The Accuracy of 16S rRNA Polymerase Chain Reaction for the Diagnosis of Neonatal Sepsis: A Meta-Analysis.

Ying Wang,Jingyi Zhao,Yinhui Yao,Shiquan Liu,Lan Yang,Dan Zhao,Sanket Kaushik

doi:10.1155/2021/5550387

Abstract

Objective To determine the accuracy of 16S rRNA polymerase chain reaction (PCR) for the diagnosis of neonatal sepsis through a systematic review and meta-analysis. Methods Studies involving 16S rRNA PCR tests for the diagnosis of neonatal sepsis were searched in the PubMed, Medline, Embase, and Cochrane Library databases. The methodological quality of the identified studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), and the sensitivity, the specificity, the positive likelihood ratio (PLR), the negative likelihood ratio (NLR), the diagnostic odds ratio (DOR), and the area under the curve (AUC) of operator characteristic (SROC) curves were determined. Heterogeneity between studies was analyzed by metaregression. Stata 14.0 and Meta-disc 1.4 software were used for the analyses. Results This meta-analysis included 19 related studies. The analysis found a sensitivity of 0.98 (95% CI: 0.85-1), specificity of 0.94 (95% CI: 0.87-0.97), PLR of 16.0 (95% CI: 7.6-33.9), NLR of 0.02 (95% CI: 0.00-0.18), DOR of 674 (95% CI: 89-5100), and AUC of 0.99 (95% CI: 0.97-0.99). Metaregression analysis identified Asian countries, arterial blood in blood samples, and sample size > 200 as the main sources of heterogeneity. This meta-analysis did not uncover publication bias. Sensitivity analysis showed that the study was robust. Fagan's nomogram results showed clinical usability. Conclusions The results from this meta-analysis indicate that 16S rRNA PCR testing is effective for the rapid diagnosis of neonatal sepsis.

Highlights

Neonatal sepsis, a systemic inflammatory reaction to the invasion of bacteria, viruses, fungi, and other pathogens in a newborn’s blood, produces toxins and is the most common form of infectious disease among newborns [1]
Past studies demonstrated the high potential of 16S rRNA PCR tests for diagnosing bloodstream infections. This strategy has been suggested to be effective and fast for screening sepsis [42]. In this meta-analysis, we evaluated the performance of 16S rRNA PCR for neonatal sepsis diagnosis relative to blood culture techniques. 16S rRNA PCR tests have the potential to accelerate neonatal sepsis diagnosis, thereby ensuring timely and effective treatment
Our analysis found that the sensitivity and specificity of 16S rRNA PCR tests for neonatal sepsis diagnosis were 0.98 and 0.94, respectively, indicating high diagnostic effectiveness

Summary

Objective

To determine the accuracy of 16S rRNA polymerase chain reaction (PCR) for the diagnosis of neonatal sepsis through a systematic review and meta-analysis. Studies involving 16S rRNA PCR tests for the diagnosis of neonatal sepsis were searched in the PubMed, Medline, Embase, and Cochrane Library databases. Metaregression analysis identified Asian countries, arterial blood in blood samples, and sample size > 200 as the main sources of heterogeneity. This meta-analysis did not uncover publication bias. The results from this meta-analysis indicate that 16S rRNA PCR testing is effective for the rapid diagnosis of neonatal sepsis

Introduction

Methods

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Discussion