万古霉素琼脂平板对异质性万古霉素中介金黄色葡萄球菌筛查价值的Meta分析

发布时间：2018-02-26 00:14

本文关键词： 万古霉素平板异质性万古霉素耐药金黄色葡萄球菌菌群谱型分析-曲线下面积 Meta分析　出处：《中国抗生素杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的评价6mg/m L万古霉素平板筛查异质性万古霉素中介金黄色葡萄球菌的准确性和特异性。方法计算机检索The Cochrane Library、Pub Med、ISI Web of Knowledge、中文期刊全文数据库、中文科技期刊数据库、万方数据库,并用辅助手工检索,2名评价员严格根据纳入排除标准收集6mg/m L万古霉素平板筛查异质性万古霉素中介金黄色葡萄球菌的文献数据。依据QUADAS质量评价标准评价纳入文献的质量后,用Meta-Disc 1.4软件进行Meta分析。结果最后4篇文献纳入分析,包含873例受试者。4篇文献异质性检验I2大于50%,P0.05,提示各研究结果间具有统计学异质性,采用随机效应模型进行Meta分析,Meta分析结果显示:万古霉素平板筛查万古霉素不敏感的金黄色葡萄球菌合并敏感性、特异性、阳性预测值、阴性似然比、诊断似然比、阳性预测值、阴性预测值和SROC曲线下面积分别为0.20[95%CI(0.14,0.27)]、0.98[95%CI(097,0.99)]、8.76[95%CI(4.11,18.66)]、0.86[95%CI(0.73,1.02)]、10.74[95%CI(4.66,24.76)]、0.595[95%CI(0.399,0.765)]、0.821[95%CI(0.790,0.849]和0.9044。结论 6mg/m L万古霉素平板筛查万古霉素不敏感菌具有高特异性,但敏感性和诊断准确性都相对较低,建议在临床上使用可联合其它试验筛查,提高其敏感性。
[Abstract]:Objective to evaluate the accuracy and specificity of 6 mg / mL vancomycin plate screening for heterogeneous vancomycin mediated Staphylococcus aureus. Methods The Cochrane Library Pub MedISI Web of knowledge, Chinese journal full-text database and Chinese sci-tech journal database were searched by computer. Wanfang database, The literature data of 6 mg / mL vancomycin plate screening for heterogeneous vancomycin intermediate Staphylococcus aureus were collected strictly according to the exclusion criteria and the QUADAS quality evaluation criteria were used to evaluate the quality of the literature. Results the last four papers were included in the analysis, including 873 subjects. The heterogeneity test of I2 was larger than 50 (P0.05), which indicated that there was statistical heterogeneity among the results. The results of Meta analysis and meta-analysis showed that vancomycin plate screening vancomycin insensitive Staphylococcus aureus with sensitivity, specificity, positive predictive value, negative likelihood ratio, diagnostic likelihood ratio. The positive predictive value, negative predictive value and area under the SROC curve were 0.20 [95CI0.140.27)] 0.98 [95CI0970.99)] 8.76 [95CI0.114.1118.66] 0.86 [95CI0.730.02] 10.74 [95CI4.6624.76] 0.595 [95CI0.3990.765] 0.821 [95CI0.90900.849] and 0.9044.Conclusion the screening of vancomycin insensitive bacteria with 6mgm-L vancomycin plate has high specificity, but the sensitivity and diagnostic accuracy are relatively low. It is suggested that clinical screening should be combined with other tests to improve its sensitivity.
【作者单位】：兰州大学第一医院;
【分类号】：R96

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