Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
BMC Infect Dis. 2024 May 14;24(1):494. doi: 10.1186/s12879-024-09274-4.
Brain-heart infusion agar supplemented with 4 µg/mL of vancomycin (BHI-V4) was commonly used for the detection of heterogeneous (hVISA) and vancomycin-intermediate Staphylococcus aureus (VISA). However, its diagnostic value remains unclear. This study aims to compare the diagnostic accuracy of BHI-V4 with population analysis profiling with area under the curve (PAP-AUC) in hVISA/VISA.
The protocol of this study was registered in INPLASY (INPLASY2023120069). The PubMed and Cochrane Library databases were searched from inception to October 2023. Review Manager 5.4 was used for data visualization in the quality assessment, and STATA17.0 (MP) was used for statistical analysis.
In total, eight publications including 2153 strains were incorporated into the meta-analysis. Significant heterogeneity was evident although a threshold effect was not detected across the eight studies. The summary receiver operating characteristic (SROC) was 0.77 (95% confidence interval [CI], 0.74-0.81). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic score and diagnostic odds ratio were 0.59 (95% CI: 0.46-0.71), 0.96 (95%CI: 0.83-0.99), 14.0 (95% CI, 3.4-57.1), 0.43 (95%CI, 0.32-0.57), 3.48(95%CI, 2.12-4.85) and 32.62 (95%CI, 8.31-128.36), respectively.
Our study showed that BHI-V4 had moderate diagnostic accuracy for diagnosing hVISA/VISA. However, more high-quality studies are needed to assess the clinical utility of BHI-V4.
脑心浸液琼脂添加 4μg/mL 万古霉素（BHI-V4）常用于检测异质性万古霉素敏感性金黄色葡萄球菌（hVISA）和万古霉素中介金黄色葡萄球菌（VISA）。然而，其诊断价值尚不清楚。本研究旨在比较 BHI-V4 与群体分析谱与曲线下面积（PAP-AUC）在 hVISA/VISA 中的诊断准确性。
本研究方案已在 INPLASY（INPLASY2023120069）中注册。从成立到 2023 年 10 月，检索了 PubMed 和 Cochrane 图书馆数据库。使用 Review Manager 5.4 进行质量评估中的数据可视化，使用 STATA17.0（MP）进行统计分析。
共有八项研究包括 2153 株纳入了荟萃分析。尽管八项研究均存在显著异质性，但未检测到阈值效应。综合受试者工作特征（SROC）为 0.77（95%置信区间 [CI]，0.74-0.81）。汇总的敏感性、特异性、阳性似然比、阴性似然比、诊断评分和诊断比值比分别为 0.59（95%CI：0.46-0.71）、0.96（95%CI：0.83-0.99）、14.0（95%CI，3.4-57.1）、0.43（95%CI，0.32-0.57）、3.48（95%CI，2.12-4.85）和 32.62（95%CI，8.31-128.36）。
本研究表明，BHI-V4 对诊断 hVISA/VISA 具有中等诊断准确性。然而，需要更多高质量的研究来评估 BHI-V4 的临床实用性。
