DIAGNOSTIC-VALUE OF A SINGLE, PRETREATMENT WIDAL TEST IN SUSPECTED ENTERIC FEVER CASES IN THE PHILIPPINES
DIAGNOSTIC-VALUE OF A SINGLE, PRETREATMENT WIDAL TEST IN SUSPECTED ENTERIC FEVER CASES IN THE PHILIPPINES
复制标题
DOI：
10.1016/0035-9203(87)90056-3
复制
发表时间：
1987-01-01
影响因子：
2.2
通讯作者：
CROSS, JH
中科院分区：
文献类型：
--
作者：
BUCK, RL;ESCAMILLA, J;CROSS, JH
对菲律宾马尼拉圣拉扎罗医院收治的101例临床疑似伤寒或副伤寒（肠）热患者进行了血液、直肠拭子、尿液和十二指肠囊袋细菌学培养; 35例还进行了骨髓穿刺液细菌学培养。其中44名患者经培养证实患有肠热病;其余患者被归类为非肠热病病例。对所有患者治疗前的肥达凝集效价分析表明，以伤寒沙门氏菌O抗原的抗体效价≥ 1：80作为诊断标准，其特异性为100%，而相应的敏感性仅为64%。通过使用鞭毛抗原滴度的不同截止值，可将试验的灵敏度提高至80%，但这同时将试验特异性从100%降低至82%。数据表明，在疑似肠热病病例中，单一的预处理肥达试验具有明确的诊断价值，但是必须谨慎地解释结果，并预知试验的缺点和局限性。
101 patients with a clinical suspicion of typhoid or paratyphoid (enteric) fever admitted to San Lazaro Hospital, Manila, Philippines, were studied by bacteriological culture of blood, rectal swab, urine and duodenal string capsule; 35 also had bacteriological culture of bone marrow aspirate. 44 of the patients were culture-confirmed as having enteric fever; the remainder were classified as non-enteric fever cases. Analysis of the pretreatment Widal agglutination titres of all patients revealed that using as a diagnostic criterion an antibody titre of ⩾ 1:80 to the O antigen ofSalmonella typhiyielded a test specificity of 100%, although the corresponding sensitivity was only 64%. The sensitivity of the test could be increased to 80% by using different cut-off values for titres to flagellar antigens, but this concomitantly decreased the test specificity from 100 to 82%. The data indicate that a single pretreatment Widal test in suspected enteric fever cases is of definite diagnostic value, but that the results must be interpreted with caution and foreknowledge of the test#x0027;s shortcomings and limitations.