Accuracy of real-time polymerase chain reaction test for Group B Streptococcus detection in pregnant women: A systematic review and meta-analysis

Jie Peng; Yi Liu; Jiaqi Zou; Jingyao Wang; Cuyubamba Dominguez Jorge Luis; Hong Zhong

doi:10.1016/j.ejogrb.2024.11.035

Accuracy of real-time polymerase chain reaction test for Group B Streptococcus detection in pregnant women: A systematic review and meta-analysis

Eur J Obstet Gynecol Reprod Biol. 2024 Nov 26:304:141-151. doi: 10.1016/j.ejogrb.2024.11.035. Online ahead of print.

Authors

Jie Peng¹, Yi Liu¹, Jiaqi Zou¹, Jingyao Wang¹, Cuyubamba Dominguez Jorge Luis², Hong Zhong³

Affiliations

¹ Department of Laboratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610091, China.
² Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Laboratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610091, China. Electronic address: zhonghong@cdsfnetzxyy.wecom.work.

PMID: 39616805
DOI: 10.1016/j.ejogrb.2024.11.035

Abstract

Objectives: This study aimed to determine the performance of RT PCR of GBS screening in pregnant women under different situations, especially compared to different reference methods (culture or composite standards) and preprocessing before detection (directly or enrichment).

Materials and methods: We searched PubMed, the Cochrane Library: Cochrane Database of Systematic Reviews, EMBASE, and Google Scholar, and clinical trial registries such as ClinicalTrials.gov and WHO ICTRP until March 2024. The assessment of each study quality was performed using a modified QUADAS-2 instrument. The meta-analysis included pooled sensitivity, specificity, summary receiver operating characteristic (SROC) curve, and AUC. Publication bias was examined using Deek's funnel plot. Sensitivity analysis was conducted to evaluate the robustness of the meta-analysis. Index (I-square) and Q-test were performed to analyze the heterogeneity, and subgroup analysis and logistic meta-regression were used to identify the potential causes.

Results: A total of 81 reports, including 133 research, were involved in the analysis. The pooled sensitivity and specificity of RT-PCR for detection of Group B Streptococcus in pregnant women were 96 % (95 %CI: 94 %-97 %) and 98 % (95 %CI:97 %-98 %), respectively. The pooled AUC value was 0.99 (95 %CI:0.98-1.00). In subgroup studies, there were four groups, including Group A (Enrichment & culture), Group B (Direct & culture), Group C (Enrichment & composite standard), and Group D (Direct & composite standard). Group A's pooled sensitivity and specificity were 98 % (95 %CI: 97 %-99 %) and 94 % (95 %CI:92 %-96 %), respectively. Group B's pooled sensitivity and specificity were 92 % (95 %CI: 89 %-94 %) and 96 % (95 %CI:95 %-97 %), respectively. Group C's pooled sensitivity and specificity were 98 % (95 %CI: 97 %-99 %) and 99 % (95 %CI: 99 %-99 %), respectively. Group D's pooled sensitivity and specificity were 93 %(95 %CI: 87 %-97 %) and 100 % (95 %CI:99 %-100 %), respectively. The pooled AUC values of the SROC for groups A, B, C, and D were 0.99 (95 %CI: 0.98-1.00), 0.98(95 %CI: 0.97-0.99), 1.00 (95 %CI: 0.99-1.00), and 0.99(95 %CI: 0.99-1.00), respectively.

Publication types

Review