Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.

<h4>Background</h4>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 fo...

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Main Authors: 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
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0062323
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author 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
author_facet 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
author_sort Shy-Shin Chang
collection DOAJ
description <h4>Background</h4>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.<h4>Method</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
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spelling doaj-art-1f1127cc1ebf42b89fc174a8b4b03b022025-08-20T03:16:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0185e6232310.1371/journal.pone.0062323Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.Shy-Shin ChangWen-Han HsiehTing-Shou LiuSi-Huei LeeChih-Hung WangHao-Chang ChouYee Hui YeoChing-Ping TsengChien-Chang Lee<h4>Background</h4>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.<h4>Method</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.https://doi.org/10.1371/journal.pone.0062323
spellingShingle 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
Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.
PLoS ONE
title Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.
title_full Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.
title_fullStr Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.
title_full_unstemmed Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.
title_short Multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis - a systemic review and meta-analysis.
title_sort multiplex pcr system for rapid detection of pathogens in patients with presumed sepsis a systemic review and meta analysis
url https://doi.org/10.1371/journal.pone.0062323
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