Blood Procalcitonin Level as a Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy, Study Selection, and Eligibility Criteria
2.2. Data Extraction
2.3. Quality Assessment
2.4. Statistical Analysis
3. Results
3.1. Characterization of the Studies
3.2. Quality Assessment of the Included Studies
3.3. Pooled Diagnostic Accuracy of Procalcitonin
3.4. Subgroup Analysis according to the Cutoff Value
3.5. Comparison of Pooled Diagnostic Accuracy between Biomarkers
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Author (Year), Reference | Country | BM (n) | Non-BM (n) | Sample Type | Cutoff (ng/mL) | PCT Assay | Time of PCT Assessment |
---|---|---|---|---|---|---|---|
Gendrel (1997) [27] | France | 18 | 41 | Plasma | 5 | LUMItest PCT (Brahms Diagnostica, Berlin, Germany) | On admission |
Dubos-1 (2006) [28] | France | 18 | 134 | Serum | 0.5 | LUMItest PCT (Brahms Diagnostica, Berlin, Germany) | On admission |
Dubos-2 (2006) [28] | France | 18 | 134 | Serum | 0.2 | LUMItest PCT (Brahms Diagnostica, Berlin, Germany) | On admission |
Dubos (2008) [16] | Switzerland, France, Spain, Turkey, Poland | 90 | 100 | Serum | 0.5 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | On admission |
Onal (2008) [29] | Turkey | 16 | 14 | Plasma | 0.5 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | On admission |
Ibrahim (2011) [30] | KSA | 18 | 20 | Serum | 0.5 | Immunoluminometric assay (Brahms Diagnostica, Berlin, Germany) | On admission |
Alkholi-1 (2011) [31] | Egypt | 20 | 20 | Serum | 2 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | On diagnosis |
Alkholi-2 (2011) [31] | Egypt | 20 | 20 | Serum | 10 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | On diagnosis |
Monsef (2012) [32] | Iran | 8 | 32 | Serum | 0.5 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | Before antibiotic therapy |
Mayah (2013) [33] | Egypt | 24 | 44 | Serum | 3.3 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | On admission |
Umran (2014) [34] | Iraq | 29 | 16 | Serum | 0.05 | ELIZA M6 (NA, USA) | On admission |
Sanaei Dashti (2017) [10] | Iran | 12 | 27 | Serum | 0.6 | Human PCT ELISA (BT Laboratory, Shanghai, China) | On admission |
El Shorbagy-1 (2018) [35] | KSA | 24 | 41 | Serum | 2 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | On diagnosis |
El Shorbagy-2 (2018) [35] | KSA | 24 | 41 | Serum | 10 | Lumitest PCT (Brahms Diagnostica, Berlin, Germany) | On diagnosis |
Chaudhary (2018) [36] | Nepal | 22 | 26 | Serum | 0.5 | Maglumi PCT (Snibe Diagnostics, Shenzhen, China) | On admission |
Garcia-1 (2018) [37] | Spain | 7 | 165 | NA | 0.5 | NA | At the time of ED visit |
Garcia-2 (2018) [37] | Spain | 7 | 165 | NA | 2 | NA | At the time of ED visit |
Zhang (2019) [38] | China | 29 | 18 | Serum | 5.91 | VIDAS BRAHMS PCT (Biomerieux, Marcy l’Etoile, France) | On admission |
Cutoff | Number of Studies | Sensitivity (95% CI) | Specificity (95% CI) | LR+ (95% CI) | LR− (95% CI) | DOR (95% CI) | AUC |
---|---|---|---|---|---|---|---|
≤0.5 pg/mL | 9 | 0.899 (0.81–0.949) | 0.844 (0.702–0.96) | 5.763 (2.718–23.725) | 0.12 (0.271–0.053) | 48.157 (10.043–446.588) | 0.935 |
>0.5 pg/mL | 9 | 0.831 (0.647–0.93) | 0.851 (0.706–0.931) | 5.577 (2.201–13.478) | 0.199 (0.5–0.075) | 28.084 (4.401–179.261) | 0.908 |
Biomarkers | Number of Studies | Sensitivity (95% CI) | Specificity (95% CI) | LR+ (95% CI) | LR− (95% CI) | DOR (95% CI) |
---|---|---|---|---|---|---|
CRP | 10 | 0.797 (0.741–0.844) | 0.725 (0.665–0.777) | 2.894 (2.213–3.781) | 0.28 (0.39–0.201) | 10.334 (5.679–18.808) |
WBCs | 5 | 0.659 (0.504–0.786) | 0.713 (0.587–0.813) | 2.294 (1.22–4.195) | 0.479 (0.845–0.263) | 4.794 (1.443–15.925) |
CSF WBCs | 4 | 0.733 (0.601–0.834) | 0.669 (0.58–0.748) | 2.217 (1.43–3.309) | 0.399 (0.689–0.223) | 5.556 (2.076–14.87) |
CSF neutrophils | 4 | 0.793 (0.377–0.96) | 0.749 (0.519–0.892) | 3.158 (0.784–8.895) | 0.277 (1.201–0.045) | 11.403 (0.652–199.271) |
CSF protein | 4 | 0.838 (0.699–0.92) | 0.658 (0.55–0.753) | 2.452 (1.552–3.718) | 0.247 (0.548–0.107) | 9.934 (2.833–34.833) |
CSF glucose | 3 | 0.563 (0.172–0.889) | 0.193 (0.145–0.253) | 0.698 (0.201–1.189) | 2.264 (5.718–0.44) | 0.308 (0.035–2.701) |
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Kim, H.; Roh, Y.-H.; Yoon, S.-H. Blood Procalcitonin Level as a Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis. Diagnostics 2021, 11, 846. https://doi.org/10.3390/diagnostics11050846
Kim H, Roh Y-H, Yoon S-H. Blood Procalcitonin Level as a Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis. Diagnostics. 2021; 11(5):846. https://doi.org/10.3390/diagnostics11050846
Chicago/Turabian StyleKim, Heeyeon, Yun-Ho Roh, and Seo-Hee Yoon. 2021. "Blood Procalcitonin Level as a Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis" Diagnostics 11, no. 5: 846. https://doi.org/10.3390/diagnostics11050846