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  

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

作　　者：孙丽芳[1] 马东礼[2] 陈虹宇[1] 赖建威 孟青 叶炳均 杨方华[1] Sun Lifang;Ma Dongli;Chen Hongyu;Lai Jianwei;Meng Qing;Ye Bingjun;Yang Fanghua(Laboratory of Shenzhen Children′s Hospital,Shenzhen 518038,Guangdong Province,China;Pediatric Institute of Shenzhen Children′s Hospital,Shenzhen 518038,Guangdong Province,China)

机构地区：[1]深圳市儿童医院检验科,518038 [2]深圳市儿童医院儿科研究所,518038

出　　处：《中华实用儿科临床杂志》2021年第1期46-49,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：深圳市科创委基础研究学科布局项目(JCYJ20170413094034978)。

摘　　要：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44733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血培养基进行传统的细菌培养,再行GAS抗原快速检测,比较2种方法的灵敏度和特异度,并根据GAS抗原快速检测结果,分析其年龄、性别及季节变化趋势。应用SPSS 19.0软件对数据进行统计分析。结果346例同时用2种方法检测的患儿中,以细菌培养法结果作为参考方法,GAS抗原快速检测法敏感度为89.41%(152/170例),特异度为94.32%(166/176例)。共检测GAS抗原44733例,其中阳性10024例,阳性检出率为22.41%。GAS抗原快速检测法阳性率5年的曲线趋势一致,均以3~8岁阳性率较高,其中4~6岁阳性率最高。2个季节性高峰明显,分别出现于每年的4-6月,11月-次年1月。男女检出率比例为1.74∶1,性别差异有统计学意义(χ2=27.93,P<0.0001)。GAS抗原快速检测在不同病区阳性检出率由高到低依次为皮肤科门诊(52.34%)、急诊科门诊(47.74%)、内科门诊(37.36%)、感染病区(19.71%)、五官科病区(10.27%)、内科病区(8.63%)、外科病区(7.34%)、新生儿病区(0)。结论GAS抗原快速检测法和细菌培养法结果符合率高,且具有较高的敏感度和特异度,可在儿童GAS感染性疾病诊断中推广使用。GAS检出率在急诊科门诊和皮肤科就诊患儿较高。GAS抗原阳性检出率存在明显的季节性和人群(年龄和性别)差异,未发现新生儿感染者。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 ar

关 键 词：A群链球菌 A群链球菌抗原快速检测 儿童 猩红热 

分 类 号：R725.1[医药卫生—儿科]