Gurol Yesim, Akan Hulya, Izbirak Guldal, Tekkanat Zuhal Tazegun, Gunduz Tehlile Silem, Hayran Osman, Yilmaz Gulden
Faculty of Medicine, Department of Clinical Microbiology, Yeditepe University, Inönü Mahallesi, Kayişdaği Cad, 26 Ağustos Yerleşimi 34755 Kadiköy, Istanbul, Turkey.
Int J Pediatr Otorhinolaryngol. 2010 Jun;74(6):591-3. doi: 10.1016/j.ijporl.2010.02.020. Epub 2010 Mar 15.
It is aimed to detect the sensitivity and specificity of rapid antigen detection of group A beta hemolytic streptococci from throat specimen compared with throat culture. The other goal of the study is to help in giving clinical decisions in upper respiratory tract infections according to the age group, by detection of sensitivity and positive predictive values of the rapid tests and throat cultures.
Rapid antigen detection and throat culture results for group A beta hemolytic streptococci from outpatients attending to our university hospital between the first of November 2005 and 31st of December 2008 were evaluated retrospectively. Throat samples were obtained by swabs from the throat and transported in the Stuart medium and Quickvue Strep A [Quidel, San Diego, USA] cassette test was applied and for culture, specimen was inoculated on 5% blood sheep agar and identified according to bacitracin and trimethoprim-sulphametaxazole susceptibility from beta hemolytic colonies.
During the dates between the first of November 2005 and 31st of December 2008, from 453 patients both rapid antigen detection and throat culture were evaluated. Rapid antigen detection sensitivity and specificity were found to be 64.6% and 96.79%, respectively. The positive predictive value was 80.95% whereas negative predictive value was 92.82%. Kappa index was 0.91. When the results were evaluated according to the age groups, the sensitivity and the positive predictive value of rapid antigen detection in children were 70%, 90.3% and in adults 59.4%, 70.4%.
When bacterial infection is concerned to prevent unnecessary antibiotic use, rapid streptococcal antigen test (RSAT) is a reliable method to begin immediate treatment. To get the maximum sensitivity of RSAT, the specimen collection technique used and education of the health care workers is important. While giving clinical decision, it must be taken into consideration that the sensitivity and the positive predictive value of the RSAT is quite lower in adult age group than in pediatric age group.
旨在检测与咽拭子培养相比，从咽拭子标本中快速抗原检测A组β溶血性链球菌的敏感性和特异性。本研究的另一个目标是通过检测快速检测和咽拭子培养的敏感性和阳性预测值，根据年龄组为上呼吸道感染的临床决策提供帮助。
回顾性评估2005年11月1日至2008年12月31日期间到我校医院就诊的门诊患者A组β溶血性链球菌的快速抗原检测和咽拭子培养结果。用拭子从咽部获取咽拭子样本，在Stuart培养基中运送，并应用Quickvue A群链球菌检测试剂盒[美国Quidel公司，圣地亚哥]进行检测，对于培养，将标本接种于5%血羊琼脂上，并根据杆菌肽和甲氧苄啶-磺胺甲恶唑敏感性从β溶血性菌落中进行鉴定。
在2005年11月1日至2008年12月31日期间，对453例患者同时进行了快速抗原检测和咽拭子培养评估。快速抗原检测的敏感性和特异性分别为64.6%和96.79%。阳性预测值为80.95%，而阴性预测值为92.82%。Kappa指数为0.91。根据年龄组评估结果时，儿童快速抗原检测的敏感性和阳性预测值分别为70%、90.3%，成人分别为59.4%、70.4%。
在关注细菌感染以避免不必要的抗生素使用时，快速链球菌抗原检测（RSAT）是开始立即治疗的可靠方法。为了获得RSAT的最大敏感性，所使用的标本采集技术和医护人员的培训很重要。在做出临床决策时，必须考虑到RSAT在成人年龄组中的敏感性和阳性预测值比儿童年龄组低得多。
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