Hasin M, Furst A
J R Coll Gen Pract. 1989 Aug;39(325):332-4.
The Ventrescreen (Ventrex) rapid enzyme immunoassay test for detecting group A streptococcal antigen directly from a throat swab was compared with conventional blood agar throat culture in the diagnosis of beta haemolytic streptococcal infection among 311 patients with a sore throat attending a large suburban Jerusalem primary care clinic. Using the throat culture as the 'gold standard' the Ventrescreen test had a sensitivity of 82%, a specificity of 50%, a positive predictive value of 49%, and a negative predictive value of 82% for beta haemolytic streptococcal infection. These results are not good enough for the test to be considered a reliable substitute for throat culture in such a setting. The negative predictive value, however, supports the use of a negative test result to identify those patients in whom antibiotic therapy could be withheld until the result of their throat culture became available. These conclusions are at variance with recommendations from other studies of similar tests in different population groups, and stress the need for the careful evaluation, especially in primary care clinics, of any such rapid test which claims to be able to replace throat culture in the detection of beta haemolytic streptococcal infection.
在耶路撒冷一个大型郊区初级保健诊所就诊的311例咽痛患者中，对用于直接从咽拭子检测A组链球菌抗原的Ventrescreen（Ventrex）快速酶免疫测定试验与传统血琼脂咽培养进行了比较，以诊断β溶血性链球菌感染。以咽培养作为“金标准”，Ventrescreen试验对β溶血性链球菌感染的敏感性为82%，特异性为50%，阳性预测值为49%，阴性预测值为82%。在这种情况下，这些结果不足以使该试验被视为咽培养的可靠替代方法。然而，阴性预测值支持利用阴性试验结果来识别那些在咽培养结果出来之前可以暂不进行抗生素治疗的患者。这些结论与其他针对不同人群组进行的类似试验的研究结果不一致，并强调了对任何声称能够在检测β溶血性链球菌感染时替代咽培养的快速试验进行仔细评估的必要性，尤其是在初级保健诊所。
