Value of multiple polymerase chain reaction test in cerebrospinal fluid for pathogenic diagnosis of community-acquired bacterial meningitis:a meta-analysis
LI Yi-xuan
GUO Ling-yun
GAO Cheng-feng
NIE Xiao-lu
LIU Gang
Abstract：Objective To systematically evaluate the value of multiple polymerase chain reaction(mPCR)in cerebrospinal fluid for pathogenic diagnosis of community-acquired bacterial meningitis(CABM).Methods Wanfang,Sinomed,Pubmed,Cochrane Library and Embase databases were searched from the establishment of the database to September 2021 according to the retrieval strategy.Two researchers conducted literature screening,quality assessment and data extraction independently.Meta-analysis was performed using Stata11.0 to calculate the combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio.The subject receiver operating characteristic(SROC)curve was drawn and the area under the curve(AUC)was also calculated.Subgroup analysis was performed according to study type,pathogen species and affected population.Sensitivity analysis was performed by one-by-one exclusion method,and publication bias was evaluated by Deek's funnel plot method.Results A total of 279 articles were retrieved,and 4679 cases of 19 articles were finally included according to exclusion and inclusion criteria.Meta-analysis showed that mPCR in CSF could increase the positive rate of bacterial culture pathogens by 0.89％～49.51％.The combined sensitivity and specificity of mPCR in CSF were 0.91[95％CI 0.75-0.97]and 0.88[95％CI 0.78-0.94],and the positive and negative likelihood ratios were 7.7[95％CI 3.9-15.2]and 0.11[95％CI 0.04-0.31],respectively.The diagnostic odds ratio was 72[95％CI 18-295]and the AUC was 0.95[95％CI 0.93-0.97].Subgroup analysis showed that mPCR detection had high diagnostic efficiency for three common pathogens of CABM(Streptococcus pneumoniae,Haemophilus and Meningococcal)and children.Sensitivity analysis showed that the results of this study were stable and credible.Conclusion The mPCR test in cerebrospinal fluid has high diagnostic efficiency in the diagnosis of CABM,and can be used as an auxiliary method for the pathogenic diagnosis of CABM.
Keywords：community acquired bacterial meningitisCABMmultiplex polymerase chain reactionmPCRdiagnostic valuemeta-analysis
Publication Date：2024-07-06
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 509-517 )