Abstract：
BACKGROUND: Urinary antigen tests (UATs) have been used for the early detection of legionellosis and have demonstrated moderate sensitivity and high specificity. However, the most recent systematic review and meta-analysis published in 2009 evaluated the accuracy of UATs; since then, UAT accuracy may have changed owing to advances and developments in UAT technology and epidemiological changes in the frequency of Legionella species that cause legionellosis. Therefore, this systematic review and meta-analysis aimed to update the accuracy of UATs for legionellosis among patients with suspected pneumonia.
METHODS: Overall, 1326 studies were screened, 21 of which fulfilled the eligibility criteria for quality assessment and meta-analysis. Data from 5772 patients, including 1368 (23.7%) with the target condition (i.e., suspected legionellosis), were included in the analysis. The overall quality of the included studies, which was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, was unclear.
RESULTS: The calculated pooled sensitivity and specificity were 0.79 (95% confidence interval [CI], 0.71-0.85) and 1.00 (95% CI, 0.99-1.00), respectively. Subpopulation analysis revealed that the accuracy of UATs for sensitivity and specificity for Legionella pneumophilia serogroup 1 was 0.86 (95% CI, 0.78-0.91) and 1.00 (95% CI, 0.99-1.00), respectively.
CONCLUSIONS: This study demonstrated that the sensitivity and specificity of UATs were moderate and high, respectively, which is comparable to the results reported in 2009. Therefore, UATs may be a useful method for the early detection of legionellosis caused by Legionella pneumophila serogroup 1.
BACKGROUND: The review protocol was prospectively registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000041080).
METHODS: Overall, 1326 studies were screened, 21 of which fulfilled the eligibility criteria for quality assessment and meta-analysis. Data from 5772 patients, including 1368 (23.7%) with the target condition (i.e., suspected legionellosis), were included in the analysis. The overall quality of the included studies, which was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, was unclear.
RESULTS: The calculated pooled sensitivity and specificity were 0.79 (95% confidence interval [CI], 0.71-0.85) and 1.00 (95% CI, 0.99-1.00), respectively. Subpopulation analysis revealed that the accuracy of UATs for sensitivity and specificity for Legionella pneumophilia serogroup 1 was 0.86 (95% CI, 0.78-0.91) and 1.00 (95% CI, 0.99-1.00), respectively.
CONCLUSIONS: This study demonstrated that the sensitivity and specificity of UATs were moderate and high, respectively, which is comparable to the results reported in 2009. Therefore, UATs may be a useful method for the early detection of legionellosis caused by Legionella pneumophila serogroup 1.
BACKGROUND: The review protocol was prospectively registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000041080).
摘要：
背景：尿液抗原测试（UAT）已用于军团病的早期检测，并已显示出中等灵敏度和高特异性。然而,2009年发表的最新系统评价和荟萃分析评估了UAT的准确性；从那时起，由于UAT技术的进步和发展以及引起军团菌病的军团菌物种的流行病学变化，UAT的准确性可能已经改变。因此,本系统综述和荟萃分析旨在更新UATs对疑似肺炎患者军团菌病的准确性.
方法：总的来说，筛选了1326项研究，其中21项符合质量评估和荟萃分析的资格标准。5772名患者的数据，包括1368(23.7%)的目标条件(即，疑似军团菌病)，包括在分析中。纳入研究的总体质量，使用诊断准确性研究质量评估-2工具进行评估，不清楚。
结果：计算的合并敏感性和特异性为0.79（95％置信区间[CI]，0.71-0.85)和1.00(95%CI，0.99-1.00)，分别。亚群分析显示，UAT对肺炎军团菌血清组1的敏感性和特异性的准确性为0.86（95％CI，0.78-0.91）和1.00（95％CI，0.99-1.00），分别。
结论：这项研究表明，UATs的敏感性和特异性中等，分别,这与2009年报告的结果相当。因此,UATs可能是早期检测由嗜肺军团菌血清群1引起的军团菌病的有用方法。
背景：审查方案在大学医院医学信息网络临床试验注册中心（UMIN000041080）进行了前瞻性注册。
方法：总的来说，筛选了1326项研究，其中21项符合质量评估和荟萃分析的资格标准。5772名患者的数据，包括1368(23.7%)的目标条件(即，疑似军团菌病)，包括在分析中。纳入研究的总体质量，使用诊断准确性研究质量评估-2工具进行评估，不清楚。
结果：计算的合并敏感性和特异性为0.79（95％置信区间[CI]，0.71-0.85)和1.00(95%CI，0.99-1.00)，分别。亚群分析显示，UAT对肺炎军团菌血清组1的敏感性和特异性的准确性为0.86（95％CI，0.78-0.91）和1.00（95％CI，0.99-1.00），分别。
结论：这项研究表明，UATs的敏感性和特异性中等，分别,这与2009年报告的结果相当。因此,UATs可能是早期检测由嗜肺军团菌血清群1引起的军团菌病的有用方法。
背景：审查方案在大学医院医学信息网络临床试验注册中心（UMIN000041080）进行了前瞻性注册。
