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Zuverlässigkeit und Praxistauglichkeit von 2 Streptokokken-A-Schnelltests

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Zusammenfassung

Streptokokken-A-Schnelltests haben im Vergleich zur konventionellen Kultur eine gute Spezifität über 90% bei jedoch nur mäßiger Sensitivität um 80–90%.

Wir untersuchten die Zuverlässigkeit des optischen Immunoassays Strep A OIA MAX der Fa. Thermo BioStar im Vergleich mit dem Enzym-Immunoassay Strep A Plus der Fa. Abbott an 65 Notfallpatienten mit akuter Tonsillopharyngitis. Als Referenz wurde eine Schafblutagarkultur verwendet, die bei unterschiedlichen Ergebnissen beider Schnelltests mit einer selektiven Anreicherungsbouillon und einem Genomnachweis mittels Gensonde (Gen-Probe) bestätigt wurde.

Zusammenfassend war der Strep A Plus bei ähnlicher Zuverlässigkeit wesentlich einfacher und schneller durchzuführen als der Strep A OIA MAX. Wegen der nur moderaten Sensitivität beider Schnelltests ist ggf. das Anlegen einer Kultur empfehlenswert.

Abstract

Rapid streptococcal-A-antigen detection assays have good specificity (over 90 percent) but moderate sensitivity (between 80 and 90 percent), when the tests are compared with a standard throat culture. Contradictory results have been found for one of the more recent tests, the optical immune assay Strep A OIA MAX, while for 6 years, we have been using the immune assay Strep A Plus.

Results of the optical immunoassay and the conventional immune assay Strep A Plus were compared in 65 patients with acute pharyngitis. A standard culture was used as reference and confirmed by enhanced broth culturing and nucleic acid hybridization assay (Gen-Probe) when the two detection assays produced contradictory results.

While both assays were equally sensitive (78.3%), Strep A OIA MAX and Strep A Plus had a similar specificity of 95.2% and 100%, respectively.

Four and nine steps were required for Strep A Plus and for Strep A OIA MAX test procedures, respectively with results being available in 4–5 min and in 9–10 min, respectively.

We conclude that both rapid immunoassays have a similar reliability while the handling of the Strep A Plus is much simpler than the handling of the Strep A OIA MAX. Neither rapid immunoassays are sensitive enough to eliminate the need for backup cultures.

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Danksagung

Wir bedanken uns herzlich für die Finanzierung dieser Studie durch einen wissenschaftlichen Kredit des Kantonsspitals Basel-Stadt und möchten darauf hinweisen, dass diese Studie firmenunabhängig finanziert wurde.

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Authors and Affiliations

  1. HNO-Universitätsklinik, Kantonspital Basel

    N. Schmuziger & S. Schneider

  2. Bakteriologielabor, Departement Zentrallaboratorium, Kantonsspital Basel

    R. Frei

  3. HNO-Universitätsklinik, Kantonsspital, Petersgraben 4, CH-4031 Basel

    N. Schmuziger

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  1. N. Schmuziger
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  2. S. Schneider
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  3. R. Frei
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Correspondence to N. Schmuziger.

Additional information

Auszugsweise vorgestellt während der 89. Frühjahresversammlung der Schweizerischen Gesellschaft für Oto-Rhino-Laryngologie, Hals- und Gesichtschirurgie in Pontresina 2002.

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Schmuziger, N., Schneider, S. & Frei, R. Zuverlässigkeit und Praxistauglichkeit von 2 Streptokokken-A-Schnelltests. HNO 51, 806–812 (2003). https://doi.org/10.1007/s00106-003-0816-z

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