...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>JAMA pediatrics >Assessment of C-Reactive Protein Diagnostic Test Accuracy for Late-Onset Infection in Newborn Infants A Systematic Review and Meta-analysis
【24h】

Assessment of C-Reactive Protein Diagnostic Test Accuracy for Late-Onset Infection in Newborn Infants A Systematic Review and Meta-analysis

机译：新生儿婴幼儿晚期感染的C反应蛋白诊断试验精度评估系统审查和荟萃分析

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Importance Rapid and accurate diagnosis of late-onset infection in newborn infants could inform treatment decisions and avoid unnecessary administration of antibiotics. Objective To compare the accuracy of serum C-reactive protein (CRP) with that of microbiological blood culture for diagnosing late-onset infection in newborns. Data Sources MEDLINE (1946-2019), Embase (1946-2019), and Science Citation Index (1900-2019) databases were searched for references (any language). The MeSH search terms included were "exp infant, newborn/" or "premature birth/" plus free text synonyms; and "C-reactive protein/" plus free text synonyms; and "exp sepsis/" or "exp bacterial infections/" plus free text synonyms. The proceedings from relevant conferences and references of identified papers were scrutinized. Authors were contacted to request missing data. Study Selection Cohort and cross-sectional studies were included that compared the accuracy of serum CRP levels with microbiological culture results to diagnose late-onset (>72 hours after birth) infection in newborns (any gestational age) hospitalized after birth. Two reviewers assessed study eligibility. Among 10 & x202f;394 records, 148 studies were assessed as full texts. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline extension for Diagnostic Test Accuracy () reviews was followed. Two reviewers assessed the method quality of each study using guidance from the Cochrane Screening and Diagnostic Test Methods Group (adapted from the Quality Assessment of Diagnostic Accuracy Studies 2). Main Outcomes and Measures The primary meta-analysis outcome was diagnostic test accuracy of serum CRP level taken at initial investigation of an infant with suspected late-onset infection. The median specificity (proportion of true-negative results) and calculated pooled sensitivity (proportion of true-positive results) were determined by generating hierarchical summary receiver characteristic operating curves. Results In total, 22 studies with 2255 infants were included (sample size range, 11-590 infants). Participants in most studies were preterm (<37 weeks) or very low-birth weight (<1500 g) infants. Two studies additionally enrolled infants born at term. Most studies (14 of 16) used a prespecified CRP level cutoff for a "positive" index test (5-10 mg/L) and the culture of a pathogenic microorganism from blood as the reference standard. Risk of bias was low with independent assessment of index and reference tests. At median specificity (0.74), pooled sensitivity was 0.62 (95% CI, 0.50-0.72). Adding serum CRP level to the assessment of an infant with a 40% pretest probability of late-onset infection (the median for the included studies) generated posttest probabilities of 26% for a negative test result and 61% for a positive test result. Conclusions and Relevance The findings suggest that determination of serum CRP level at initial evaluation of an infant with suspected late-onset infection is unlikely to aid early diagnosis or to select infants to undergo further investigation or treatment with antimicrobial therapy or other interventions.
机译：重要性快速准确地诊断新生儿婴儿的后期感染可能会通知治疗决策，避免不必要的抗生素给药。目的比较血清C-反应蛋白（CRP）与微生物血液培养的准确性，以诊断新生儿晚期发作感染。数据源MEDLINE（1946-2019），EMBASE（1946-2019），以及搜索科学引文指数（1900-2019）数据库参考（任何语言）。包含的网格搜索条款包括“Exp婴儿，新生儿/”或“早产/”加免费文本同义词;和“C反应蛋白/”加免费文本同义词;和“EXP SEPSIS /”或“EXP细菌感染/”加免费文本同义词。审查了相关会议的诉讼和所确定的文件的参考文献。联系作者请求缺失数据。研究选择队列和横截面研究包括，将血清CRP水平与微生物培养结果进行比较，以诊断出生后的新生儿（任何孕胎）的晚期发病（出生后的72小时）感染。两位审稿人评估了研究资格。在10＆x202f中; 394条记录，148项研究被评估为全文。数据提取和综合进行系统评测和荟萃分析的首选报告项目（PRISMA）指南延长诊断测试准确性（）审查。两位评估员使用Cochrane筛查和诊断测试方法组的指导评估每项研究的方法质量（适应诊断准确性研究2的质量评估2）。主要结果和测量初级荟萃分析结果是血清CRP水平的诊断测试准确性，在初步调查婴幼儿患有疑似后期感染。通过生成分层摘要接收器特性操作曲线来确定中值特异性（真实阴性结果的比例）和计算的汇集灵敏度（真实阳性结果的比例）确定。结果总共22项婴儿的22项研究（样本量范围，11-590婴儿）。大多数研究的参与者是早产（<37周）或非常低的出生体重（<1500克）婴儿。两项研究另外注册婴儿出生于期限。大多数研究（14个中的14个）使用预定的CRP水平截止为“阳性”指数试验（5-10mg / L）和从血液作为参考标准的致病微生物的培养。偏差风险较低，对指数和参考测试的独立评估。在中位特异性（0.74），合并敏感性为0.62（95％CI，0.50-0.72）。将血清CRP水平添加到婴儿的评估，以40％的前期感染概率（所纳入研究的中值）产生26％的后塔，对于阳性测试结果为61％。结论和相关性研究表明，在涉嫌晚期发病感染的婴儿初步评估中确定血清CRP水平的测定不太可能有助于早期诊断或选择婴儿进行进一步调查或用抗菌治疗或其他干预治疗。

著录项

  • 来源
    《JAMA pediatrics》 |2020年第3期|共9页
  • 作者

    Brown Jennifer Valeska Elli; Meader Nick; Wright Kath; Cleminson Jemma; McGuire William;

  • 作者单位

    Univ York Ctr Reviews &

    Disseminat York YO10 5DD N Yorkshire England;

    Univ York Ctr Reviews &

    Disseminat York YO10 5DD N Yorkshire England;

    Univ York Ctr Reviews &

    Disseminat York YO10 5DD N Yorkshire England;

    Univ York Ctr Reviews &

    Disseminat York YO10 5DD N Yorkshire England;

    Univ York Ctr Reviews &

    Disseminat York YO10 5DD N Yorkshire England;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 儿科学;
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号