White C B, Harris R, Weir M R, Gonzales I, Bass J W
Department of Pediatrics, William Beaumont Army Medical Center, El Paso, TX 79920-5001.
Clin Pediatr (Phila). 1988 Sep;27(9):431-4. doi: 10.1177/000992288802700904.
Despite its imperfections, the throat culture remains the "gold standard" against which all rapid streptococcal antigen detection tests are compared. Using triple throat swabs, the accuracy of a rapid latex agglutination (LA) test and back up throat culture was determined and compared with a simultaneously obtained additional throat culture in children with suspected streptococcal pharyngitis. Although there was a 95 percent concordancy between throat cultures, the sensitivity of the throat culture was only 87 percent. Despite the LA test's lower sensitivity (78 percent), in this clinical population with a relatively low prevalence of positive throat cultures (19 percent), the predictive value of a negative LA test was only slightly lower than that of the throat culture (94-95 percent vs. 97 percent). Backup throat cultures are commonly recommended for patients with initially negative LA test results, but 10 percent of the patients with group A beta-hemolytic streptococci-positive throat cultures would have been undetected using this approach.
尽管存在缺陷，但咽拭子培养仍是所有快速链球菌抗原检测试验进行比较的“金标准”。采用三联咽拭子，确定了快速乳胶凝集（LA）试验和备用咽拭子培养的准确性，并与疑似链球菌性咽炎儿童同时获得的另一咽拭子培养结果进行比较。尽管咽拭子培养之间的一致性为95%，但其敏感性仅为87%。尽管LA试验的敏感性较低（78%），但在咽拭子培养阳性率相对较低（19%）的这一临床人群中，LA试验阴性的预测值仅略低于咽拭子培养（94 - 95%对97%）。通常建议对LA试验结果最初为阴性的患者进行备用咽拭子培养，但采用这种方法会有10% A组β溶血性链球菌阳性咽拭子培养的患者漏诊。
