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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

Diagnostic Odds Ratio with Cochran-Q value.
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pone.0127195.g004: Diagnostic Odds Ratio with Cochran-Q value.

Mentions: Spearman correlation coefficient of sensitivity and 1-specificity was found to be -0.177 with a ρ value of 0.367, indicating that there was no heterogeneity caused by the threshold effect. As was depicted in the Fig 4, statistically significant heterogeneity was observed when we pooled DOR of included studies. The result suggested that there should be other factors rather than threshold effect resulting in variations in accuracy estimates. We performed the univariable meta-regression analysis based on the publication year, sample size, disease type (sepsis or bacteremia), population characteristics (neonates or adult), and PCR test (qualitative or quantitative). Meta-regression analysis indicated that disease type and PCR test were significantly (p<0.05) associated with specificity and that population characteristics were significantly (p<0.05) related to the sensitivity. The detailed results of meta-regression analysis are presented in S4 Table and S1 Fig. Therefore, we decided that a random-effects model was used to eliminate some heterogeneity.


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)

Diagnostic Odds Ratio with Cochran-Q value.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0127195.g004: Diagnostic Odds Ratio with Cochran-Q value.
Mentions: Spearman correlation coefficient of sensitivity and 1-specificity was found to be -0.177 with a ρ value of 0.367, indicating that there was no heterogeneity caused by the threshold effect. As was depicted in the Fig 4, statistically significant heterogeneity was observed when we pooled DOR of included studies. The result suggested that there should be other factors rather than threshold effect resulting in variations in accuracy estimates. We performed the univariable meta-regression analysis based on the publication year, sample size, disease type (sepsis or bacteremia), population characteristics (neonates or adult), and PCR test (qualitative or quantitative). Meta-regression analysis indicated that disease type and PCR test were significantly (p<0.05) associated with specificity and that population characteristics were significantly (p<0.05) related to the sensitivity. The detailed results of meta-regression analysis are presented in S4 Table and S1 Fig. Therefore, we decided that a random-effects model was used to eliminate some heterogeneity.

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