Bromberg K, Hammerschlag M R
Department of Pediatrics, College of Medicine, State University of New York Health Science Center, Brooklyn.
Semin Respir Infect. 1987 Sep;2(3):159-65.
Antigen detection techniques are available for the identification of bacterial polysaccharides, viruses, and chlamydia. Viruses and chlamydia are detected by direct immunofluorescence (DFA) or enzyme immunoassay (EIA). Bacterial polysaccharides are detected by latex agglutination or staphylococcal coagglutination of serum or concentrated urine. Most studies have not compared these techniques to the gold standard of lung puncture, so the role of dual infections with bacteria and viruses cannot be adequately determined. The sensitivity of any of these techniques is dependent on the quality of the antisera used. Monoclonal sera are now available for the detection of most viruses and seem to be as sensitive as polyclonal sera. DFA or EIA may offer equal sensitivity but their advantages and disadvantages must be considered by the local diagnostic laboratories. Most DFA and EIA systems have a sensitivity of 90% when compared with viral cultural for the identification of the organism. Agglutination reagents are available commercially for the detection of pneumococcal and Hemophilus influenzae type b polysaccharides. The sensitivity and specificity of each brand should be determined on serum or urine from patients known to have positive blood cultures and those free of disease. The brand chosen should be the one that has reasonable sensitivity and specificity. Rapid diagnostic techniques are helpful if they are used within a clinical context and they are positive. Negative tests do not rule out infection.
抗原检测技术可用于鉴定细菌多糖、病毒和衣原体。病毒和衣原体通过直接免疫荧光法（DFA）或酶免疫测定法（EIA）检测。细菌多糖通过血清或浓缩尿液的乳胶凝集或葡萄球菌协同凝集检测。大多数研究尚未将这些技术与肺穿刺的金标准进行比较，因此无法充分确定细菌和病毒双重感染的作用。这些技术中任何一种的敏感性都取决于所用抗血清的质量。现在有单克隆血清可用于检测大多数病毒，其敏感性似乎与多克隆血清相同。DFA或EIA可能具有相同的敏感性，但当地诊断实验室必须考虑它们的优缺点。与病毒培养用于鉴定病原体相比，大多数DFA和EIA系统的敏感性为90%。有商业化的凝集试剂可用于检测肺炎球菌和b型流感嗜血杆菌多糖。每个品牌的敏感性和特异性应根据已知血培养阳性患者和无疾病患者的血清或尿液来确定。应选择具有合理敏感性和特异性的品牌。如果在临床环境中使用且结果为阳性，快速诊断技术会有所帮助。阴性检测结果不能排除感染。
