Tunik M G, Fierman A H, Dreyer B P, Krasinski K, Hanna B, Rosenberg C
Department of Pediatrics, New York University School of Medicine, NY 10016.
Pediatr Emerg Care. 1990 Jun;6(2):93-5. doi: 10.1097/00006565-199006000-00005.
A rapid latex agglutination (LA) method was evaluated in 2401 consecutive pediatric patients presenting to an emergency service with suspected group A beta-hemolytic streptococcal pharyngitis. LA tests were performed by the treating physicians, who were not blinded to the clinical condition of the children and who made therapeutic decisions based on the results of the tests. When compared with anaerobic culture, the LA method had a sensitivity of 91%, a specificity of 82%, and a positive predictive value of 43%. There was a marked seasonal variation in the positive predictive value: 62% in winter and 16% in summer. However, even in peak streptococcal pharyngitis season (January to March), basing therapy on a positive LA test leads to the unnecessary treatment of a large number of patients. Therefore, we cannot recommend the routine performance of this test by all practitioners in all clinical settings.
对2401例连续到急诊就诊、疑似A组β溶血性链球菌咽炎的儿科患者评估了一种快速乳胶凝集（LA）方法。LA检测由主治医生进行，这些医生知晓患儿的临床状况，且根据检测结果做出治疗决策。与厌氧培养相比，LA方法的灵敏度为91%，特异度为82%，阳性预测值为43%。阳性预测值存在明显的季节性变化：冬季为62%，夏季为16%。然而，即使在链球菌咽炎高发季节（1月至3月），基于LA检测阳性进行治疗也会导致大量患者接受不必要的治疗。因此，我们不建议所有从业者在所有临床环境中常规进行此项检测。
