AdenoPlus即时检测用于诊断腺病毒性结膜炎的评估及其对抗生素管理的影响。
An Assessment of the AdenoPlus Point-of-Care Test for Diagnosing Adenoviral Conjunctivitis and Its Effect on Antibiotic Stewardship.
作者信息
Holtz Kelly K, Townsend Kalie R, Furst Joseph W, Myers Jane F, Binnicker Matthew J, Quigg Stephanie M, Maxson Julie A, Espy Mark J
机构信息
Department of Family Medicine, Mayo Clinic, Rochester, MN.
Urgent Care and Emergency Medicine Department, Mayo Clinic Health System Red Cedar, Menomonie, WI.
出版信息
Mayo Clin Proc Innov Qual Outcomes. 2017 Jul 25;1(2):170-175. doi: 10.1016/j.mayocpiqo.2017.06.001. eCollection 2017 Sep.
OBJECTIVE
To determine the sensitivity and specificity of the AdenoPlus test compared with real-time polymerase chain reaction (PCR) and to determine whether there was a reduction in antibiotic prescriptions with the use of AdenoPlus compared with the previous year.
PATIENTS AND METHODS
A total of 125 patients with suspected infectious conjunctivitis were accrued from June 4, 2015, through September 27, 2015. Forty-six participants from the prospective cohort completed both AdenoPlus and PCR testing. Two hundred fifty age-matched individuals were in the retrospective cohort.
RESULTS
There was a significant reduction in the percentage of patients who received an antibiotic ophthalmic prescription in the prospective cohort vs the retrospective cohort (32% vs 45%; χ=.01). AdenoPlus test sensitivity was 50% (5 of 10) and specificity was 92% (33 of 36) compared with real-time PCR testing.
CONCLUSION
The AdenoPlus test has high specificity for diagnosing adenoviral conjunctivitis but lower sensitivity than has been previously published. These data suggest that negative AdenoPlus results should be confirmed by real-time PCR owing to the low overall sensitivity of AdenoPlus observed.
目的
确定AdenoPlus检测相对于实时聚合酶链反应（PCR）的敏感性和特异性，并确定与上一年相比，使用AdenoPlus检测是否会减少抗生素处方的开具。
患者和方法
从2015年6月4日至2015年9月27日共纳入125例疑似感染性结膜炎患者。前瞻性队列中的46名参与者同时完成了AdenoPlus检测和PCR检测。回顾性队列中有250名年龄匹配的个体。
结果
与回顾性队列相比，前瞻性队列中接受抗生素眼科处方的患者百分比显著降低（32%对45%；χ = 0.01）。与实时PCR检测相比，AdenoPlus检测的敏感性为50%（10例中的5例），特异性为92%（36例中的33例）。
结论
AdenoPlus检测对腺病毒性结膜炎的诊断具有高特异性，但敏感性低于先前发表的数据。这些数据表明，由于观察到AdenoPlus的总体敏感性较低，其阴性结果应由实时PCR予以确认。
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