Diagnostic Accuracy of Carba NP test for Rapid Detection of Carbapenemase-Producing Enterobacteriaceae: Systematic Review and Meta-Analysis

Abstract

Background: Carbapenem-Resistant Enterobacteriaceae is a major health concern that needs a fastresponse by rapid detection and management. The Polymerase chain reaction is the gold standard methodfor the detection of this infection, but it is expensive and needs special laboratory facilities, so there isan urgent demand for an alternative method characterized by cheap, rapid, and accurate. CARPA NP testhas been proposed as a rapid method for the detection of Carbapenemase-Producing Enterobacteriaceae,but its overall accuracy has not been systematically estimated. We performed a systematic review andmeta-analysis to evaluate the accuracy of CARPA NP test for the detection of Carbapenemase-ProducingEnterobacteriaceae.Methods: We searched Pubmed and Embase databases and eighteen studies met our inclusion criteria.We utilized summary receiver operating characteristic (SROC) to summarize the accuracy. Results: Thesensitivity and specificity of CARPA NP test were 0.96 (95% CI, 0.92 to 0.98) and 1.00 (95% CI, 0.97 to1.00) respectively, the positive likelihood ratio was 33.1 (95% CI, 24.3 to 45.1), the negative likelihood ratiowas 0.06 (95% CI, 0.05 to 0.07), and the diagnostic odds ratio was 573.46 (95% CI, 397.4 to 827.49).Conclusion: CARPA NP test has a high level of accuracy for the rapid detection of Carbapenemase-Producing Enterobacteriaceae. Additional studies are required to estimate the accuracy of Carba NP testwhen applied directly to clinical samples, especially in areas with high rates of carbapenemase-producingEnterobacteriaceae