MALDI-TOFMS在尿液中直接鉴定病原体准确性的Meta分析  

Meta-analysis of the accuracy of MALDI-TOF MS for direct bacterial identification from culture-positive urine samples

作　　者：王倩[1] 吴凡 张绮思 董阳阳 李冰洁 WANG Qian;WU Fan;ZHANG Qi-si(Department of Medical Laboratory,Henan Provincial People's Hospital,Department of Medical Laboratory of Central China Fuwai Hospital,Central China Fuwai Hospital of Zhengzhou University,Henan Zhengzhou 450003)

机构地区：[1]河南省人民医院医学检验科/华中阜外医院医学检验科/郑州大学华中阜外医院,河南郑州450003

出　　处：《医学检验与临床》2024年第6期1-5,共5页Medical Laboratory Science and Clinics

摘　　要：目的:本研究旨在评估基质辅助激光解吸电离飞行时间质谱(MALDI-TOFMS)与传统方法相比较从尿液样本中直接鉴定病原体的诊断性能。方法:检索Cochrane Library Medline、Embase、Pubmed、万方数据库、维普中国科技期刊数据库、中国生物医学文献数据库、中国知网数据库等有关MALDI-TOFMS用于直接从尿液中鉴定病原体的文献。采用MetaDisc1.4软件和STATA12.0进行系统评价。评价指标为总体灵敏度、特异性、阳性似然比、阴性似然比、诊断优势比以及受试者工作特征曲线下面积。结果:本研究在检索选择后最终纳入11篇文章。总体灵敏度为0.87(95%CI0.86-0.88),总体特异性为0.97(95%CI0.96-0.98)。阳性似然比、阴性似然比分别为30.56(95%CI9.42-99.13)和0.17(95%CI0.12-0.23)。受试者工作特征曲线下面积为0.9365。敏感性分析表明,该Meta分析的结果是稳定的。结论:MALDI-TOFMS提供了一种可靠的直接鉴定病原体的方法,可以直接从尿液样本中识别微生物,具有高灵敏度和特异性。Objective:To evaluate the diagnostic performance of matrix assisted laser desorption ionization time of flight mass spectrometry(MALDI-TOF MS)in direct identification of pathogens from urine samples compared with traditional methods.Methods:We searched Cochrane Library Medline,Embase,Pubmed,Wanfang Database,Vip China Science and Technology Journal Database,China Biomedical Literature Database,China Knowledge Network Database and other literatures about MALDI-TOF MS used to identify pathogens directly from urine.MetaDisc 1.4 software and STATA 12.0 are used for system evaluation.The evaluation indexes were overall sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and area under the subject's working characteristic curve.Results:Eleven articles were included after final selection in the meta-analysis.The overall sensitivity was 0.87(95%CI 0.86-0.88),and the overall specificity was 0.97(95%CI 0.96-0.98).Positive likelihood ratio and negative likelihood ratio were 30.56(95%CI 9.42-99.13)and 0.17(95%CI 0.12-0.23),respectively.The area under the working characteristic curve of the subject is 0.9365.The sensitivity analysis shows that the result of this meta-analysis is stable.Conclusion:MALDI-TOF MS provides a reliable method for directidentification of pathogens,which can directly identify microorganisms from urine samples with high sensitivity and specificity.

关 键 词：MALDI-TOFMS 尿路感染 病原体 

分 类 号：R446.12[医药卫生—诊断学]