澳大利亚湿热带地区的 A 群链球菌携带率及其对咽拭子临床用途的影响。

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Australian Journal of General Practice Pub Date : 2024-10-01 DOI:10.31128/AJGP-07-23-6897

Ronny K Gunnarsson, Ulrich Orda, Bradley Elliott, Clare Heal

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引用次数: 0

摘要

背景和目的：快速护理点检测（POCT）可能有助于检测 A 组链球菌（GAS），但其有用性取决于是否存在 GAS 携带者。在潮湿的热带地区，对这一问题的研究还很不够：这项研究包括 77 名因咽喉痛而到湿热带基层医疗机构就诊的患者和 49 名健康对照者。结果：GAS 携带率为 8.3%，POCT 预测值为 P-EPV 和 N-EPV：结果：健康儿童的携带率为 8.3%，成人为 2.7%。儿童的 P-EPV 为 71%（95% 置信区间 [CI]：0.0-100%），成人的 P-EPV 为 85%（95% 置信区间 [CI]：0.0-100%）。相应的 N-EPV，儿童为 99%（95% 置信区间：95-100%），成人为 99%（95% 置信区间：98-100%）：讨论：排除 GAS 的 N-EPV足够高，且 CI 很窄，可用于定义停止规则，以避免不必要的抗生素处方。

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Carrier rates of group A streptococci in Australian wet tropics and their impact on the clinical usefulness of throat swabs.

Background and objectives: Rapid point-of-care tests (POCT) are likely to assist with the detection of group A streptococci (GAS), but their usefulness is determined by the presence of carriers of GAS. This is insufficiently explored in the wet tropics.

Method: This study included 77 patients attending primary care in the wet tropics complaining of a sore throat, and 49 healthy controls. Carrier rates of GAS and the positive and negative etiological predictive values (P-EPV and N-EPV, respectively) of a POCT were calculated.

Results: The carrier rates were 8.3% among healthy children and 2.7% for adults. The P-EPV for children was 71% (95% confidence interval [CI]: 0.0-100%) and for adults it was 85% (95% CI: 0.0-100%). The corresponding N-EPV was 99% (95% CI: 95-100%) for children and 99% (95% CI: 98-100%) for adults.

Discussion: N-EPV, ruling out GAS, was sufficiently high with narrow CIs to allow for defining a stopping rule to avoid unnecessary antibiotic prescribing.

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来源期刊

Australian Journal of General Practice Medicine-Family Practice

CiteScore

2.80

自引率

4.50%

发文量

284

期刊介绍： The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.