男男性行为者尿道直肠和口咽部位混合标本检测沙眼衣原体感染准确性的Meta分析  

A meta-analysis on the accuracy of pooling specimens from urethral,anorectal and oropharyngeal,sites in detection of infection with Chlamydia trachomatis in men who have sex with men

作　　者：姜婷婷 尹跃平[1] 曹宁校[1] 陈祥生[1] JIANG Tingting;YIN Yueping;CAO Ningxiao;CHEN Xiangsheng(Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College,National Center for STD Control,China CDC,Nanjing 210042,China)

机构地区：[1]中国医学科学院北京协和医学院皮肤病研究所中国疾病预防控制中心性病控制中心,南京210042

出　　处：《中国艾滋病性病》2022年第8期995-999,共5页Chinese Journal of Aids & STD

摘　　要：目的对MSM尿道、直肠和口咽部位的标本混合后检测沙眼衣原体感染的准确性进行文献资料的Meta分析。方法基于Pubmed和Embase检索,截至2021年8月共获得与混合多个部位标本检测沙眼衣原体感染有关的文献共114篇,最终筛选出11篇文献。采用双变量混合效应模型计算合并效应值,对多个部位标本混合检测的灵敏度及特异度进行推断。进一步根据纳入文献中单检和混检标本的采集者、多个部位标本混合的时机、混检标本中是否保留拭子、混检标本中加入的尿液量、混检的核酸检测方法进行亚组分析。结果纳入的11篇文献共有调查人数3979例。通过数据合并分析得到不同部位标本混合检测对于沙眼衣原体感染的总体灵敏度为0.91(95%CI:0.88~0.94),总体特异度为0.99(95%CI:0.98~0.99)。亚组分析发现,混合检测的灵敏度下降可能与混检标本中保留拭子、尿液量较高和不同检测方法的性能有关。结论与单个部位检测相比,MSM中混合不同部位标本检测其沙眼衣原体感染状况具有较高的一致性。Objective To determine the accuracy of pooled specimens from urethral,anorectal and oropharyngeal sites for detection of infection with Chlamydia trachomatis in men who have sex with men.Methods By August 2021,a total of 114 studies published in peer-reviewed journals were searched by PubMed and Embase and 11 of them were finally included in the meta-analysis.A bivariate mixed-effects model was used for overall value merging.In addition to the overall sensitivity and specificity,the analyses were also performed among certain subgroups,including swab taker,time of pooling,swab left in pooled specimen,volume of urine in pooled sample and NAAT used for pooled samples.Results A total of 3979 subjects were included in the analysis.Pooled specimens of multiple anatomic sites in MSM had an overall integrated sensitivity of 0.91(95%CI:0.88-0.94)and an overall integrated specificity of 0.99(95%CI:0.98-0.99)for detection of Chlamydia trachomatis.In the subgroup analysis,we found that the decreased sensitivity of pooled specimens may be related to swab left in pooled specimen,higher urine volume and the performance of different assays.Conclusions Pooling specimens from multiple anatomic sites in men who have sex with men has comparably high consistency with single-site specimen testing for detection of infection with Chlamydia trachomatis.

关 键 词：沙眼衣原体 混合检测 灵敏度与特异度 META分析 

分 类 号：R374[医药卫生—病原生物学]