The following is a summary of “Diagnostic value of BHI-V4 for heterogeneous and vancomycin-intermediate Staphylococcus aureus isolates: a systematic review and meta-analysis,” published in the May 2024 issue of Infectious Disease by Cheng et al.
Brain-heart infusion agar with 4 mcg/mL vancomycin (BHI-V4) was used to identify heterogeneous (hVISA) and vancomycin-intermediate Staphylococcus aureus (VISA), but its accuracy remains uncertain.
Researchers conducted a retrospective study comparing the diagnostic accuracy of BHI-V4 with population analysis profiling with the area under the curve (PAP-AUC) for diagnosing hVISA/VISA.
They registered the study protocol in INPLASY (INPLASY2023120069). The PubMed and Cochrane Library databases were searched (October 2023). Quality assessment data was visualized using Review Manager 5.4, while statistical analysis was performed using STATA17.0 (MP).
The results showed 8 publications with 2,153 strains. Although significant heterogeneity was observed, no threshold effect was detected across the eight studies. The summary receiver operating characteristic (SROC) was 0.77 (95% CI, 0.74–0.81). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic score, and diagnostic OR were 0.59 (95% CI: 0.46–0.71), 0.96 (95%CI: 0.83–0.99), 14.0 (95% CI, 3.4–57.1), 0.43 (95%CI, 0.32–0.57), 3.48(95%CI, 2.12–4.85), and 32.62 (95%CI, 8.31-128.36), respectively.
Investigators concluded that BHI-V4 offered only moderate accuracy in diagnosing hVISA/VISA, highlighting the need for further high-quality research to determine its clinical value.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09274-4
