Dijagnostičke karakteristike McIsaac skora za streptokokni faringitis grupe A kod dece mlađe od tri godine
Sažetak
Uvod/Cilj. Faringitis izazvan β-hemolitičkim streptokokom grupe A (group A β-hemolytic streptococcus – GAS) najčešće pogađa decu školskog uzrasta. Cilj rada bio je da se procene efikasnost i klinička primenljivost McIsaac skora u dijagnostikovanju faringitisa izazvanog GAS-om kod dece mlađe od 3 godine. Metode. Retrospektivnom studijom obuhvaćeno je 282 dece mlađe od 3 godine, kojima je postavljena dijagnoza akutni faringitis u pedijatrijskoj ambulanti u Subotici, Srbija, u periodu od septembra 2023. do avgusta 2024. godine. Prikupljeni su podaci o demografskim i kliničkim karakteristikama, uključujući vrednosti McIsaac skora. Dobijeni rezultati analizirani su u odnosu na nalaze brzog antigenskog testa (rapid antigen detection test – RADT), koji je urađen svakom detetu. Rezultati. Od ukupno 282 dece, 143 (50,7%) bilo je RADT pozitivno. McIsaac skor pokazao je ograničenu dijagnostičku tačnost, sa vrednostima osetljivosti i specifičnosti za rezultate 0–2 od 69,9% i 38,1%, redom, i za rezultate 3–4 od 30,7% i 61,9%, redom. Analizom receiver operating characteristic (ROC) krive dobijena je vrednost površine ispod krive (area under the curve – AUC) od 0,561. Odsustvo kašlja bio je jedini pojedinačni kriterijum McIsaac skora značajno povezan sa pozitivnim nalazom RADT-a. Zaključak. McIsaac skor, sam po sebi, ima ograničenu efikasnost u prepoznavanju GAS izazvanog faringitisa kod dece mlađe od 3 godine. S obzirom na značajno preklapanje simptoma bakterijskih i virusnih infekcija u ovoj uzrasnoj grupi, neophodne su dodatne dijagnostičke metode radi unapređenja tačnosti dijagnoze.
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