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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

Forest plots for the diagnostic accuracy of 16S rRNA gene PCR.A. Sensitivity; B. Specificity; C. Positive likelihood ratio; D. Negative likelihood ratio.
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pone.0127195.g005: Forest plots for the diagnostic accuracy of 16S rRNA gene PCR.A. Sensitivity; B. Specificity; C. Positive likelihood ratio; D. Negative likelihood ratio.

Mentions: After analysis using the random effect model, our meta-analysis showed that sensitivity and specificity were 0.87 (95% CI, 0.85–0.89) and 0.94 (95% CI, 0.93–0.95), respectively (Fig 5A and 5B). The results suggested that 16S rRNA gene PCR test had a higher specificity than sensitivity in the diagnosis of BSIs. The overall PLR was 12.65 (95% CI, 8.04–19.90) (Fig 5C), the overall NLR was 0.14 (95% CI, 0.08–0.24) (Fig 5D), and the pooled DOR was 116.76 (95% CI, 52.02–262.05) (Fig 4). The SROC curve for the included studies was shown in Fig 6. The pooled AUC and Q* of SROC curve were 0.9690 and 0.9183, respectively.


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)

Forest plots for the diagnostic accuracy of 16S rRNA gene PCR.A. Sensitivity; B. Specificity; C. Positive likelihood ratio; D. Negative likelihood ratio.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0127195.g005: Forest plots for the diagnostic accuracy of 16S rRNA gene PCR.A. Sensitivity; B. Specificity; C. Positive likelihood ratio; D. Negative likelihood ratio.
Mentions: After analysis using the random effect model, our meta-analysis showed that sensitivity and specificity were 0.87 (95% CI, 0.85–0.89) and 0.94 (95% CI, 0.93–0.95), respectively (Fig 5A and 5B). The results suggested that 16S rRNA gene PCR test had a higher specificity than sensitivity in the diagnosis of BSIs. The overall PLR was 12.65 (95% CI, 8.04–19.90) (Fig 5C), the overall NLR was 0.14 (95% CI, 0.08–0.24) (Fig 5D), and the pooled DOR was 116.76 (95% CI, 52.02–262.05) (Fig 4). The SROC curve for the included studies was shown in Fig 6. The pooled AUC and Q* of SROC curve were 0.9690 and 0.9183, respectively.

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