비인두 면봉 검체와 비인두 흡인 검체로 시행한 SD BIOLINE Influenza Antigen 키트의 비교 평가
Comparison of SD BIOLINE Rapid Influenza Antigen Test Using Two Different Specimens, Nasopharyngeal Swabs and Nasopharyngeal Aspirates
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배경: 2009년 4월에 처음 발견되어 전 세계적으로 빠르게 퍼진 H1N1 2009에 대해 적절한 치료를 하기 위해서는 빠르고정확한 진단이 필요하다. SD Bioline 신속항원검사에서 비인두 면봉 검체와 비인두 흡인 검체를 사용하였을 때의 정확성을 비교하기 위해 다음 연구를 시행하였다. 방법: 2009년 8월부터 11월 사이 급성열성호흡기 증상으로 내원한 환자들을 대상으로 비인두 면봉 검체와 비인두 흡인검체를 채취하여 신속항원검사를 시행하였으며 이를 참고 표준인 multiplex RT-PCR과 비교하여 민감도, 특이도, 양성예측도와 음성예측도를 구하였다. 결과: 신속항원검사에 각각 244개 검체가 사용되었다. 비인두 면봉 검체로 시행한 신속항원검사의 민감도는 75.8%, 특이도는 93.3%였고 비인두 흡인 검체로 시행한 신속항원검사의 민감도는 61.3%, 특이도는 98.3%였다. 민감도는 비인두 면봉 검체가 높았고 특이도는 비인두 흡인 검체가 더 높았다. 결론: 비록 비인두 흡인 검체가 비인두 면봉 검체보다 민감도가 더 낮긴 하나 특이도가 높아 신속항원검사에서 위양성률을 줄일 수 있어 더 유용할 것으로 생각한다. [대한임상미생물학회지 2010;13:147-150]
Abstract
Background: The pandemic swine origin influenza A/H1N1 2009 virus (H1N1 2009) was rapidly spread out all over the world after it was first found in April,2009. This study was made to compare the performance of nasopharyngeal swabs and nasopharyngeal aspirates for the SD Bioline rapid influenza antigen test. Methods: From Aug to Nov, 2009 the SD Bioline rapid influenza antigen tests were conducted with the nasopharyngeal swabs and the nasopharyngeal aspirates from the 244 specimens of patients who had come to the hospital with influenza-like illness. The data from the examination were compared with the multiplex RT-PCR as a reference standard to obtain sensitivity, specificity, positive predictive value and negative predictive value. Results: The sensitivity and the specificity of the SD Bioline rapid influenza antigen tests with the nasopharyngeal swabs were 75.8%, and 93.3% respectively,and the sensitivity and specificity with the nasopharyngeal aspirates were 61.3%, and 98.3% respectively. Conclusion: Even if the nasopharyngeal aspirates showed the lower sensitivity than the nasopharyngeal swabs, since the specificity is higher, the nasopharyngeal aspirates are more useful because we can reduce false positive rate. (Korean J Clin Microbiol 2010;13:147-150)
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