Evaluation of GeneXpert vanA/vanB in the early diagnosis of vancomycin-resistant enterococci infection

Autor: Shan-Shan Xiao, Zhuo-Lei Li, Ze-Hong Lin, Qi-Bing Luo, Xu-Guang Guo, Tianxing Ji, Meng-Yi Han, Ye-Ling Liu, Jing-Hua Zhong
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Bacterial Diseases
RC955-962
Publication Ethics
Artificial Gene Amplification and Extension
Diagnostic accuracy
Pathology and Laboratory Medicine
Polymerase Chain Reaction
Likelihood ratios in diagnostic testing
Database and Informatics Methods
Medical Conditions
Mathematical and Statistical Techniques
Arctic medicine. Tropical medicine
Medicine and Health Sciences
Medicine
Database Searching
Research Integrity
GeneXpert MTB/RIF
Statistics
Vancomycin-Resistant Enterococci
Metaanalysis
Bacterial Pathogens
Anti-Bacterial Agents
Infectious Diseases
Medical Microbiology
Physical Sciences
Anatomy
Pathogens
Public aspects of medicine
RA1-1270
Research Article
medicine.medical_specialty
Web of science
Science Policy
Research and Analysis Methods
Microbiology
Sensitivity and Specificity
Bacterial Proteins
Vancomycin
Microbial Control
Internal medicine
Enterococcus Infections
Humans
Statistical Methods
Molecular Biology Techniques
Microbial Pathogens
Molecular Biology
Carbon-Oxygen Ligases
Gram-Positive Bacterial Infections
Pharmacology
Bacteria
business.industry
Rectum
Organisms
Public Health
Environmental and Occupational Health
Biology and Life Sciences
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
Gastrointestinal Tract
carbohydrates (lipids)
Diagnostic odds ratio
Antimicrobial Resistance
business
Digestive System
Enterococcus
Mathematics
Zdroj: PLoS Neglected Tropical Diseases, Vol 15, Iss 11 (2021)
PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 15, Iss 11, p e0009869 (2021)
ISSN: 1935-2735
1935-2727
Popis: 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.
Author summary Vancomycin-resistant enterococci (VRE), firstly identified in the mid-1980, is a type of antimicrobial resistance bacteria. In recent years, they were found more colonization in patients with critical diseases, showing new resistance to many antibacterial drugs, which is a worrisome clinical problem worldwide. Traditionally, VRE testing is performed mainly by culture which is a standard reference but requires complex steps and takes a long time. Currently, GeneXpert vanA/vanB were approved as a rapid and sensitive molecular assay for detecting VRE. However, the accuracy of GeneXpert vanA/vanB is without systematic-analyses in evidence-based medicine. Therefore, we conducted a data integration and analysis in this study. Finally, we draw a conclusion that GeneXpert vanA/vanB has a high accuracy diagnosing VRE in comparation with conventional culture and PCR. Furthermore, GeneXpert vanA/vanB shows more accuracy in diagnosing vanA. In addition, we suggest that an additional test is needed for further detecting vanB. This finding provides a promising direction for the diagnosis of VRE to a certain extent.
Databáze: OpenAIRE
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