Accuracy of real-time polymerase chain reaction test for Group B Streptococcus detection in pregnant women: A systematic review and meta-analysis

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-11-26 DOI:10.1016/j.ejogrb.2024.11.035

Jie Peng , Yi Liu , Jiaqi Zou , Jingyao Wang , Cuyubamba Dominguez Jorge Luis , Hong Zhong

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引用次数: 0

Abstract

Objectives

This study aimed to determine the performance of RT PCR of GBS screening in pregnant women under different situations, especially compared to different reference methods (culture or composite standards) and preprocessing before detection (directly or enrichment).

Materials and methods

We searched PubMed, the Cochrane Library: Cochrane Database of Systematic Reviews, EMBASE, and Google Scholar, and clinical trial registries such as ClinicalTrials.gov and WHO ICTRP until March 2024. The assessment of each study quality was performed using a modified QUADAS-2 instrument. The meta-analysis included pooled sensitivity, specificity, summary receiver operating characteristic (SROC) curve, and AUC. Publication bias was examined using Deek’s funnel plot. Sensitivity analysis was conducted to evaluate the robustness of the meta-analysis. Index (I-square) and Q-test were performed to analyze the heterogeneity, and subgroup analysis and logistic meta-regression were used to identify the potential causes.

Results

A total of 81 reports, including 133 research, were involved in the analysis. The pooled sensitivity and specificity of RT-PCR for detection of Group B Streptococcus in pregnant women were 96 % (95 %CI: 94 %–97 %) and 98 % (95 %CI:97 %–98 %), respectively. The pooled AUC value was 0.99 (95 %CI:0.98–1.00). In subgroup studies, there were four groups, including Group A (Enrichment & culture), Group B (Direct & culture), Group C (Enrichment & composite standard), and Group D (Direct & composite standard). Group A’s pooled sensitivity and specificity were 98 % (95 %CI: 97 %-99 %) and 94 % (95 %CI:92 %-96 %), respectively. Group B’s pooled sensitivity and specificity were 92 % (95 %CI: 89 %-94 %) and 96 % (95 %CI:95 %-97 %), respectively. Group C’s pooled sensitivity and specificity were 98 % (95 %CI: 97 %-99 %) and 99 % (95 %CI: 99 %-99 %), respectively. Group D’s pooled sensitivity and specificity were 93 %(95 %CI: 87 %-97 %) and 100 % (95 %CI:99 %-100 %), respectively. The pooled AUC values of the SROC for groups A, B, C, and D were 0.99 (95 %CI: 0.98–1.00), 0.98(95 %CI: 0.97–0.99), 1.00 (95 %CI: 0.99–1.00), and 0.99(95 %CI: 0.99–1.00), respectively.

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实时聚合酶链反应检测孕妇B群链球菌的准确性：系统回顾和荟萃分析

目的探讨RT - PCR在不同情况下筛查孕妇GBS的性能，特别是对比不同参考方法（培养或复合标准）和检测前预处理（直接或富集）。材料和方法我们检索了PubMed， Cochrane图书馆：Cochrane系统评价数据库，EMBASE和谷歌Scholar，临床试验注册如ClinicalTrials.gov和WHO ICTRP，直到2024年3月。使用改进的QUADAS-2仪器对每个研究质量进行评估。荟萃分析包括敏感性、特异性、总受试者工作特征（SROC）曲线和AUC。采用Deek漏斗图检验发表偏倚。进行敏感性分析以评价meta分析的稳健性。采用指数（i方）检验和q检验分析异质性，采用亚组分析和logistic元回归分析确定潜在原因。结果共纳入报告81篇，其中研究133篇。RT-PCR检测孕妇B群链球菌的总敏感性和特异性分别为96% （95% CI: 94% ~ 97%）和98% （95% CI: 97% ~ 98%）。合并AUC值为0.99 （95% CI: 0.98-1.00）。在亚组研究中，有四个组，包括A组(富集&；B组(Direct &；C组(富集&；组合标准)和D组(直接&；复合标准)。A组的合并敏感性和特异性分别为98% （95% CI: 97% - 99%）和94% （95% CI: 92% - 96%）。B组的合并敏感性和特异性分别为92% （95% CI: 89% - 94%）和96% （95% CI: 95% - 97%）。C组的合并敏感性和特异性分别为98% （95% CI: 97% - 99%）和99% （95% CI: 99% - 99%）。D组的合并敏感性和特异性分别为93% （95% CI: 87% - 97%）和100% （95% CI: 99% - 100%）。A、B、C、D组的SROC合并AUC值分别为0.99（95% CI: 0.98 - 1.00）、0.98（95% CI: 0.97-0.99）、1.00 （95% CI: 0.99 - 1.00）、0.99（95% CI: 0.99 - 1.00）。

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.