Department of Epidemiology, UCLA School of Public Health, 650 Charles E. Young Drive S, CHS 41-275, Los Angeles, CA 90095, USA.
Int J Infect Dis. 2010 Dec;14(12):e1048-53. doi: 10.1016/j.ijid.2010.02.2269. Epub 2010 Oct 30.
To evaluate the utility of rapid antigen detection testing (RADT) for the diagnosis of group A streptococcal (GAS) pharyngitis in pediatric outpatient clinics in four countries with varied socio-economic and geographic profiles.
We prospectively evaluated the utility of a commercial RADT in children aged 2-12 years presenting with symptoms of pharyngitis to urban outpatient clinics in Brazil, Croatia, Egypt, and Latvia between August 2001 and December 2005. We compared the performance of the RADT to culture using diagnostic and agreement statistics, including sensitivity, specificity, and positive and negative predictive values. The Centor scores for GAS diagnosis were used to assess the potential effect of spectrum bias on RADT results.
Two thousand four hundred and seventy-two children were enrolled at four sites. The prevalence of GAS by throat culture varied by country (range 24.5-39.4%) and by RADT (range 23.9-41.8%). Compared to culture, RADT sensitivity ranged from 72.4% to 91.8% and specificity ranged from 85.7% to 96.4%. The positive predictive value ranged from 67.9% to 88.6% and negative predictive value ranged from 88.1% to 95.7%.
In limited-resource regions where microbiological diagnosis is not feasible or practical, RADTs should be considered an option that can be performed in a clinic and provide timely results.
评估快速抗原检测试验（RADT）在四个具有不同社会经济和地理特征的国家的儿科门诊用于诊断 A 组链球菌（GAS）咽炎的效用。
我们前瞻性地评估了一种商业 RADT 在 2001 年 8 月至 2005 年 12 月期间，在巴西、克罗地亚、埃及和拉脱维亚的城市门诊就诊的 2-12 岁出现咽炎症状的儿童中的效用。我们使用诊断和一致性统计数据（包括敏感性、特异性和阳性及阴性预测值）比较了 RADT 与培养的性能。使用 GAS 诊断的 Centor 评分评估了光谱偏倚对 RADT 结果的潜在影响。
四个地点共纳入 2472 名儿童。咽培养 GAS 的患病率因国家而异（范围为 24.5%-39.4%），RADT 也不同（范围为 23.9%-41.8%）。与培养相比，RADT 的敏感性范围为 72.4%-91.8%，特异性范围为 85.7%-96.4%。阳性预测值范围为 67.9%-88.6%，阴性预测值范围为 88.1%-95.7%。
在微生物诊断不可行或不切实际的资源有限地区，RADT 可以作为一种选择，可在诊所进行并提供及时的结果。
