Use of real-time polymerase chain reaction for the diagnosis of Pneumocystis pneumonia in immunocompromised patients: a meta-analysis / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 1965-1973, 2013.
Article
in English
| WPRIM
| ID: wpr-273062
ABSTRACT
<p><b>BACKGROUND</b>The diagnosis of Pneumocystis pneumonia (PCP) in immunocompromised patients is still challenging today due to the absence of an in vitro culture system and the low diagnostic accuracy of microscopic examinations. Herein, we performed a meta-analysis to evaluate the accuracy of real-time polymerase chain reaction (PCR) in the diagnosis of PCP.</p><p><b>METHODS</b>We searched Web of Knowledge and Medline from 1990 to May 2010 for studies reporting diagnostic accuracy data regarding the use of real-time PCR in the diagnosis of PCP in immunocompromised patients.</p><p><b>RESULTS</b>Ten individual studies were included. Overall, the sensitivity of real-time PCR was 97% (95%CI 93% - 99%); the specificity was 94% (95%CI 90% - 96%). The area under the HSROC curve (95%CI) for real-time PCR was 0.99 (0.97 - 0.99). In a subgroup analysis regarding studies involving HIV patients among the study population, the sensitivity and specificity were 97% (95%CI 93% - 99%) and 93% (95%CI 89% - 96%), respectively. Regarding studies using Bronchoalveolar lavage (BAL) samples only sensitivity = 98% (95%CI 94% - 99%); specificity = 93% (95%CI 89% - 96%), respectively. Regarding studies using microscopy as a reference standard sensitivity = 97% (95%CI 92% - 99%); specificity = 93% (95%CI 88% - 96%). However, high between-study statistical heterogeneity was observed in all analyses.</p><p><b>CONCLUSIONS</b>Real-time PCR has a good diagnostic accuracy and may provide a useful adjunctive tool for the diagnosis of PCP in immunocompromised patients. Further studies are needed in order to identify any differences in the diagnostic performance of real-time PCR in HIV and non-HIV immunocompromised patients.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumonia, Pneumocystis
/
Immunocompromised Host
/
Diagnosis
/
Real-Time Polymerase Chain Reaction
/
Genetics
/
Methods
Type of study:
Diagnostic study
/
Systematic reviews
Limits:
Humans
Language:
English
Journal:
Chinese Medical Journal
Year:
2013
Type:
Article
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