Pooled analysis of nuclear acid sequence‐based amplification for rapid diagnosis of Mycoplasma pneumoniae infection

Abstract

Background Mycoplasma pneumoniae (M pneumoniae) is a common human etiology of respiratory infections. Nuclear acid sequence‐based amplification (NASBA) shows good value for the detection of M pneumoniae that surpasses PCR. However, the optimal detection technology still remains to be identified. The purpose of this meta‐analysis was to systematically evaluate the overall accuracy of NASBA for diagnosing M pneumoniae infections.MethodsThe databases PubMed, Cochrane Library, Google Scholar, CNKI, Wang Fang, and Baidu Scholar were comprehensively searched from their initiation date to December 2017 for NASBA in the diagnosis of M pneumoniae infection. Meta‐DiSc 1.4 statistical software was used to evaluate the sensitivity (SEN), specificity (SPE), negative likelihood ratio (−LR), positive likelihood ratio (+LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC). RevMan 5.2 statistical software was used for quality evaluation of the included articles. Publication bias was evaluated by funnel plot.ResultsSix articles with high quality, including 10 studies, were finally included in this meta‐analysis. The combined statistics results for the diagnosis of M pneumoniae infection by NASBA were 0.77 (SEN, 95% CI: 0.71 to 0.82); 0.98 (SPE, 95% CI: 0.98 to 0.99); 0.22 (‐LR, 95% CI: 0.13 to 0.39); 50.38 (+ LR, 95% CI: 21.85 to 116.17); 292.72 (DOR, 95% CI: 95.02 to 901.75); and 0.9875 (the area under the curve of SROC).ConclusionNuclear acid sequence‐based amplification is a reliable technique to diagnose M pneumoniae infection. However, whether it can replace PCR and serology need to be further studied.

Comparison of different detection methods for Mycoplasma pneumoniae infection in children with community-acquired pneumonia

“…In addition, NAAT has various detection formats, which can provide quantitative data, detect antimicrobial resistance genes and analyse the genetic relatedness of organisms [ 12 ]. However, there are a several limitations, such as contamination, which may result in false positives; difficulty in obtaining high-quality samples; sampling time point affecting results; and the possibility of PCR inhibitors leading to false negatives [ 22 ]. These limitations may have contributed to the lower positive rate of NAAT in this study.…”

An Accuracy-Based Approach to the Microbiologic Diagnosis of Pulmonary Infection

“…PCR can effectively replace time-consuming culture, with sensitivity reported at 100% [63] of culture-positive cases. The viral mPCR positive predictive agreement (PPA) with Mycoplasma PCR has been reported at 78% [64], 88% [65], and 96% [66], with a negative predictive agreement (NPA) of 100% [65,67]. This suboptimal agreement only further reduces an already modest sensitivity.…”

“…Less commonly used diagnostic techniques, including nuclear acid sequence-based amplification (NASBA) and loop-mediated isothermal amplification (LAMP) have been used as alternatives to PCR. The pooled sensitivity of NASBA has been reported at 77% [67] of PCR-positive cases, with a specificity of 98% [67]. LAMP sensitivity has been reported at 90% [68] of PCR-positive cases, with a specificity of 98% [68].…”

Application of Lab-on-Chip for Detection of Microbial Nucleic Acid in Food and Environment

“…RNase H specifically hydrolyzes RNA in the DNA-RNA heterozygote. The reaction usually takes place at around 42°C ( Huang et al, 2019 ). Its principle is shown in Figure 6 .…”