Gerber M A, Randolph M F, Chanatry J, Wright L L, DeMeo K K, Anderson L R
J Pediatr. 1986 May;108(5 Pt 1):654-8. doi: 10.1016/s0022-3476(86)81036-8.
The clinical significance of false-negative results on antigen detection tests for group A beta-hemolytic streptococcal (GABHS) pharyngitis (negative test results and positive culture) has yet to be determined. We recently compared the Culturette Brand Ten-Minute Group A Strep ID Kit with blood agar cultures in 313 patients with pharyngitis, 257 (82%) of whom had positive throat cultures for GABHS. The Culturette Brand test had a sensitivity of 88%, specificity of 96%, a positive predictive value of 99%, and negative predictive value of 64%. More than half of the false-negative Culturette Brand test results occurred in children with less than 10 GABHS colonies on throat culture (1+ culture). When these 1+ cultures were not considered positive, the sensitivity of the Culturette Brand test was 93%. The sensitivity of the Culturette Brand test increased with an increased degree of positivity of the corresponding throat culture. Of the 31 children with false-negative Culturette Brand test results, 14 (45%) had a significant streptococcal antibody response; of the 224 children with true-positive Culturette Brand test results (positive test results and positive culture) from whom serologic data were available, 114 (51%) had a significant streptococcal antibody response. This difference is not statistically significant. These findings suggest that almost half of patients with false-negative results on antigen detection tests for GABHS pharyngitis have true infections (positive culture and antibody rise) and are not merely streptococcal carriers.
A组β溶血性链球菌（GABHS）咽炎抗原检测试验假阴性结果（检测结果为阴性但培养结果为阳性）的临床意义尚未确定。我们最近将Culturette品牌的十分钟A组链球菌鉴定试剂盒与313例咽炎患者的血琼脂培养结果进行了比较，其中257例（82%）患者的咽喉培养结果显示GABHS阳性。Culturette品牌检测的灵敏度为88%，特异性为96%，阳性预测值为99%，阴性预测值为64%。超过一半的Culturette品牌检测假阴性结果出现在咽喉培养GABHS菌落少于10个（1+培养）的儿童中。当这些1+培养结果不被视为阳性时，Culturette品牌检测的灵敏度为93%。Culturette品牌检测的灵敏度随着相应咽喉培养阳性程度的增加而提高。在31例Culturette品牌检测结果为假阴性的儿童中，14例（45%）有显著的链球菌抗体反应；在224例Culturette品牌检测结果为真阳性（检测结果为阳性且培养结果为阳性）且有血清学数据的儿童中，114例（51%）有显著的链球菌抗体反应。这种差异无统计学意义。这些发现表明，GABHS咽炎抗原检测试验结果为假阴性的患者中，近一半有真正的感染（培养结果为阳性且抗体升高），而不仅仅是链球菌携带者。
