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16S Ribosomal Ribonucleic Acid Gene Polymerase Chain Reaction in the Diagnosis of Bloodstream Infections: A Systematic Review and Meta-Analysis.

Su G, Fu Z, Hu L, Wang Y, Zhao Z, Yang W - PLoS ONE (2015)

Bottom Line: Using random-effect model analysis, the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.87 (95% CI, 0.85-0.89), 0.94 (95% CI, 0.93-0.95), 12.65 (95% CI, 8.04-19.90), 0.14 (95% CI, 0.08-0.24), and 116.76 (95% CI, 52.02-262.05), respectively.In addition, heterogeneity was statistically significant but was not caused by the threshold effect.Existing data suggest that 16S rRNA gene PCR test is a practical tool for the rapid screening of sepsis.

View Article: PubMed Central - PubMed

Affiliation: Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical College, Dongguan, China.

ABSTRACT

Objective: We aim to evaluate the accuracy of the 16S ribosomal ribonucleic acid (rRNA) gene polymerase chain reaction (PCR) test in the diagnosis of bloodstream infections through a systematic review and meta-analysis.

Methods: A computerized literature search was conducted to identify studies that assessed the diagnostic value of 16S rRNA gene PCR test for bloodstream infections. Study quality was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95% confidence intervals (95% CI) for each study. Summary receiver operating characteristic (SROC) curve was used to summarize overall test performance. Statistical analysis was performed in Meta-DiSc 1.4 and Stata/SE 12.0 software.

Results: Twenty-eight studies were included in our meta-analysis. Using random-effect model analysis, the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.87 (95% CI, 0.85-0.89), 0.94 (95% CI, 0.93-0.95), 12.65 (95% CI, 8.04-19.90), 0.14 (95% CI, 0.08-0.24), and 116.76 (95% CI, 52.02-262.05), respectively. The SROC curve indicated that the area under the curve (AUC) was 0.9690 and the maximum joint sensitivity and specificity (Q*) was 0.9183. In addition, heterogeneity was statistically significant but was not caused by the threshold effect.

Conclusion: Existing data suggest that 16S rRNA gene PCR test is a practical tool for the rapid screening of sepsis. Further prospective studies are needed to assess the diagnostic value of PCR amplification and DNA microarray hybridization of 16S rRNA gene in the future.

No MeSH data available.


Related in: MedlinePlus

Risk of bias and applicability concerns summary.Review authors' judgments about each domain for each included study.
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pone.0127195.g003: Risk of bias and applicability concerns summary.Review authors' judgments about each domain for each included study.

Mentions: The detailed quality information of the included studies is shown in S3 Table. According to QUADAS-2 tool, 24 (85.7%) studies were at low risk of patient selection bias. A similar situation was observed in the flow and timing. As for index test and reference standard, the overwhelming majority (82.1% and 92.9%, respectively) studies were at high or unclear risk due to insufficient information to judge whether their test results were interpreted blind. Only 6 studies reported blinded interpretation of index test [1, 10, 12, 18, 19, 36], and 2 studies reported the blinded interpretation of reference standard [35, 37]. From an overall perspective, the qualities of the reported studies all turned out to be moderate to high concerns about applicability. Risk of bias and applicability concerns graph is presented in Fig 2. Risk of bias and applicability concerns summary is presented in Fig 3.


16S Ribosomal Ribonucleic Acid Gene Polymerase Chain Reaction in the Diagnosis of Bloodstream Infections: A Systematic Review and Meta-Analysis.

Su G, Fu Z, Hu L, Wang Y, Zhao Z, Yang W - PLoS ONE (2015)

Risk of bias and applicability concerns summary.Review authors' judgments about each domain for each included study.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440735&req=5

pone.0127195.g003: Risk of bias and applicability concerns summary.Review authors' judgments about each domain for each included study.
Mentions: The detailed quality information of the included studies is shown in S3 Table. According to QUADAS-2 tool, 24 (85.7%) studies were at low risk of patient selection bias. A similar situation was observed in the flow and timing. As for index test and reference standard, the overwhelming majority (82.1% and 92.9%, respectively) studies were at high or unclear risk due to insufficient information to judge whether their test results were interpreted blind. Only 6 studies reported blinded interpretation of index test [1, 10, 12, 18, 19, 36], and 2 studies reported the blinded interpretation of reference standard [35, 37]. From an overall perspective, the qualities of the reported studies all turned out to be moderate to high concerns about applicability. Risk of bias and applicability concerns graph is presented in Fig 2. Risk of bias and applicability concerns summary is presented in Fig 3.

Bottom Line: Using random-effect model analysis, the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.87 (95% CI, 0.85-0.89), 0.94 (95% CI, 0.93-0.95), 12.65 (95% CI, 8.04-19.90), 0.14 (95% CI, 0.08-0.24), and 116.76 (95% CI, 52.02-262.05), respectively.In addition, heterogeneity was statistically significant but was not caused by the threshold effect.Existing data suggest that 16S rRNA gene PCR test is a practical tool for the rapid screening of sepsis.

View Article: PubMed Central - PubMed

Affiliation: Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical College, Dongguan, China.

ABSTRACT

Objective: We aim to evaluate the accuracy of the 16S ribosomal ribonucleic acid (rRNA) gene polymerase chain reaction (PCR) test in the diagnosis of bloodstream infections through a systematic review and meta-analysis.

Methods: A computerized literature search was conducted to identify studies that assessed the diagnostic value of 16S rRNA gene PCR test for bloodstream infections. Study quality was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95% confidence intervals (95% CI) for each study. Summary receiver operating characteristic (SROC) curve was used to summarize overall test performance. Statistical analysis was performed in Meta-DiSc 1.4 and Stata/SE 12.0 software.

Results: Twenty-eight studies were included in our meta-analysis. Using random-effect model analysis, the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.87 (95% CI, 0.85-0.89), 0.94 (95% CI, 0.93-0.95), 12.65 (95% CI, 8.04-19.90), 0.14 (95% CI, 0.08-0.24), and 116.76 (95% CI, 52.02-262.05), respectively. The SROC curve indicated that the area under the curve (AUC) was 0.9690 and the maximum joint sensitivity and specificity (Q*) was 0.9183. In addition, heterogeneity was statistically significant but was not caused by the threshold effect.

Conclusion: Existing data suggest that 16S rRNA gene PCR test is a practical tool for the rapid screening of sepsis. Further prospective studies are needed to assess the diagnostic value of PCR amplification and DNA microarray hybridization of 16S rRNA gene in the future.

No MeSH data available.


Related in: MedlinePlus