Yilmaz Fahrettin, Karabay Oğuz, Ince Nevin Koç, Ekerbiçer Hasan, Koçoğlu Esra
Department of Otolaryngology, Izzet Baysal Medicine Faculty of Abant Izzet Baysal University, Bolu, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2008 Sep-Oct;18(5):280-3.
The most important disadvantage of rapid antigen tests (RAT) is low sensitivity for the diagnosis of group A beta-hemolytic streptococci (BHS). We determined the sensitivity, specificity, positive and negative predictive values of RAT in gargling samples.
The study included 106 patients (53 females, 53 males, mean age 22+/-12 years; range 16-65 years) with an initial diagnosis of tonsillopharyngitis. Swab samples were taken from the posterior pharyngeal wall and tonsil surface with a sterile cotton swab. Then, gargle samples were obtained by gargling for 10 seconds with sterile 0.9% NaCl to be examined by the RAT for group A BHS. Throat cultures were processed using standard microbiologic techniques.
Throat cultures were positive in 12 patients (11.3%) and negative in 94 patients (88.6%). Rapid antigen test yielded five positive (4.7%) and 101 negative (95.2%) results. The sensitivity and specificity rates of RAT with throat gargling were 41.7% and 100%, with positive and negative predictive values of 100% and 93.1%, respectively.
Despite satisfactory specificity, positive and negative predictive rates of RAT with throat gargling, its low sensitivity limits its use for the diagnosis of group A BHS.
快速抗原检测（RAT）用于诊断A组β溶血性链球菌（BHS）的最重要缺点是灵敏度低。我们测定了含漱液样本中RAT的灵敏度、特异性、阳性预测值和阴性预测值。
该研究纳入了106例初步诊断为扁桃体咽炎的患者（53例女性，53例男性，平均年龄22±12岁；范围16 - 65岁）。用无菌棉拭子从咽后壁和扁桃体表面采集拭子样本。然后，用无菌0.9%氯化钠含漱10秒获取含漱液样本，通过RAT检测A组BHS。采用标准微生物学技术进行咽拭子培养。
咽拭子培养12例（11.3%）呈阳性，94例（88.6%）呈阴性。快速抗原检测得出5例阳性（4.7%）和101例阴性（95.2%）结果。含漱液样本RAT的灵敏度和特异性分别为41.7%和100%，阳性预测值和阴性预测值分别为100%和93.1%。
尽管含漱液样本RAT的特异性、阳性和阴性预测率令人满意，但其低灵敏度限制了它在A组BHS诊断中的应用。
