A群链球菌抗原快速检测法在儿童A群链球菌感染性疾病诊断中的应用

目的:探讨A群链球菌(GAS)抗原快速检测法在儿童GAS感染中的临床应用价值。方法:收集2015年1月至2019年12月在深圳市儿童医院门诊和住院部就诊的疑为GAS感染的患儿44 733例。采集所有患儿的咽拭子标本，用BinaxNOW Strep A Test试剂进行GAS抗原快速检测，其中有346例患儿的咽拭子先接种...

Diagnosis application of rapid detection of group A Streptococcus antigen in group A Streptococcus infection in children

Objective To explore the clinical application value of group A Streptococcus(GAS)antigen rapid detection method in children suffering from GAS infection.Methods A total of 44733 children with suspected GAS infection who were admitted to the Outpatient and Inpatient Departments of Shenzhen Children′s Hospital from January 2015 to December 2019.Throat swab specimens from all children were collected,and BinaxNOW Strep A Test reagent was used for GAS antigen rapid detection.Among them,the throat swabs of 346 children were inoculated with blood culture medium for traditional bacterial culture,and then the GAS antigen rapid detection was tested.The sensitivity and specificity of the two methods were compared,and according to the result of the GAS antigen rapid detection,its age,gender and seasonal trends were analyzed.SPSS 19.0 software was applied for statistical analysis of the data.Results Among the 346 children tested by both methods,the results of bacterial culture were adopted as the reference method,the sensitivity of the rapid detection method for GAS antigen was 89.41%(152/170 cases),and the specificity was 94.32%(166/176 cases)compared with culture methods.A total of 44733 cases GAS antigen were tested in children in Shenzhen,of which 10024 cases were positive,with the positive detection rate of 22.41%.The trend of GAS antigen rapid detection was consistent with the five-year trend,with the high positive rate of 3-8 years,of which 4-6 years of positive rate was the highest.The two seasonal peaks were evident each year,with peaks occurring in April-June,and November and January of next year.The detection rate ratio of male and female was 1.74∶1,and the gender difference was significant(χ2=27.93,P<0.0001).GAS antigen rapid detection rate in different clinical departments from high to low in order are as follows:dermatology outpatient(52.34%),emergency clinic(47.74%),internal medicine outpatient(37.36%),infectious disease area(19.71%),five-level disease area(10.27%),internal medicine area(8.63%),surgical areas(7.34%)and neonatal areas(0).Conclusions GAS antigen rapid detection method and bacterial culture method have high coincidence rate,and high sensitivity and specificity,and can be popularized and applied in the diagnosis of GAS infectious diseases in children.GAS detection rate is higher in outpatient emergency department and dermatology clinics.There are obvious differences from seasonal and population(age and gender)in the positive detection of GAS antigen.No neonates were found.