Multiplex PCR System for Rapid Detection of Pathogens in Patients with Presumed Sepsis - A Systemic Review and Meta-Analysis

Shy Shin Chang, Wen Han Hsieh, Ting Shou Liu, Si Huei Lee, Chih Hung Wang, Hao Chang Chou, Yee Hui Yeo, Ching Ping Tseng, Chien Chang Lee

Research output: Contribution to journalArticle

151 Citations (Scopus)

Abstract

Background:Blood culture is viewed as the golden standard for the diagnosis of sepsis but suffers from low sensitivity and long turnaround time. LightCycler SeptiFast (LC-SF) is a real-time multiplex polymerase chain reaction test able to detect 25 common pathogens responsible for bloodstream infections within hours. We aim to assess the accuracy of LC-SF by systematically reviewing the published studies.Method:Related literature on Medline, Embase, and Cochrane databases was searched up to October 2012 for studies utilizing LC-SF to diagnose suspected sepsis and that provided sufficient data to construct two-by-two tables.Results:A total of 34 studies enrolling 6012 patients of suspected sepsis were included. The overall sensitivity and specificity for LC-SF to detect bacteremia or fungemia was 0·75 (95% CI: 0·65-0·83) and 0·92 (95%CI:0·90-0·95), respectively. LC-SF had a high positive likelihood ratio (10·10) and a moderate negative likelihood ratio (0·27). Specifically, LC-SF had a sensitivity of 0·80 (95%CI: 0·70-0·88) and a specificity of 0·95(95%CI: 0·93-0·97) for the bacteremia outcome, and a sensitivity of 0·61 (95%CI: 0·48-0·72) and a specificity of 0·99 (95%CI: 0·99-0·99) for the fungemia outcome. High heterogeneity was found in the bacteremia outcome subgroup but not in the fungemia outcome subgroup.Conclusion:LC-SF is of high rule-in value for early detection of septic patients. In a population with low pretest probability, LC-SF test can still provide valuable information for ruling out bacteremia or fungemia.

Original languageEnglish
Article numbere62323
JournalPLoS One
Volume8
Issue number5
DOIs
Publication statusPublished - May 29 2013
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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    Chang, S. S., Hsieh, W. H., Liu, T. S., Lee, S. H., Wang, C. H., Chou, H. C., Yeo, Y. H., Tseng, C. P., & Lee, C. C. (2013). Multiplex PCR System for Rapid Detection of Pathogens in Patients with Presumed Sepsis - A Systemic Review and Meta-Analysis. PLoS One, 8(5), [e62323]. https://doi.org/10.1371/journal.pone.0062323