ABSTRACT
To evaluate the accuracy of heparin binding protein (HBP) in the diagnosis of adult sepsis by meta-analysis. Methods The retrospective, randomized controlled and prospective researches on the diagnosis of adult sepsis using HBP were reviewed by searching VIP network, China National Knowledge Infrastructure (CNKI), Wanfang database, PubMed, Embase and Web of Science from foundation to August 2018. The researches were selected according to inclusion and exclusion criteria, and QUADAS was used to evaluate the quality of eligible studies. Metadisc 14.0 was used to analyze the threshold effect, pool the estimation and do Meta regression analysis. Publication bias was assessed using Stata 12.0 with Deeks funnel plot. Results A total of 728 related literatures were searched and 14 studies were enrolled in this study with a total of 2 023 subjects, with 1 120 in sepsis group and 903 in non-sepsis control group (795 patients with non-sepsis and 108 healthy volunteers). The total score of literature quality was 14-23, indicating that the overall quality was good. Meta-analysis showed that Spearman correlation coefficient between sensitivity logorithm and 1－specificity logorithm of 14 groups of data was 0.106 (P = 0.719), indicating no threshold effect. The pooled sensitivity was 0.74 [95% confidence interval (95%CI) was 0.72-0.77], the pooled specificity was 0.73 (95%CI was 0.70-0.76), the diagnostic odds ratio (DOR) was 14.15 (95%CI was 7.77-25.78), and the area under summary receiver operating characteristic curve (AUC) was 0.865. Deeks funnel plot was asymmetrical on the left and right (P = 0.60), indicating that there was no publication bias of the eligible studies. Conclusion HBP has good accuracy for the diagnosis of adult sepsis and it can be used as an auxiliary index for adult sepsis diagnosis.
ABSTRACT
Objective@#To evaluate the accuracy of heparin binding protein (HBP) in the diagnosis of adult sepsis by meta-analysis.@*Methods@#The retrospective, randomized controlled and prospective researches on the diagnosis of adult sepsis using HBP were reviewed by searching VIP network, China National Knowledge Infrastructure (CNKI), Wanfang database, PubMed, Embase and Web of Science from foundation to August 2018. The researches were selected according to inclusion and exclusion criteria, and QUADAS was used to evaluate the quality of eligible studies. Metadisc 14.0 was used to analyze the threshold effect, pool the estimation and do Meta regression analysis. Publication bias was assessed using Stata 12.0 with Deeks funnel plot.@*Results@#A total of 728 related literatures were searched and 14 studies were enrolled in this study with a total of 2 023 subjects, with 1 120 in sepsis group and 903 in non-sepsis control group (795 patients with non-sepsis and 108 healthy volunteers). The total score of literature quality was 14-23, indicating that the overall quality was good. Meta-analysis showed that Spearman correlation coefficient between sensitivity logorithm and 1-specificity logorithm of 14 groups of data was 0.106 (P = 0.719), indicating no threshold effect. The pooled sensitivity was 0.74 [95% confidence interval (95%CI) was 0.72-0.77], the pooled specificity was 0.73 (95%CI was 0.70-0.76), the diagnostic odds ratio (DOR) was 14.15 (95%CI was 7.77-25.78), and the area under summary receiver operating characteristic curve (AUC) was 0.865. Deeks funnel plot was asymmetrical on the left and right (P = 0.60), indicating that there was no publication bias of the eligible studies.@*Conclusion@#HBP has good accuracy for the diagnosis of adult sepsis and it can be used as an auxiliary index for adult sepsis diagnosis.
ABSTRACT
Objective To analyze the distribution and drug resistance of bile-isolated pathogens in Xiamen area ,providing evi-dence for clinical use of antibiotics .Methods Bile cultures and antibiotic susceptibility tests were performed on strains isolated from the First Affiliated Hospital of Xiamen University .WHONET 5 .6 was used for data analysis .Results In 35 out of 217 samples ,2 kinds of pathogens were isolated .Among these ,Enterococcus and Enterobacteriaceae coinfection was most common .There were 252 strains isolated totally ,with 83 gram-positive strains(32 .9% ) ,165 gram-negative strains (65 .5% ) and 4 fungi strains (1 .6% ) . Escherichia coli ,Enterococcus faecalis and Klebsiella pneumoniae were three of the most common pathogens isolated .Pseudomonas aeruginosa and Acinetobacter baumannii were two of the most common nonfermenters isolated .The resistance rates of Enterobacte-riaceae to aminoglycosides ,fourth generation cephalosporins ,carbapenems or piperacillin/tazobactam were lower than 40 .0% .The resistance rate of Escherichia coli to quinolones was higher than 50 .0% .Enterococcus faecalis or enterococcus faecium were less re-sistant to vancomycin ,linezolid and tigecycline .The resistance rates of enterococcus to high concentration of streptomycin or genta-micin were lower than 30 .0% .Conclusion The top three common pathogens isolated from bile are Escherichia coli ,Enterococcus faecalis and Klebsiella pneumonia in Xiamen area .Infections by Enterococcus together with Enterobacteriaceae account for large numbers of coinfection cases .The resistance rates to cephalosporin or quinolones of pathogens causing biliary tract infections have increased dramatically .