title: 16S Ribosomal Ribonucleic Acid Gene Polymerase Chain Reaction in the Diagnosis of Bloodstream Infections: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  We aim to evaluate the accuracy of the 16S ribosomal ribonucleic acid (rRNA) gene polymerase chain reaction (PCR) test in the diagnosis of bloodstream infections through a systematic review and meta-analysis.
  
  
  METHODS
  A computerized literature search was conducted to identify studies that assessed the diagnostic value of 16S rRNA gene PCR test for bloodstream infections. Study quality was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. We calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95% confidence intervals (95% CI) for each study. Summary receiver operating characteristic (SROC) curve was used to summarize overall test performance. Statistical analysis was performed in Meta-DiSc 1.4 and Stata/SE 12.0 software.
  
  
  RESULTS
  Twenty-eight studies were included in our meta-analysis. Using random-effect model analysis, the pooled sensitivity, specificity, PLR, NLR, and DOR were 0.87 (95% CI, 0.85-0.89), 0.94 (95% CI, 0.93-0.95), 12.65 (95% CI, 8.04-19.90), 0.14 (95% CI, 0.08-0.24), and 116.76 (95% CI, 52.02-262.05), respectively. The SROC curve indicated that the area under the curve (AUC) was 0.9690 and the maximum joint sensitivity and specificity (Q*) was 0.9183. In addition, heterogeneity was statistically significant but was not caused by the threshold effect.
  
  
  CONCLUSIONS
  Existing data suggest that 16S rRNA gene PCR test is a practical tool for the rapid screening of sepsis. Further prospective studies are needed to assess the diagnostic value of PCR amplification and DNA microarray hybridization of 16S rRNA gene in the future.
authors.affiliation: Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical College, Dongguan, China.
authors.forename: Guoming
authors.initials: G
authors.lastname: Su
authors.affiliation: Department of Microbiology and Immunology, Guangdong Medical College, Zhanjiang, China.
authors.forename: Zhuqing
authors.initials: Z
authors.lastname: Fu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical College, Zhanjiang, China.
authors.forename: Liren
authors.initials: L
authors.lastname: Hu
authors.affiliation: Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical College, Dongguan, China.
authors.forename: Yueying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Microbiology and Immunology, Guangdong Medical College, Zhanjiang, China.
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical College, Dongguan, China.
authors.forename: Weiqing
authors.initials: W
authors.lastname: Yang
mesh_terms: D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology; D016208:Databases, Factual; D006801:Humans; D016017:Odds Ratio; D016133:Polymerase Chain Reaction / Q000379:methods; D017594:Publication Bias; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology*
chemical_list: D012336:RNA, Ribosomal, 16S