Peng Jie, Liu Yi, Zou Jiaqi, Wang Jingyao, Jorge Luis Cuyubamba Dominguez, Zhong Hong
Department of Laboratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610091, China.
Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu, China.
Eur J Obstet Gynecol Reprod Biol. 2025 Jan;304:141-151. doi: 10.1016/j.ejogrb.2024.11.035. Epub 2024 Nov 26.
This study aimed to determine the performance of RT PCR of GBS screening in pregnant women under different situations, especially compared to different reference methods (culture or composite standards) and preprocessing before detection (directly or enrichment).
We searched PubMed, the Cochrane Library: Cochrane Database of Systematic Reviews, EMBASE, and Google Scholar, and clinical trial registries such as ClinicalTrials.gov and WHO ICTRP until March 2024. The assessment of each study quality was performed using a modified QUADAS-2 instrument. The meta-analysis included pooled sensitivity, specificity, summary receiver operating characteristic (SROC) curve, and AUC. Publication bias was examined using Deek's funnel plot. Sensitivity analysis was conducted to evaluate the robustness of the meta-analysis. Index (I-square) and Q-test were performed to analyze the heterogeneity, and subgroup analysis and logistic meta-regression were used to identify the potential causes.
A total of 81 reports, including 133 research, were involved in the analysis. The pooled sensitivity and specificity of RT-PCR for detection of Group B Streptococcus in pregnant women were 96 % (95 %CI: 94 %-97 %) and 98 % (95 %CI:97 %-98 %), respectively. The pooled AUC value was 0.99 (95 %CI:0.98-1.00). In subgroup studies, there were four groups, including Group A (Enrichment & culture), Group B (Direct & culture), Group C (Enrichment & composite standard), and Group D (Direct & composite standard). Group A's pooled sensitivity and specificity were 98 % (95 %CI: 97 %-99 %) and 94 % (95 %CI:92 %-96 %), respectively. Group B's pooled sensitivity and specificity were 92 % (95 %CI: 89 %-94 %) and 96 % (95 %CI:95 %-97 %), respectively. Group C's pooled sensitivity and specificity were 98 % (95 %CI: 97 %-99 %) and 99 % (95 %CI: 99 %-99 %), respectively. Group D's pooled sensitivity and specificity were 93 %(95 %CI: 87 %-97 %) and 100 % (95 %CI:99 %-100 %), respectively. The pooled AUC values of the SROC for groups A, B, C, and D were 0.99 (95 %CI: 0.98-1.00), 0.98(95 %CI: 0.97-0.99), 1.00 (95 %CI: 0.99-1.00), and 0.99(95 %CI: 0.99-1.00), respectively.
本研究旨在确定不同情况下孕妇B族链球菌（GBS）筛查的逆转录聚合酶链反应（RT-PCR）性能，特别是与不同参考方法（培养或综合标准）以及检测前预处理（直接检测或富集）进行比较。
我们检索了截至2024年3月的PubMed、Cochrane图书馆：Cochrane系统评价数据库、EMBASE和谷歌学术，以及ClinicalTrials.gov和世界卫生组织国际临床试验注册平台（WHO ICTRP）等临床试验注册库。使用改良的QUADAS-2工具对每项研究的质量进行评估。荟萃分析包括合并敏感性、特异性、汇总接受者操作特征（SROC）曲线和曲线下面积（AUC）。使用Deek漏斗图检查发表偏倚。进行敏感性分析以评估荟萃分析的稳健性。采用I²指数和Q检验分析异质性，并使用亚组分析和逻辑荟萃回归来确定潜在原因。
共有81篇报告（包括133项研究）纳入分析。RT-PCR检测孕妇B族链球菌的合并敏感性和特异性分别为96%（95%CI：94%-97%）和98%（95%CI：97%-98%）。合并AUC值为0.99（95%CI：0.98-1.00）。在亚组研究中，有四组，包括A组（富集&培养）、B组（直接检测&培养）、C组（富集&综合标准）和D组（直接检测&综合标准）。A组的合并敏感性和特异性分别为98%（95%CI：97%-99%）和94%（95%CI：92%-96%）。B组的合并敏感性和特异性分别为92%（95%CI：89%-94%）和96%（95%CI：95%-）。C组的合并敏感性和特异性分别为98%（95%CI：97%-99%）和99%（95%CI：99%-99%）。D组的合并敏感性和特异性分别为9%（95%CI：87%-97%）和100%（95%CI：99%-100%）。A、B、C、D四组SROC的合并AUC值分别为0.99（95%CI：0.98-1.00）、0.98（95%CI：0.97-0.99）、1.00（95%CI：0.99-1.00）和0.99（95%CI：0.99-1.00）。
