Hirose Yumi, Akashi Yusaku, Sun Yu, Notake Shigeyuki, Ueda Atsuo, Kato Daisuke, Muramatsu Shino, Ishikawa Hiroichi, Suzuki Hiromichi
Department of General Medicine and Primary Care Tsukuba Medical Center Hospital Tsukuba Japan.
Division of Infectious Diseases, Department of Medicine Tsukuba Medical Center Hospital Tsukuba Japan.
J Gen Fam Med. 2022 Nov 28;24(2):102-109. doi: 10.1002/jgf2.596. eCollection 2023 Mar.
Microscopic examination of stool samples can contribute to the early diagnosis of gastroenteritis. However, it is unclear whether the diagnostic performance is reliable when performed by physicians.
This prospective study included fresh stool samples collected from patients with gastroenteritis between August 2018 and March 2020. The samples were used for microscopic examination through Gram staining. Two physicians, a clinical laboratory technician, and microbiologists performed the examinations. In addition, antigen tests (QuickNavi-Campylobacter; Denka Co., Ltd.) were evaluated for the samples collected between May 2019 and March 2020. Infection with spp. was confirmed when stool cultures or polymerase chain reaction tests provided positive results.
Microscopic examination was performed on 205 samples, of which 46 (22.4%) were positive for spp. For the microscopic examination, the sensitivity and specificity were 53.5% and 98.1% for physician A, 46.7% and 96.2% for physician B, 63.0% and 100% for the clinical laboratory technician, and 67.4% and 100% for microbiologists, respectively. The antigen testing was evaluated in 131 of the 205 samples and showed a sensitivity of 93.3% and specificity of 99.0%.
Microscopic examination of the stool samples showed high specificity. The sensitivity when the examinations were performed by the physicians was insufficient. The rapid antigen tests can reliably detect spp. in stool samples.
粪便样本的显微镜检查有助于肠胃炎的早期诊断。然而，尚不清楚医生进行此项检查时其诊断性能是否可靠。
这项前瞻性研究纳入了2018年8月至2020年3月期间从肠胃炎患者收集的新鲜粪便样本。样本通过革兰氏染色进行显微镜检查。两名医生、一名临床实验室技术员和微生物学家进行了检查。此外，对2019年5月至2020年3月期间收集的样本进行了抗原检测（QuickNavi - 弯曲杆菌检测试剂盒；电装株式会社）。当粪便培养或聚合酶链反应检测结果呈阳性时，确认感染了特定菌种。
对205份样本进行了显微镜检查，其中46份（22.4%）特定菌种呈阳性。对于显微镜检查，医生A的敏感性和特异性分别为53.5%和98.1%，医生B的敏感性和特异性分别为46.7%和96.2%，临床实验室技术员的敏感性和特异性分别为63.0%和100%，微生物学家的敏感性和特异性分别为67.4%和100%。在205份样本中的131份进行了抗原检测，其敏感性为93.3%，特异性为99.0%。
粪便样本的显微镜检查显示出高特异性。医生进行检查时的敏感性不足。快速抗原检测能够可靠地检测粪便样本中的特定菌种。
