Atencion primaria · 2008
[Validation of a rapid antigenic test in the diagnosis of pharyngitis caused by group a beta-haemolytic Streptococcus].
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Llor Carles, Hernández Anadón Silvia, Gómez Bertomeu Frederic Francesc, Santamaria Puig Josep Maria, Calviño Domínguez Olga, Fernández Pagés Yvonne
Аннотация
OBJECTIVE: To determine the validity of the rapid antigen test (RAT) OSOM StrepA Genzyme for the diagnosis of acute pharyngitis caused by group A beta-haemolytic strep (GABHS).
DESIGN: Diagnostic techniques survey.
SETTING: Urban primary care centre, Spain.
PARTICIPANTS: All patients over 14 years old seen in 6 surgeries with sore throat and 2 or more Centor criteria: pharyngotonsillar exudate, tender laterocervical nodes, absence of coughing, and/or history or presence of fever.
PRINCIPAL MEASUREMENTS: Pharyngeal swabs were taken from all the patients, one for RAT and another to send for culture in the microbiology department.
RESULTS: A total of 182 patients were evaluable, with a mean age of 30.6 (12.1) years of which 116 were women (63.7%); 63 patients had 2 Centor criteria; 83 had 3 and 36, the 4 criteria. The culture was positive in 102 patients (56%), with GABHS showing infection in forty (22%; 95% confidence interval [CI], 21.2-22.8). Group C Streptococcus was isolated in 26 patients (14.3%). GABHS was higher among patients with four Centor criteria (38.9% vs 25.3% observed among those with 3 criteria and 7.9% with 2 criteria; P<.001). Sensitivity of RAT was 95%, with a specificity of 93%, a positive predictive value of 79.2% and a negative predictive value of 98.5%.
CONCLUSIONS: These results show the usefulness of RAT for diagnosing streptococcal pharyngitis. Its use should be spread to all primary care practices.
DESIGN: Diagnostic techniques survey.
SETTING: Urban primary care centre, Spain.
PARTICIPANTS: All patients over 14 years old seen in 6 surgeries with sore throat and 2 or more Centor criteria: pharyngotonsillar exudate, tender laterocervical nodes, absence of coughing, and/or history or presence of fever.
PRINCIPAL MEASUREMENTS: Pharyngeal swabs were taken from all the patients, one for RAT and another to send for culture in the microbiology department.
RESULTS: A total of 182 patients were evaluable, with a mean age of 30.6 (12.1) years of which 116 were women (63.7%); 63 patients had 2 Centor criteria; 83 had 3 and 36, the 4 criteria. The culture was positive in 102 patients (56%), with GABHS showing infection in forty (22%; 95% confidence interval [CI], 21.2-22.8). Group C Streptococcus was isolated in 26 patients (14.3%). GABHS was higher among patients with four Centor criteria (38.9% vs 25.3% observed among those with 3 criteria and 7.9% with 2 criteria; P<.001). Sensitivity of RAT was 95%, with a specificity of 93%, a positive predictive value of 79.2% and a negative predictive value of 98.5%.
CONCLUSIONS: These results show the usefulness of RAT for diagnosing streptococcal pharyngitis. Its use should be spread to all primary care practices.