Holte M, Gaustad P, Bevanger L, Andersen K
Mikrobiologisk laboratorium, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1990 Jan 10;110(1):50-3.
In Norway anually half a million consultations are for acute sore throat. The clinical differentiation between streptococcal and non-streptococcal infection remains poor. A reliable diagnosis of beta-hemolytic streptococcal infections requires a screening test. In a multicenter study from general practice the rapid test Phadirect Strep A was compared with cultivation at two microbiological laboratories. 257 patients were included and the prevalence of beta-hemolytic streptococci was 41.6%. The results of valid calculations were: Sensitivity 70-77%; Specificity 86-89%; Positive predictive value 74-82%; Negative predictive value 81-88%. The results were considered in relation to body temperature and signs of local infection in the throat. There was no correlation between clinical signs and occurrence of beta-hemolytic streptococci. The Phadirect Strep A test was acceptably sensitive and specific for use in general practice. The test is easy to perform, and the results are available after five minutes. The test seems to be useful, and is an improvement in the daily management of patients with acute throat infections, especially in relation to the question of whether or not to prescribe antibiotics.
在挪威,每年有50万例门诊是因急性咽喉痛就诊。链球菌感染与非链球菌感染之间的临床鉴别仍然不佳。对β溶血性链球菌感染进行可靠诊断需要进行筛查试验。在一项来自全科医疗的多中心研究中,将快速检测试剂Phadirect A链球菌与两个微生物实验室的培养法进行了比较。纳入了257例患者,β溶血性链球菌的患病率为41.6%。有效计算结果为:灵敏度70 - 77%;特异度86 - 89%;阳性预测值74 - 82%;阴性预测值81 - 88%。结合体温和咽喉局部感染体征对结果进行了分析。临床体征与β溶血性链球菌的出现之间没有相关性。Phadirect A链球菌检测在全科医疗中的灵敏度和特异度可接受。该检测操作简便,5分钟后即可获得结果。该检测似乎很有用,是急性咽喉感染患者日常管理中的一项改进,特别是在是否开具抗生素的问题上。