（38.9%，有3项标准的患者中观察到的感染率为25.3%，有2项标准的患者中为7.9%；P<0.001）。RAT的敏感性为95%，特异性为93%，阳性预测值为79.2%，阴性预测值为98.5%。
这些结果表明RAT在诊断链球菌性咽炎方面有用。应将其应用推广到所有初级保健机构。
