Noorbakhsh S, Tabatabaei A, Farhadi M, Ebrahimi Taj F
Pediatric Infectious Diseases Research center,Tehran University of Medical Sciences, Tehran, Iran.
Iran J Microbiol. 2011 Jun;3(2):99-103.
Group A beta-hemolytic streptococcus (GABHS) is an important pharyngotonsillitis etiologic agent in children. The objective of this study was diagnosis of streptococcal pharyngitis based on rapid antigen detection test and conventional pharyngeal culture.
The rapid GABHS antigen detection test was compared to culture on blood agar, the gold standard for the diagnosis of this etiologic agent.
Streptococcal antigen was detected in pharyngeal specimens of 34.5% of cases by rapid strip test. We detected group A Streptococcus in 17.2% of pharyngeal culture. There was no agreement between two methods ( PV < 0.1). The negative pharyngeal culture results are probably due to antibiotic usage in 43.2% of patients. Positive rapid test results in pharyngeal swab was age dependent ( P < 0.05). There was good correlation between observing the "petechia in pharynx of patients" and positive rapid test in pharyngeal swab (P < 0.004). Throat culture results were relatated to previous antibiotic usage ( P < 0.03).
The rapid test in pharyngeal swab is helpful for rapid diagnosis and treatment of GABHS pharyngitis. Diagnosis of GABHS pharyngitis based on soley clinical findings is misleading in the majority of cases. Petechia observed in pharynx of the cases was highly predictive of streptococcal pharyngitis.
A 组β溶血性链球菌(GABHS)是儿童咽扁桃体炎的重要病原体。本研究的目的是基于快速抗原检测试验和传统咽拭子培养来诊断链球菌性咽炎。
将 GABHS 快速抗原检测试验与血琼脂培养(该病原体诊断的金标准)进行比较。
通过快速试纸条试验在 34.5%的病例咽拭子标本中检测到链球菌抗原。在 17.2%的咽拭子培养中检测到 A 组链球菌。两种方法之间无一致性(Kappa 值<0.1)。43.2%的患者咽拭子培养结果为阴性可能是由于使用了抗生素。咽拭子快速试验阳性结果与年龄有关(P<0.05)。观察“患者咽部瘀点”与咽拭子快速试验阳性之间存在良好相关性(P<0.004)。咽拭子培养结果与先前使用抗生素有关(P<0.03)。
咽拭子快速试验有助于 GABHS 咽炎的快速诊断和治疗。在大多数情况下,仅根据临床症状诊断 GABHS 咽炎会产生误导。病例咽部观察到的瘀点对链球菌性咽炎具有高度预测性。