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Meta-analysis of the diagnostic value of polymerase chain reaction-based nucleic acid detection methods for pertussis
Fengyuan He1, Limin Mei1, Linzi Zeng2
1Chengdu Pidu District Center for Disease Control and Prevention, Chengdu, 611730, Sichuan, China.
Introduction:
Pertussis is an acute respiratory disease primarily caused by Bordetella pertussis, and its incidence has shown a resurgence. Polymerase chain reaction (PCR) is a recognized molecular detection method, and various related detection methods have emerged.
Methods:
This study is performed according to the PRISMA checklist. Relevant literature is adopted from the online databases. The quality of the included studies is assessed based on the REVMAN software (version 5.4). Statistical analysis is performed by STATA 14.0 and Meta-DiSc 1.4 software.
Results:
The results of this meta-analysis show that four different PCR techniques-conventional PCR, real-time quantitative PCR (Q-PCR), multiplex PCR, and nested PCR-have a pooled sensitivity of 0.95 (95 % CI: 0.93-0.97), pooled specificity of 0.93 (95 % CI: 0.89-0.95), pooled positive likelihood ratio (PLR) of 12.22 (95 % CI: 8.62-17.33), pooled negative likelihood ratio (NLR) of 0.05 (95 % CI: 0.03-0.08), and pooled diagnostic odds ratio (DOR) of 244.88 (95 % CI: 133.34-449.72). Multiplex PCR has the highest pooled specificity, PLR, and DOR. Nested PCR has the highest sensitivity and the lowest NLR. PCR testing holds significant value in the early diagnosis of pertussis. Multiplex PCR, nested PCR, and Q-PCR outperform conventional PCR in diagnostic performance.
Conclusions:
Each type of PCR test has its advantages and disadvantages, and clinical selection should consider factors such as testing purpose, personnel, and conditions.
Insights
Polymerase chain reaction (PCR) tests are valuable for early pertussis diagnosis. Multiplex PCR, nested PCR, and quantitative PCR (Q-PCR) show superior diagnostic performance compared to conventional PCR.
Area of Science:
- Medical Diagnostics
- Microbiology
- Molecular Biology
Background:
- Pertussis, caused by Bordetella pertussis, is an acute respiratory illness with increasing incidence.
- Polymerase chain reaction (PCR) is a key molecular detection method for pertussis.
- Various PCR-based detection methods have been developed.
Purpose of the Study:
- To systematically evaluate the diagnostic performance of different PCR techniques for pertussis.
- To compare the effectiveness of conventional PCR, real-time quantitative PCR (Q-PCR), multiplex PCR, and nested PCR.
Main Methods:
- A meta-analysis was conducted following the PRISMA checklist.
- Literature search was performed across online databases.
- Study quality was assessed using REVMAN software (version 5.4).
- Statistical analysis was performed using STATA 14.0 and Meta-DiSc 1.4 software.
Main Results:
- The meta-analysis included four PCR techniques: conventional PCR, Q-PCR, multiplex PCR, and nested PCR.
- Pooled sensitivity was 0.95, pooled specificity was 0.93.
- Multiplex PCR demonstrated the highest specificity, positive likelihood ratio (PLR), and diagnostic odds ratio (DOR).
- Nested PCR showed the highest sensitivity and lowest negative likelihood ratio (NLR).
- Advanced PCR methods (multiplex, nested, Q-PCR) outperformed conventional PCR.
Conclusions:
- PCR testing is highly valuable for the early diagnosis of pertussis.
- Each PCR method has unique advantages and disadvantages.
- Clinical selection of PCR tests should consider specific needs, available resources, and personnel expertise.
