Department of ICU, Zaozhuang Municipal Hospital, Zaozhuang277100, Shandong Province, P.R. China.
Postpartum Health Care Pelvic Floor Function Diagnosis and Treatment Center, Zaozhuang Maternity and Child Health Care Hospital, Zaozhuang277100, Shandong Province, P.R. China.
Epidemiol Infect. 2020 Jul 27;148:e171. doi: 10.1017/S0950268820001673.
Catheter-related blood-stream infections (CRBSIs) are the most common healthcare-associated blood-stream infections. They can be diagnosed by either semi-quantitative or quantitative methods, which may differ in diagnostic accuracy. A meta-analysis was undertaken to compare the diagnostic accuracy of semi-quantitative and quantitative methods for CRBSI. A systematic search of Medline, Scopus, Cochrane and Embase databases up to January 2020 was performed and subjected to a QUADAS (quality assessment of diagnostic accuracy studies 2) tool to evaluate the risk of bias among studies. The pooled sensitivity and specificity of the methods were determined and heterogeneity was evaluated using the χ2 test and I2. Publication bias was assessed using a Funnel plot and the Egger's test. In total, 45 studies were analysed with data from 11 232 patients. The pooled sensitivity and specificity of semi-quantitative methods were 85% (95% CI 79-90%) and 84% (95% CI 79-88%), respectively; and for quantitative methods were 85% (95% CI 79-90%) and 95% (95% CI 91-97%). Considerable heterogeneity was statistically evident (P < 0.001) by both methods with a correspondingly symmetrical Funnel plot that was confirmed by a non-significant Deek's test. We conclude that both semi-quantitative and quantitative methods are highly useful for screening for CRBSI in patients and display high sensitivity and specificity. Quantitative methods, particularly paired quantitative cultures, had the highest sensitivity and specificity and can be used to identify CRBSI cases with a high degree of certainty.
导管相关血流感染（CRBSI）是最常见的与医疗保健相关的血流感染。可以通过半定量或定量方法进行诊断，这两种方法的诊断准确性可能不同。进行了一项荟萃分析，以比较 CRBSI 的半定量和定量方法的诊断准确性。系统地检索了 Medline、Scopus、Cochrane 和 Embase 数据库，截至 2020 年 1 月，并使用 QUADAS（诊断准确性研究质量评估 2 工具）工具评估了研究中的偏倚风险。确定了方法的汇总敏感性和特异性，并使用 χ2 检验和 I2 评估了异质性。使用漏斗图和 Egger 检验评估发表偏倚。总共分析了 45 项研究，共纳入了 11232 名患者的数据。半定量方法的汇总敏感性和特异性分别为 85%（95%CI 79-90%）和 84%（95%CI 79-88%）；定量方法的汇总敏感性和特异性分别为 85%（95%CI 79-90%）和 95%（95%CI 91-97%）。两种方法均显示出统计学上显著的异质性（P<0.001），相应的 Funnel 图对称，并通过非显著的 Deek 检验得到证实。我们得出的结论是，半定量和定量方法都非常有助于筛查患者的 CRBSI，并具有较高的敏感性和特异性。定量方法，特别是配对定量培养，具有最高的敏感性和特异性，可以用于确定具有高度确定性的 CRBSI 病例。
