GeneXpert vanA/vanB 在万古霉素耐药肠球菌感染早期诊断中的评价。
Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection.
机构信息
Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China.
出版信息
PLoS Negl Trop Dis. 2021 Nov 8;15(11):e0009869. doi: 10.1371/journal.pntd.0009869. eCollection 2021 Nov.
PURPOSE
Vancomycin-resistant enterococci infection is a worrying worldwide clinical problem. To evaluate the accuracy of GeneXpert vanA/vanB in the diagnosis of VRE, we conducted a systematic review in the study.
METHODS
Experimental data were extracted from publications until May 03 2021 related to the diagnostic accuracy of GeneXpert vanA/vanB for VRE in PubMed, Embase, Web of Science and the Cochrane Library. The accuracy of GeneXpert vanA/vanB for VRE was evaluated using summary receiver to operate characteristic curve, pooled sensitivity, pooled specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio.
RESULTS
8 publications were divided into 3 groups according to two golden standard references, vanA and vanB group, vanA group, vanB group, including 6 researches, 5 researches and 5 researches, respectively. The pooled sensitivity and specificity of group vanA and vanB were 0.96 (95% CI, 0.93-0.98) and 0.90 (95% CI, 0.88-0.91) respectively. The DOR was 440.77 (95% CI, 37.92-5123.55). The pooled sensitivity and specificity of group vanA were 0.86 (95% CI, 0.81-0.90) and 0.99 (95% CI, 0.99-0.99) respectively, and those of group vanB were 0.85 (95% CI, 0.63-0.97) and 0.82 (95% CI, 0.80-0.83) respectively.
CONCLUSION
GeneXpert vanA/vanB can diagnose VRE with high-accuracy and shows greater accuracy in diagnosing vanA.
目的
耐万古霉素肠球菌感染是一个令人担忧的全球性临床问题。为了评估 GeneXpert vanA/vanB 诊断 VRE 的准确性，我们在本研究中进行了系统评价。
方法
从 PubMed、Embase、Web of Science 和 Cochrane Library 中提取截至 2021 年 5 月 03 日与 GeneXpert vanA/vanB 诊断 VRE 的诊断准确性相关的实验数据。使用汇总受试者工作特征曲线、合并敏感度、合并特异度、阳性似然比、阴性似然比和诊断比值比评估 GeneXpert vanA/vanB 对 VRE 的准确性。
结果
根据两个金标准参考（vanA 和 vanB 组、vanA 组和 vanB 组），将 8 篇文献分为 3 组，分别包括 6 项研究、5 项研究和 5 项研究。vanA 和 vanB 组的合并敏感度和特异度分别为 0.96（95%CI，0.93-0.98）和 0.90（95%CI，0.88-0.91）。DOR 为 440.77（95%CI，37.92-5123.55）。vanA 组的合并敏感度和特异度分别为 0.86（95%CI，0.81-0.90）和 0.99（95%CI，0.99-0.99），vanB 组的合并敏感度和特异度分别为 0.85（95%CI，0.63-0.97）和 0.82（95%CI，0.80-0.83）。
结论
GeneXpert vanA/vanB 可高度准确地诊断 VRE，且在诊断 vanA 方面具有更高的准确性。
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