Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Chełmska str. 30/34, 00-725, Warsaw, Poland.
Centre for Quality Control in Microbiology, Warsaw, Poland.
Eur J Clin Microbiol Infect Dis. 2017 Oct;36(10):1733-1738. doi: 10.1007/s10096-017-2986-8. Epub 2017 Apr 21.
Group A Streptococci (GAS) are the main causative agents of bacterial pharyngitis, which require antibiotic therapy. Rapid diagnostic tests detecting GAS combined with Centor/McIsaac score enable accurate differential diagnosis (viral vs. bacterial) and prompt commencement of targeted treatment. The aim of this study was to assess the specificity, sensitivity, PPV and NPV of QuikRead go® Strep A (Orion Diagnostica Oy, Finland) recommended for the detection of GAS in pharyngeal swabs. Quick diagnostic test results were compared with physical examination findings, Centor/McIsaac score and results of reference testing (conventional microbial cultures). The study group of 96 participants consisted of 44 women (46%) and 52 men (54%); children aged 3-14 years constituted 46% of the patients. S. pyogenes were cultured from 43 of 96 pharyngeal swabs. Almost half of all positive samples (47%, n = 20) were collected from children aged 3 to 14 years. Positive GAS cultures were confirmed in 33% of patients with Centor/McIsaac score of 2 points, 48% of patients with score of 3, and 50% of patients with score of 4-5. Microbial cultures confirmed the positive results of QuikRead go® Strep A test in 83% of cases. Test specificity and sensitivity were calculated for the entire study group, which were 85% and 91%, respectively. The PPV of the test was 83% and its NPV was 92%. Using quick tests to detect GAS antigens appears a good alternative to conventional microbial diagnosis of strep throat, as it enables making a diagnosis and deciding on treatment plan in one appointment.
A 组链球菌（GAS）是细菌性咽炎的主要病原体，需要进行抗生素治疗。快速诊断检测 GAS 与 Centor/McIsaac 评分相结合，可实现准确的鉴别诊断（病毒与细菌）并及时开始靶向治疗。本研究旨在评估 QuikRead go® Strep A（芬兰 Orion Diagnostica Oy 公司）检测咽拭子中 GAS 的特异性、敏感性、PPV 和 NPV，该方法推荐用于 GAS 的检测。快速诊断检测结果与体格检查结果、Centor/McIsaac 评分和参考检测（常规微生物培养）结果进行比较。96 名参与者的研究组包括 44 名女性（46%）和 52 名男性（54%）；3-14 岁的儿童占患者的 46%。96 份咽拭子中培养出 43 株 S. pyogenes。所有阳性样本中近一半（47%，n=20）来自 3-14 岁的儿童。Centor/McIsaac 评分为 2 分的患者中，有 33%的患者 GAS 培养阳性，评分为 3 分的患者中有 48%阳性，评分为 4-5 分的患者中有 50%阳性。微生物培养证实 QuikRead go® Strep A 检测的阳性结果在 83%的病例中成立。计算了整个研究组的检测特异性和敏感性，分别为 85%和 91%。该检测的 PPV 为 83%，NPV 为 92%。使用快速检测来检测 GAS 抗原似乎是一种替代传统微生物诊断链球菌性咽炎的方法，因为它可以在一次就诊中做出诊断并决定治疗方案。
