Sarikaya Sezgin, Aktaş Can, Ay Didem, Cetin Asli, Celikmen Ferudun
Emergency Department, Yeditepe University Hospital, Devlet Yolu Ankara Cad 102/104, Istanbul, Turkey 34778.
Ear Nose Throat J. 2010 Apr;89(4):180-2.
Acute pharyngitis in adults is primarily a viral infection; only about 10% of cases are of bacterial etiology. Most cases of bacterial pharyngitis are caused by group A beta-hemolytic streptococci (GABHS). One laboratory method for the diagnosis of GABHS is rapid antigen diagnostic testing (RADT), which can be processed during an emergency department visit and which has become a popular alternative to throat swab cultures. We conducted a study to define the sensitivity and specificity of RADT, using throat culture results as the gold standard, in 100 emergency department patients who presented with symptoms consistent with streptococcal pharyngitis. We found that RADT had a sensitivity of 68.2% (15 of 22), a specificity of 89.7% (70 of 78), a positive predictive value of 65.2% (15 of 23), and a negative predictive value of 90.9% (70 of 77). We conclude that RADT is useful in the emergency department when the clinical suspicion is GABHS, but results should be confirmed with a throat culture in patients whose RADT results are negative.
成人急性咽炎主要是病毒感染；仅约10%的病例由细菌引起。大多数细菌性咽炎病例由A组β溶血性链球菌（GABHS）引起。诊断GABHS的一种实验室方法是快速抗原诊断检测（RADT），该检测可在急诊科就诊时进行，已成为咽喉拭子培养的一种常用替代方法。我们进行了一项研究，以咽喉培养结果作为金标准，确定100名出现与链球菌性咽炎相符症状的急诊科患者中RADT的敏感性和特异性。我们发现，RADT的敏感性为68.2%（22例中的15例），特异性为89.7%（78例中的70例），阳性预测值为65.2%（23例中的15例），阴性预测值为90.9%（77例中的70例）。我们得出结论，当临床怀疑为GABHS时，RADT在急诊科是有用的，但对于RADT结果为阴性的患者，应通过咽喉培养来确认结果。
