■目前尚不清楚A组链球菌(GAS)毒力因子(VFs)在GAS的侵入潜力中的作用。这项工作调查了GASVFs与侵袭性疾病关联的证据。
■我们采用了广泛的搜索策略,用于报告在侵入性和非侵入性GAS疾病中存在GASVF的研究。数据由两名评审员独立提取,质量评估,并使用Stata®进行荟萃分析。
■共有32项研究报告了45个假定的毒力因子[侵入性(n=3,236);非侵入性(n=5,218)],以聚合酶链反应(PCR)(n=30)和全基因组测序(WGS)(n=2)为特征。偏见的风险被评为低和中等,在23和9项研究中,分别。元-,对高质量研究(n=23)的分析揭示了speM[OR,1.64(95CI,1.06;2.52)]伴侵袭性感染。WGS研究的荟萃分析表明hasA[OR,1.91(95CI,1.36;2.67)]和speG[OR,2.83(95CI,1.63;4.92)]伴侵入性GAS(iGAS)。PCR研究的荟萃分析表明speA[OR,1.59(95CI,1.10;2.30)]和speK[OR,2.95(95CI,1.81;4.80)]伴侵袭性感染。在prtf1[OR,0.42(95CI,0.20;0.87)]和侵袭性感染。
■本系统综述和基因组荟萃分析提供了hasA基因与侵袭性感染有统计学显著关联的证据,而smeZ,ssa,pnga3,sda1,原文如此,和NaDase显示与侵袭性感染的统计学显著负相关。SpeA,spek,和speG与GAS毒力有关;然而,目前尚不清楚它们是否是侵袭性感染的标志物。这项工作可能有助于制定预防策略。
UNASSIGNED: It is currently unclear what the role of Group A streptococcus (GAS) virulence factors (VFs) is in contributing to the invasive potential of GAS. This work investigated the evidence for the association of GAS VFs with invasive disease.
UNASSIGNED: We employed a broad search strategy for studies reporting the presence of GAS VFs in invasive and non-invasive GAS disease. Data were independently extracted by two reviewers, quality assessed, and meta-analyzed using Stata®.
UNASSIGNED: A total of 32 studies reported on 45 putative virulence factors [invasive (n = 3,236); non-invasive (n = 5,218)], characterized by polymerase chain reaction (PCR) (n = 30) and whole-genome sequencing (WGS) (n = 2). The risk of bias was rated as low and moderate, in 23 and 9 studies, respectively. Meta-,analyses of high-quality studies (n = 23) revealed a significant association of speM [OR, 1.64 (95%CI, 1.06; 2.52)] with invasive infection. Meta-analysis of WGS studies demonstrated a significant association of hasA [OR, 1.91 (95%CI, 1.36; 2.67)] and speG [OR, 2.83 (95%CI, 1.63; 4.92)] with invasive GAS (iGAS). Meta-analysis of PCR studies indicated a significant association of speA [OR, 1.59 (95%CI, 1.10; 2.30)] and speK [OR, 2.95 (95%CI, 1.81; 4.80)] with invasive infection. A significant inverse association was observed between prtf1 [OR, 0.42 (95%CI, 0.20; 0.87)] and invasive infection.
UNASSIGNED: This systematic review and genomic meta-analysis provides evidence of a statistically significant association with invasive infection for the hasA gene, while smeZ, ssa, pnga3, sda1, sic, and NaDase show statistically significantly inverse associations with invasive infection. SpeA, speK, and speG are associated with GAS virulence; however, it is unclear if they are markers of invasive infection. This work could possibly aid in developing preventative strategies.