Clinical Laboratory, Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Diagn Microbiol Infect Dis. 2013 Aug;76(4):464-9. doi: 10.1016/j.diagmicrobio.2013.04.023. Epub 2013 May 25.
We aimed to summarize evidence on the accuracy of procalcitonin (PCT) test in differentiating fungal infection from other causes of infection. We searched electronic database for original researches that reported diagnostic performance of PCT alone or compare with other biomarkers to diagnose invasive fungal infection (IFI). We included 8 qualifying studies studying 474 episodes of suspected fungal infection with 155 (32.7%) probable or proven IFIs. Four studies compared IFI to bacterial sepsis, in which the pooled positive likelihood ratios and negative likelihood ratios were 4.65 (95% confidence interval [CI], 2.46-8.79) and 0.15 (95% CI, 0.05-0.41), respectively. Another 4 studies compared IFI to uninfected individuals, in which the pooled positive likelihood ratios and negative likelihood ratios were 4.01 (95% CI, 2.04-7.88) and 0.23 (0.07-0.77), respectively. The existing literature suggests good diagnostic accuracy for the PCT test for discrimination between IFIs and bacterial infection or noninfectious conditions. Given the high heterogeneity, medical decisions should be based on both PCT test results and clinical findings.
我们旨在总结降钙素原 (PCT) 检测在鉴别真菌感染与其他感染原因方面的准确性的证据。我们检索了电子数据库中单独报告 PCT 或与其他生物标志物比较以诊断侵袭性真菌感染 (IFI) 的诊断性能的原始研究。我们纳入了 8 项合格的研究，这些研究共纳入了 474 例疑似真菌感染的病例，其中 155 例（32.7%）为可能或确诊的 IFI。4 项研究将 IFI 与细菌性败血症进行了比较，汇总的阳性似然比和阴性似然比分别为 4.65（95%置信区间 [CI]，2.46-8.79）和 0.15（95% CI，0.05-0.41）。另外 4 项研究将 IFI 与未感染个体进行了比较，汇总的阳性似然比和阴性似然比分别为 4.01（95% CI，2.04-7.88）和 0.23（0.07-0.77）。现有文献表明，PCT 检测在鉴别 IFI 与细菌感染或非感染性疾病方面具有良好的诊断准确性。鉴于存在高度异质性，医疗决策应基于 PCT 检测结果和临床发现。
