Evaluation of rapid methods for detecting Streptococcus pyogenes. systematic review and meta-analysis
Evaluation of rapid methods for detecting Streptococcus pyogenes. systematic review and meta-analysis
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DOI：
10.1016/j.anpedi.2009.12.012
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发表时间：
2010-06-01
影响因子：
2.1
通讯作者：
Molina Linde, J. M.
中科院分区：
文献类型：
--
作者：
Ruiz-Aragon, J.;Rodriguez Lopez, R.;Molina Linde, J. M.
前言：链球菌性咽炎是初级和儿科就诊最常见的原因之一。不适当的治疗可能会导致不良反应和细菌耐药性。快速抗原测试是一项重要的进步，使化脓性链球菌感染的诊断在几分钟内就能被诊断出来。本综述的目的是评价快速抗原检测试验在咽喉标本化脓性链球菌诊断中的应用。材料和方法：系统回顾和荟萃分析(2000-09)。来源数据库：Medline、Embase、Cochrane图书馆、Cinahl、CRD、ECRI、Hayes和HTA的机构。纳入研究的质量根据Quadas的标准进行衡量。计算了诊断效度指数。结果：共纳入24篇研究。质量中等。其敏感性为65.6%~96.4%，特异性为68.7%~99.3%，阳性预测值为59.4%~97.4%，阴性预测值为87.8%~98%。Meta分析的总体敏感性为0.85[95%CI，0.84~0.87]，特异性为0.96[95%CI，0.96~0.97]，似然比(+)22.21[95%CI，15.12~32.63]，似然比(-)0.15[95%CI，0.13~0.18]。结论：快速抗原检测作为诊断方法具有较好的准确性，但存在假阳性和阴性结果，需与微生物培养结合使用。(C)2009年西班牙儿科协会。由Elsevier Espana，S.L.出版，版权所有。
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 09). Source database: MedLine, Embase, Cochrane Library, Cinahl, CRD, ECRI, Hayes and HTA's agencies. The quality of included studies was measured according to Quadas's 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% - 99.3%; the positive predictive value was between 59.4% - 97.4%; and the negative predictive value from 87.8% - 98%. The meta-analysis determined an overall sensitivity of 0.85 [95% CI, 0.84 - 0.87], specificity was 0.96 [95% Cl, 0.96 - 0.97], likelihood ratio (+) 22.21 [95% CI, 15.12 - 32.63], and likelihood ratio (-) 0.15 [95% CI, 0.13 - 0.18]. 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. (C) 2009 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L. All rights reserved.