Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, Saudi Arabia.
Microbiology Laboratory, Medical Laboratory Department, King Fahd Hospital of the University, Al Khobar, Saudi Arabia.
J Med Microbiol. 2023 Feb;72(2). doi: 10.1099/jmm.0.001624.
. Using rapid antigen diagnostic tests (RADTs) in clinical practice has shown excellent specificity but often has diminished sensitivity.. Local data for evaluating the diagnostic performance of a new fluorescence-based RADT and its influence on the antibiotic prescription rate are not available.. To evaluate the accuracy of fluorescent immunoassay (FIA)-RADTs for diagnosing group A streptococcal (GAS) pharyngitis among children and its estimated effect as a point of care test (POCT) on the antibiotic prescription rate at the paediatric emergency department.. A prospective study was conducted, comprising children 3 to 14 years old presenting with pharyngitis. Throat swab culture and FIA-RADTs were performed on all samples. Conventional PCR was performed on the discordant samples.. A total of 246 children were included in this study. The sensitivity, specificity, and positive and negative predictive values of the FIA-RADT, based on culture results and PCR detection combined, were 95.6, 96.8, 94.6 and 97.4 %, respectively. Antibiotics have been prescribed to 162 (65.9 %) children; however, if FIA-RADTs had been added in the clinical practice as a POCT, only 92 (37.4 %) children would have received antibiotics in total. Additionally, implementation of FIA-RADTs would significantly reduce the antibiotic prescription rate from 48.8 and 60.6 % to 9.5 and 31.9 % among patients with clinical scores of 2 and 3, respectively.. The new FIA-RADT is simple, prompt and reliable. It is helpful in clinical settings and may be used to reduce antibiotic overprescription, especially for children who have a low risk for GAS pharyngitis, according to the clinical score.
. 在临床实践中使用快速抗原诊断检测（RADTs）已显示出极佳的特异性，但通常敏感性降低。. 目前尚无本地数据可用于评估新型荧光 RADT 的诊断性能及其对儿科急诊抗生素处方率的影响。. 评估荧光免疫测定（FIA）-RADT 对儿童 A 组链球菌（GAS）咽炎的诊断准确性及其作为即时检测（POCT）在儿科急诊抗生素处方率方面的估计效果。. 进行了一项前瞻性研究，纳入了 3 至 14 岁因咽炎就诊的儿童。对所有样本进行咽拭子培养和 FIA-RADT。对不一致的样本进行常规 PCR。. 本研究共纳入 246 例儿童。FIA-RADT 的敏感性、特异性、阳性和阴性预测值，基于培养结果和 PCR 检测联合，分别为 95.6%、96.8%、94.6%和 97.4%。162 例（65.9%）儿童开具了抗生素；然而，如果将 FIA-RADT 作为 POCT 添加到临床实践中，那么总共只有 92 例（37.4%）儿童会开具抗生素。此外，实施 FIA-RADT 将使临床评分分别为 2 和 3 的患者的抗生素处方率从 48.8%和 60.6%显著降低至 9.5%和 31.9%。. 新型 FIA-RADT 简单、迅速、可靠。它有助于临床应用，并且根据临床评分，可能有助于减少抗生素的过度使用，特别是对于患有低风险 GAS 咽炎的儿童。
