Agreement between gastrointestinal panel testing and standard microbiology methods for detecting pathogens in suspected infectious gastroenteritis: Test evaluation and meta-analysis in the absence of a reference standard

被引:28
作者
Freeman, Karoline [1 ]
Tsertsvadze, Alexander [1 ]
Taylor-Phillips, Sian [1 ]
McCarthy, Noel [1 ,2 ]
Mistry, Hema [1 ]
Manuel, Rohini [3 ]
Mason, James [1 ]
机构
[1] Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England
[2] NIHR Hlth Protect Res Unit Gastrointestinal Infec, Oxford, England
[3] NIHR Hlth Protect Res Unit Gastrointestinal Infec, London, England
关键词
DIAGNOSIS; PERFORMANCE; ASSAY;
D O I
10.1371/journal.pone.0173196
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective Multiplex gastrointestinal pathogen panel (GPP) tests simultaneously identify bacterial, viral and parasitic pathogens from the stool samples of patients with suspected infectious gastroenteritis presenting in hospital or the community. We undertook a systematic to compare the accuracy of GPP tests with standard microbiology techniques. Review methods Searches in Medline, Embase, Web of Science and the Cochrane library were undertaken from inception to January 2016. Eligible studies compared GPP tests with standard microbiology techniques in patients with suspected gastroenteritis. Quality assessment of included studies used tailored QUADAS-2. In the absence of a reference standard we analysed test performance taking GPP tests and standard microbiology techniques in turn as the benchmark test, using random effects meta-analysis of proportions. Results No study provided an adequate reference standard with which to compare the test accuracy of GPP and conventional tests. Ten studies informed a meta-analysis of positive and negative agreement. Positive agreement across all pathogens was 0.93 (95% CI 0.90 to 0.96) when conventional methods were the benchmark and 0.68 (95% CI: 0.58 to 0.77) when GPP provided the benchmark. Negative agreement was high in both instances due to the high proportion of negative cases. GPP testing produced a greater number of pathogen-positive findings than conventional testing. It is unclear whether these additional ` positives' are clinically important. Conclusions GPP testing has the potential to simplify testing and accelerate reporting when compared to conventional microbiology methods. However the impact of GPP testing upon the management, treatment and outcome of patients is poorly understood and further studies are needed to evaluate the health economic impact of GPP testing compared with standard methods. The review protocol is registered with PROSPERO as CRD42016033320.
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相关论文
共 20 条
[1]  
[Anonymous], 2007, STAT GUID REP RES ST
[2]   Multiplex Molecular Panels for Diagnosis of Gastrointestinal Infection: Performance, Result Interpretation, and Cost-Effectiveness [J].
Binnicker, Matthew J. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2015, 53 (12) :3723-3728
[3]   Multicenter Evaluation of the BioFire FilmArray Gastrointestinal Panel for Etiologic Diagnosis of Infectious Gastroenteritis [J].
Buss, Sarah N. ;
Leber, Amy ;
Chapin, Kimberle ;
Fey, Paul D. ;
Bankowski, Matthew J. ;
Jones, Matthew K. ;
Rogatcheva, Margarita ;
Kanack, Kristen J. ;
Bourzac, Kevin M. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2015, 53 (03) :915-925
[4]   Performance of the xTAG® Gastrointestinal Pathogen Panel, a Multiplex Molecular Assay for Simultaneous Detection of Bacterial, Viral, and Parasitic Causes of Infectious Gastroenteritis [J].
Claas, Eric C. ;
Burnham, Carey-Ann D. ;
Mazzulli, Tony ;
Templeton, Kate ;
Topin, Francois .
JOURNAL OF MICROBIOLOGY AND BIOTECHNOLOGY, 2013, 23 (07) :1041-1045
[5]   Microbiological Diagnosis of Severe Diarrhea in Kidney Transplant Recipients by Use of Multiplex PCR Assays [J].
Coste, Jean-Francois ;
Vuiblet, Vincent ;
Moustapha, Betoul ;
Bouin, Alexis ;
Lavaud, Sylvie ;
Toupance, Olivier ;
de Rougemont, Alexis ;
Benejat, Lucie ;
Megraud, Francis ;
Wolak-Thierry, Aurore ;
Villena, Isabelle ;
Chemla, Cathy ;
Le Magrex, Elisabeth ;
de Champs, Christophe ;
Andreoletti, Laurent ;
Rieu, Philippe ;
Leveque, Nicolas .
JOURNAL OF CLINICAL MICROBIOLOGY, 2013, 51 (06) :1841-1849
[6]   A comparison of Luminex xTAG® Gastrointestinal Pathogen Panel (xTAG GPP) and routine tests for the detection of enteropathogens circulating in Southern China [J].
Deng, Jiankai ;
Luo, Xin ;
Wang, Ruilian ;
Jiang, Lingxiao ;
Ding, Xixia ;
Hao, Wei ;
Peng, Yongzheng ;
Jiang, Changhong ;
Yu, Nan ;
Che, Xiaoyan .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2015, 83 (03) :325-330
[7]   Asymptomatic Clostridium difficile Colonisation and Onward Transmission [J].
Eyre, David W. ;
Griffiths, David ;
Vaughan, Alison ;
Golubchik, Tanya ;
Acharya, Milind ;
O'Connor, Lily ;
Crook, Derrick W. ;
Walker, A. Sarah ;
Peto, Tim E. A. .
PLOS ONE, 2013, 8 (11)
[8]   When Should a New Test Become the Current Reference Standard? [J].
Glasziou, Paul ;
Irwig, Les ;
Deeks, Jonathan J. .
ANNALS OF INTERNAL MEDICINE, 2008, 149 (11) :816-W168
[9]   Comparative Evaluation of Broad-Panel PCR Assays for the Detection of Gastrointestinal Pathogens in Pediatric Oncology Patients [J].
Gu, Zhengming ;
Zhu, Haiqing ;
Rodriguez, Alicia ;
Mhaissen, Mohammad ;
Schultz-Cherry, Stacey ;
Adderson, Elisabeth ;
Hayden, Randall T. .
JOURNAL OF MOLECULAR DIAGNOSTICS, 2015, 17 (06) :715-721
[10]   Multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study [J].
Halligan, E. ;
Edgeworth, J. ;
Bisnauthsing, K. ;
Bible, J. ;
Cliff, P. ;
Aarons, E. ;
Klein, J. ;
Patel, A. ;
Goldenberg, S. .
CLINICAL MICROBIOLOGY AND INFECTION, 2014, 20 (08) :O460-O467