Rogozińska Ewelina, Formina Sandra, Zamora Javier, Mignini Luciano, Khan Khalid S
Women's Health Research Unit and the Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; Centro Rosarino de Estudios Perinatales, Rosario, Argentina; and the Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS) and CIBER Epidemiology and Public Health, Madrid, Spain.
Obstet Gynecol. 2016 Sep;128(3):495-503. doi: 10.1097/AOG.0000000000001597.
To estimate the accuracy of onsite tests to detect asymptomatic bacteriuria among pregnant women.
We searched MEDLINE, EMBASE, Web of Science, Scopus, and Latin-American Literature from inception until June 2015 without language restrictions. The ClinicalTrials.gov register database was screened to identify any recently completed studies.
Two independent reviewers selected studies that recruited asymptomatic pregnant women to evaluate the accuracy of onsite tests in detecting the presence of bacteria in the urine using urine culture as a reference standard.
TABULATION, INTEGRATION, AND RESULTS: Women's characteristics, study design, urine sample collection, and handling were extracted along with the test accuracy data. Where possible, we pooled the data using a bivariate, hierarchical random-effects model. Of 1,360 screened references, 27 articles (13,641 women) with test accuracy data on nine tests met the inclusion criteria. The most commonly evaluated test was urine dipstick. The pooled sensitivity and specificity of nitrites detected by dipstick to detect asymptomatic bacteriuria were 0.55 (95% confidence interval [CI] 0.42-0.67) and 0.99 (95% CI 0.98-0.99), respectively. The Griess test to detect nitrites had a sensitivity of 0.65 (95% CI 0.50-0.78) and specificity of 0.99 (95% CI 0.98-1.00). Dipslide with Gram staining had a pooled sensitivity of 0.86 (95% CI 0.80-0.91) and specificity of 0.97 (95% CI 0.93-0.99).
The specificity of onsite tests is high; however, the sensitivity is not with the result that they will fail to detect a substantial number of cases of asymptomatic bacteriuria.
PROSPERO International prospective register of systematic reviews, http://www.crd.york.ac.uk/PROSPERO/, CRD42015027905.
评估现场检测在检测孕妇无症状菌尿方面的准确性。
我们检索了MEDLINE、EMBASE、科学网、Scopus以及拉丁美洲文献库，检索时间从建库起至2015年6月，无语言限制。对ClinicalTrials.gov注册数据库进行筛选，以识别任何近期完成的研究。
两名独立评审员选择招募无症状孕妇的研究，以尿培养作为参考标准，评估现场检测在检测尿液中细菌存在情况方面的准确性。
制表、整合与结果：提取了女性特征、研究设计、尿液样本采集及处理情况以及检测准确性数据。在可能的情况下，我们使用双变量分层随机效应模型汇总数据。在1360篇筛选的参考文献中，27篇文章（13641名女性）提供了9种检测的准确性数据，符合纳入标准。评估最频繁的检测是尿试纸检测。尿试纸检测亚硝酸盐以检测无症状菌尿的合并敏感度和特异度分别为0.55（95%置信区间[CI]0.42 - 0.67）和0.99（95%CI 0.98 - 0.99）。检测亚硝酸盐的格里斯试验敏感度为0.65（95%CI 0.50 - 0.78），特异度为0.99（95%CI 0.98 - 1.00）。革兰氏染色浸片法的合并敏感度为0.86（95%CI 0.80 - 0.91），特异度为0.97（95%CI 0.93 - 0.99）。
现场检测的特异度较高；然而，敏感度不高，结果是它们会漏检大量无症状菌尿病例。
国际前瞻性系统评价注册库PROSPERO，http://www.crd.york.ac.uk/PROSPERO/，CRD42015027905。
