Accuracy of rapid diagnosis of Talaromyces marneffei: A systematic review and meta-analysis

Abstract

BackgroundTo examine the accuracy of Rapid Diagnosis of Talaromyces marneffei (RDTM) in order to improve diagnosis and treatment for clinical measures and reduce the mortality due to associated infections.MethodsIn this systematic review and meta-analysis, we screened PubMed, Ovid (Cochrane library) and Web of Science, Chinese database CNKI and Wanfang for articles published between 1956 and December, 2017. Data were taken from cross-sectional studies as well as from baseline measurements in longitudinal studies with clinical follow-up. Articles were excluded if they did not contain a cohort with T. marneffei and a control cohort or a cohort with standard fungus culture. Data were extracted by two authors and checked by three for accuracy. For quality assessment, modified QUADAS-2 criteria were used.ResultsThe 26 included diagnostic studies enrolled 5,594 objectives in 632 patients with T. marneffei infections and 2,612 negative controls between 1996 and 2017 in Thailand, Vietnam and China. The total combined sensitivity and specificity of rapid diagnosis of T. marneffei was 0.82 (95% CI: 0.68–0.90) and 0.99 (95% CI: 0.98–1.00). According to the experimental method, the included studies can be divided into three subgroups, including PCR-based, ELISA-based and others. The results showed these three subgroups had a highly pooled specificity of 1.00 (95% CI: 0.99–1.00), 0.99 (0.98–1.00) and 0.97 (95% CI: 0.91–1.00), respectively, while combined sensitivity was 0.84 (95% CI: 0.37–0.98), 0.82 (95% CI: 0.64–0.92) and 0.77 (95% CI: 0.54–0.91), respectively.ConclusionsAlthough serological methods with a high specificity is essential for potential rapid diagnostic, false-negative results can be obtained in the serum samples, there is no suitable rapid serological test to refer to as is the case with TM infection.

Effects of Talaromyces marneffei infection on mortality of HIV/AIDS patients in southern China: a retrospective cohort study

“…However, our recent system review shows that, among current diagnostic methods of T. marneffei, a serological method with a high specificity is essential for potential rapid diagnosis. However, false-negative results are often observed in the serum samples, and there is no suitable rapid serological test for diagnosis of T. marneffei infection [41].…”

Talaromyces marneffei fungemia after travel to China in a Canadian patient with AIDS

“…More recently, molecular techniques such as the polymerase chain reaction assay and enzyme-linked immunosorbent assay, which often must be performed at a reference laboratory, have been used in an effort to expedite the diagnosis. 8 In our patient, both culture and the polymerase chain reaction assay were performed and yielded concordant positive results.…”

Predictive models for Talaromyces marneffei infection in HIV-infected patients using routinely collected data

“…Recently, a number of other diagnostic methods have been established including different polymerase chain reaction (PCR) methods [16][17][18][19] , high-throughput sequencing of specimens [20] , enzyme-linked immunosorbent assay (ELISA) [21] and Mp1p tests [22] . However, these costly approaches have not been applied in clinical practice with sensitivity ranging from 10-100% [23] .…”