Table 3.
Meta-analyses of all bacteria and per bacteria and viruses, with reference test 1 and reference test 2.
| Ref. Test 1† |
Ref. Test 2‡ |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. Studies /No. Patients (Ref. studies) | Sensitivity (95%CI) X2; p value§ | Specificity(95%CI).X2; p value§ | LR+ (95%CI) |
LR- (95%CI) |
No. Studies/No. Patients(Ref. studies) | Sensitivity(95%CI).X2; p value¥ | Specificity(95%CI)X2; p value¥ | LR+ (95%CI) |
LR- (95%CI) |
|
| All bacteria | 16/618310,17,22,24, 25, 26, 27,29, 30, 31, 32, 33 | 89.5 (81.1–94.4) 6.00; 0.98 | 97.4 (94–98.9) 251.9; <0.0001 |
34 (2.68–137) |
0.11 (0.07–3.64) |
15/5545 (10,17,29–33,18–22,24,26,27) |
93.5 (87.8–96.6) 2.17; 0.99 |
99.1 (97.8–99.6) 60.2; <0.0001 |
104 (7.60–3.98) |
0.07 (0.07–3.58) |
| S. pneumoniae | 16/709010,17, 18, 19, 20, 21, 22,24, 25, 26,30,34 | 87.5 (77–94) 3.71; 0.999 | 98.5 (97–99.3) 144.7; <0.0001 |
58 (4.63–238) |
0.13 (0.07–3.60) |
10/5287 (10,17,30,32,33,34, 18,21,22,24) |
93 (83.3–97.2) 2.64; 0.91 |
99.4 (98.2–99.8) 51.2; <0.0001 |
155 (11–600) |
0.07 (0.07–3.58) |
| H. influenzae | 10/495910,17,18,20, 21, 22,24,25,30,32 | 64.9 (39.5–84) 4.91; 0.842 | 99.4 (98.9–99.6) 22.4; 0.07 |
108 (11–601) |
0.35 (0.07–3.57) |
7/3176 (10,17,18,20,21,24,30) |
81.1 (55.6–93.6) 4.97; 0.42 |
99.8 (99.5–99.9) 5.53; 0.354 |
405 (28–1889) |
0.19 (0.07–3.56) |
| S. agalactiae | 10/526610,17,18,20,22,25, 26, 27,31,33 | 71.5 (49.6–86.5) 7.67; 0.56 | 99.5 (98.5–99.9) 7.67; 0.56 |
143 (13–722) |
0.29 (0.07–3.57) |
5/2543 10,17,18,20,27 |
81.4 (52.3–94.6) 6.71; 0.15 |
99.4 (97.7–99.9) 23.42; <0.0001 |
136 (11–609) |
0.19 (0.07–3.57) |
| E. coli | 11/474310,17, 18, 19, 20, 21,25,27,30,32,33 | 70.9 (50.2–85.5) 4.93; 0.896 | 99.6 (99.1–99.8) 25.5; 0.0043 |
177 (16–909) |
0.29 (0.07–3.56) |
5/2570 10,18,20,30,32 |
76.3 (47.6 – 91.9) 3.56; 0.46 |
99.6 (98.7–99.9) 12.62; 0.01 |
191 (15–925) |
0.24 (0.07–3.56) |
| N. meningitidis | 10/350117,18,20, 21, 22,24,25,29, 30, 31 | 74.5 (52.9–88.4) 2.26; 0.986 | 99.1 (98.6–99.5) 20.9; 0.013 |
83 (7.48–400) |
0.26 (0.07–3.58) |
5/1950 18,21,22,30,31 |
84.4 (53.9–96.2) 0.84; 0.838 |
99.1 (98.8–99.9) 1.17; 0.759 |
281 (19–1265) |
0.16 (0.07–3.56) |
| L. monocytogenes | 7/133218,21,24,25,29,31,32 | 70.4 (40–89.5) 0.504; 0.008 | 98.9 (96.9–99.6) 5.62; 0.22 |
54 (4.99–280) |
0.30 (0.07–3.60) |
3/550 18,21,24) |
80.4 (40.4–96.1) 0.205; 0.903 |
99.5 (97.8–99.9) 2.13; 0.344 |
161 (9.03–796) |
0.20 (0.07–3.57) |
| Enterovirus | 3/688310,22,23 | 93.8 (87–97.2) 2.91; 0.23 | 99.3 (98.7–99.7) 28.53; <0.001 |
313 (22–1209) |
0.06 (0.07–3.56) |
3/6883 10, 22, 23 |
99.8 (86.1–97.4) 4.18; 0.123 |
99.9 (99.7–100) 3.43; 0.179 |
998 (58–3763) |
0.04 (0.07–3.55) |
| HSV-1 | 3/688310,22,23 | 75.5 (51.2–90.1) 1.18;0.554 | 99.9 (94.7–100) 2.55;0.28 |
755 (58–3763) |
0.25 (0.07–3.55) |
3/6883 10, 22, 23 |
78.2 (58.1–90.3) 0.69;0.706 |
99.9 (99.8–100) 1.8;0.405 |
782 (58–3763) |
0.22 (0.07–3.55) |
| HSV-2 | 3/688310,22,23 | 94.4 (83.9–98.2) 0.435;0.804 | 99.9 (99.7–100) 1.36;0.507 |
944 (58–3763) |
0.06 (0.07–3.55) |
3/6883 10, 22, 23 |
94.5 (84.2–98.2) 0.46;0.79 |
99.9 (99.8–100) 1.36;0.507 |
945 (58–3763) |
0.06 (0.07–3.55) |
| VZV | 4/689710,21,23,29 | 91.4 (78.9–96.9) 0.82;0.84 | 99.8 (98.7–100) 23.55;<0.001 |
457 (32–1832) |
0.09 (0.07–3.56) |
4/6897 10,21,23,29 |
93.3 (83.6–97.4) 0.16;0.91 |
99.9 (99.6–100) 6.23;0.004 |
933 (58–3763) |
0.07 (0.07–3.55) |
CSF: Cerebro-Spinal fluid; LR+: Positive Likelihood ratio; LR-: Negative Likelihood ratio; X2: Chi-2 test.
†
Reference Test 1: Aerobic CSF cultures/Blood culture or viral PCR.
‡
Reference Test 2: It was applied only in case of disagreement of RT1. Final adjudication of the diagnosis through a retrospective analysis of each case by the authors based on additional molecular testing, findings, and clinical evolution, and/or the results of the cerebrospinal fluid study.
§
Chi2-test and corresponding p-value to assess presence of statistical heterogeneity.