PDF(Pubmed)
Abstract：
BACKGROUND: Detection of carbapenem-resistant Pseudomonas aeruginosa (CR-PA) in humans is important to prevent transmission. However, the most optimal culture method to detect CR-PA is unknown. This systematic review aims to determine which culture method is most sensitive and which culture methods are used to detect CR-PA in humans. Second, to establish the most feasible culture method taking into account the turnaround time (TAT), and third, to provide an overview of the sampling sites used to detect carriage.
METHODS: We systematically searched the electronic databases Embase, Medline Ovid, Cochrane, Scopus, CINAHL, and Web of Science until January 27, 2023. All diagnostic accuracy studies comparing two or more culture methods to detect CR-PA and recent outbreak or surveillance reports on CR-PA carriage or infection in humans, which describe culture methods and their results, were eligible for inclusion. We used QUADAS-2 guideline for diagnostic accuracy studies and the STROBE or ORION guideline for outbreak-surveillance studies to assess the risk of bias.
RESULTS: Six diagnostic accuracy studies were included. An enrichment broth was found to increase the detection of CR-PA. Using an enrichment broth extended the TAT by 18-24 h, yet selective media could reduce the TAT by 24 h compared to routine media. In total, 124 outbreak-surveillance studies were included, of which 17 studies with surveillance samples and 116 studies with clinical samples. In outbreak-surveillance studies with surveillance samples, perianal, rectal swabs or stools were the most common sampling site/specimen (13/17, 76%). A large variety was observed in whether and which kind of enrichment broth and selective media were used.
CONCLUSIONS: We found a benefit of using an enrichment step prior to inoculation of the material onto selective media for the detection of CR-PA. More research is needed to determine the most sensitive sampling site and culture method.
BACKGROUND: This study was registered in the PROSPERO International prospective register of systematic reviews (registration number: CRD42020207390, http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020207390 ).
METHODS: We systematically searched the electronic databases Embase, Medline Ovid, Cochrane, Scopus, CINAHL, and Web of Science until January 27, 2023. All diagnostic accuracy studies comparing two or more culture methods to detect CR-PA and recent outbreak or surveillance reports on CR-PA carriage or infection in humans, which describe culture methods and their results, were eligible for inclusion. We used QUADAS-2 guideline for diagnostic accuracy studies and the STROBE or ORION guideline for outbreak-surveillance studies to assess the risk of bias.
RESULTS: Six diagnostic accuracy studies were included. An enrichment broth was found to increase the detection of CR-PA. Using an enrichment broth extended the TAT by 18-24 h, yet selective media could reduce the TAT by 24 h compared to routine media. In total, 124 outbreak-surveillance studies were included, of which 17 studies with surveillance samples and 116 studies with clinical samples. In outbreak-surveillance studies with surveillance samples, perianal, rectal swabs or stools were the most common sampling site/specimen (13/17, 76%). A large variety was observed in whether and which kind of enrichment broth and selective media were used.
CONCLUSIONS: We found a benefit of using an enrichment step prior to inoculation of the material onto selective media for the detection of CR-PA. More research is needed to determine the most sensitive sampling site and culture method.
BACKGROUND: This study was registered in the PROSPERO International prospective register of systematic reviews (registration number: CRD42020207390, http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020207390 ).
摘要：
背景：在人类中检测耐碳青霉烯的铜绿假单胞菌（CR-PA）对于防止传播很重要。然而,检测CR-PA的最佳培养方法未知.本系统综述旨在确定哪种培养方法最敏感，以及哪种培养方法用于检测人体中的CR-PA。第二,为了建立考虑周转时间(TAT)的最可行的培养方法，第三，提供用于检测运输的采样点的概述。
方法：我们系统地搜索了电子数据库Embase，MedlineOvid,科克伦,Scopus,CINAHL,和WebofScience，直到2023年1月27日。所有诊断准确性研究，比较两种或多种培养方法以检测CR-PA，以及最近关于CR-PA携带或感染人的暴发或监测报告，描述培养方法及其结果，有资格列入。我们使用QUADAS-2指南进行诊断准确性研究，使用STROBE或ORION指南进行爆发监测研究，以评估偏倚风险。
结果：纳入了6项诊断准确性研究。发现富集肉汤增加CR-PA的检测。使用富集肉汤将TAT延长18-24小时，然而，与常规培养基相比，选择性培养基可以减少24小时的TAT。总的来说,纳入了124项疫情监测研究，其中17项研究采用监测样本，116项研究采用临床样本。在使用监测样本的疫情监测研究中，肛周,直肠拭子或粪便是最常见的取样部位/样本(13/17,76%).在是否使用以及使用哪种富集肉汤和选择性培养基方面观察到了各种各样的变化。
结论:我们发现在将材料接种到选择性培养基上之前使用富集步骤以检测CR-PA的益处。需要更多的研究来确定最敏感的采样地点和培养方法。
背景：本研究已在PROSPEROInternational前瞻性系统评价登记册中注册（注册号：CRD4202020207390，http：//www。crd.约克。AC.uk/PROSPERO/display_record。asp?ID=CRD42020207390)。
方法：我们系统地搜索了电子数据库Embase，MedlineOvid,科克伦,Scopus,CINAHL,和WebofScience，直到2023年1月27日。所有诊断准确性研究，比较两种或多种培养方法以检测CR-PA，以及最近关于CR-PA携带或感染人的暴发或监测报告，描述培养方法及其结果，有资格列入。我们使用QUADAS-2指南进行诊断准确性研究，使用STROBE或ORION指南进行爆发监测研究，以评估偏倚风险。
结果：纳入了6项诊断准确性研究。发现富集肉汤增加CR-PA的检测。使用富集肉汤将TAT延长18-24小时，然而，与常规培养基相比，选择性培养基可以减少24小时的TAT。总的来说,纳入了124项疫情监测研究，其中17项研究采用监测样本，116项研究采用临床样本。在使用监测样本的疫情监测研究中，肛周,直肠拭子或粪便是最常见的取样部位/样本(13/17,76%).在是否使用以及使用哪种富集肉汤和选择性培养基方面观察到了各种各样的变化。
结论:我们发现在将材料接种到选择性培养基上之前使用富集步骤以检测CR-PA的益处。需要更多的研究来确定最敏感的采样地点和培养方法。
背景：本研究已在PROSPEROInternational前瞻性系统评价登记册中注册（注册号：CRD4202020207390，http：//www。crd.约克。AC.uk/PROSPERO/display_record。asp?ID=CRD42020207390)。
