Table 2.
Performance of enterovirus blood PCR diagnosis
Patients (n) | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) | Accuracy (%) | κ (95% CI) | ||
---|---|---|---|---|---|---|---|---|
Fever without source | 165 | 100% (91–100) | 91% (85–96) | 78% (65–89) | 100% (97–100) | 93·3% | 0·83 (0·74–0·93) | |
Sepsis-like disease | 55 | 100% (66–100) | 89% (76–96) | 64% (35–87) | 100% (91–100) | 90·9% | 0·73 (0·51–0·95) | |
Suspected meningitis | 406 | 64% (57–70) | 87% (81–92) | 86% (79–91) | 66% (60–72) | 74·1% | 0·49 (0·41–0·57) | |
Newborn babies | 38 | 96% (82–100) | 70% (35–93) | 90% (74–98) | 88% (47–99) | 89·5% | 0·71 (0·45–0·97) | |
Infants | 87 | 85% (71–94) | 85% (71–94) | 87% (73–95) | 83% (69–93) | 85·1% | 0·70 (0·55–0·85) | |
Children | 281 | 51% (42–59) | 89% (82–94) | 83% (74–90) | 62% (55–69) | 68·7% | 0·39 (0·29–0·48) |
Performance was assessed in 626 patients with both CSF and blood specimens available. We excluded 46 infants (aged >3 months to <2 years) with fever without source and sepsis, since CSF enterovirus PCR is not the gold standard diagnosis test of these disease conditions. Performance of blood PCR testing was calculated with respect to the gold standard of CSF enterovirus PCR, in all patients with meningitis and in the youngest infants (aged ≤3 months) with fever without source and sepsis-like disease, for whom collection of CSF samples was integrated in routine practice. Concordance was studied by κ values and accuracy. CSF=cerebrospinal fluid. PPV=positive predictive value. NPV=negative predictive value.