AUTHOR
Marina Antillon, Neil J Saad, Stephen Baker, Andrew J Pollard, Virginia E Pitzer.
ABSTRACT
OBJECTIVE:
Blood culture is the standard diagnostic method for typhoid and paratyphoid (enteric) fever in surveillance studies and clinical trials, but sensitivity is widely acknowledged to be suboptimal. We conducted a systematic review and meta-analysis to examine sources of heterogeneity across studies and quantified the effect of blood volume.
RESULTS:
We estimated blood culture diagnostic sensitivity was 0.59 with significant between-study heterogeneity. Sensitivity ranged from 0.51 for a 2-mL blood specimen to 0.65 for a 10-mL blood specimen, indicative of a relationship between specimen volume and sensitivity. Subgroup analysis showed significant heterogeneity by patient age and a weak trend towards higher sensitivity among more recent studies. Sensitivity was 34% lower among patients with prior antimicrobial use and 31% lower after the first week of symptoms. There was no evidence of confounding by patient age, antimicrobial use, symptom duration, or study date on the relationship between specimen volume and sensitivity.
Click here to view the article, published in The Journal of Infectious Diseases.
