The following is a summary of the “Diagnostic accuracy of rapid antigen tests in cerebrospinal fluid for pneumococcal meningitis: a systematic review and meta-analysis,” published in the March 2023 issue of Clinical microbiology and infections Disease by Someko, et al.
To determine if pneumococcal meningitis can be more efficiently triaged using cerebrospinal fluid (CSF) rapid antigen tests. They looked through the databases Cochrane CENTRAL, MEDLINE, EMBASE, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. Criteria for participation in the study The sensitivity and specificity of rapid antigen tests in CSF in comparison with CSF culture can be extracted from all cohort study types with the exception of multiple-group studies.
Patients who are thought to have meningitis took part CSF antigen testing for rapid results.
Evaluation of Potential BiasQUADAS-2 was utilized to evaluate the included studies’ methodological quality. For the meta-analysis, researchers employed a random-effects bivariate model. They performed a subgroup analysis by categorizing studies by antigen test, age group, country income, and whether or not participants were exposed to antibiotics prior to lumbar puncture. There were 44 total studies with 14,791 total participants.
The methodological quality of the studies was generally low to moderate. Overall, the sensitivity was 99.5% (95% CI, 92.4-100%), and the specificity was 98.2% (95% CI, 96.9-98.9%). At a median prevalence of 4.2% across all included studies, the positive and negative predictive values were 70.8% (95% CI, 56.6-79.9%) and 100% (95% CI, 99.7-100%), respectively. Accuracy in diagnosis was similar between groups, with high-income countries having slightly lower sensitivity. Rapid antigen tests could aid triage of pneumococcal meningitis in cerebrospinal fluid. The clinical utility of rapid antigen tests for excluding pneumococcal meningitis requires further investigation.
Source: https://www.sciencedirect.com/science/article/abs/pii/S1198743X2200605X
