• 作者：J. Ruiz-Aragó ; n ; ^{jesusm.ruiz.ext@juntadeandalucia.es} ; R. Rodrí ; guez Ló ; pez ; J.M. Molina Linde
• 关键词：Faringitis ; Streptococcus pyogenes ; Test diagnó ; stico
• 刊名：Anales de Pediatr铆a
• 出版年：2010
• 期刊代码：pca47_16954033
• 类别：med
• 出版时间：June 2010
• 卷：72
• 期：6
• 页码：391-402
• 文件大小：1269 K

Introduction

Streptococcal pharyngitis is one of the most frequent reasons for consultations in primary and paediatric care. An inadequate treatment could cause adverse effects and bacterial resistance. The rapid antigen tests are an important advance, enabling the diagnosis of infection by Streptococcus pyogenes to be diagnosed in a few minutes. The aim of this review is to assess the rapid antigen-detection test in the diagnosis of S. pyogenes from throat samples.

Material and methods

Systematic review and meta-analysis (2000鈥?9). Source database: MedLine, Embase, Cochrane Library, Cinahl, CRD, ECRI, Hayes and HTA's agencies. The quality of included studies was measured according to Quadas鈥瞫 criteria. The diagnostic validity indices have been calculated. A meta-analysis was performed in order to synthesize the results of the different evaluated studies.

Results

Twenty four studies were included. The quality was moderate. The sensitivity ranged between 65.6%and 96.4%; specificity from 68.7%鈥?9.3%; the positive predictive value was between 59.4%鈥?7.4%; and the negative predictive value from 87.8%鈥?8%. The meta-analysis determined an overall sensitivity of 0.85 [95%CI, 0.84鈥?.87], specificity was 0.96 [95%CI, 0.96鈥?.97], likelihood ratio (+) 22.21 [95%CI, 15.12鈥?2.63], and likelihood ratio (鈥? 0.15 [95%CI, 0.13鈥?.18]. The rapid antigen-detection test demonstrated a good diagnostic performance.

Conclusions

Rapid tests offer good accuracy for use as diagnostic method, however, these devices have to be complemented with the microbiological culture, because there are false positive and negative results.