Clinical and Demographic Stratification of Test Performance: A Pooled Analysis of Five Laboratory Diagnostic Methods for American Cutaneous Leishmaniasis
Clinical and Demographic Stratification of Test Performance: A Pooled Analysis of Five Laboratory Diagnostic Methods for American Cutaneous Leishmaniasis
复制标题
DOI：
10.4269/ajtmh.2010.09-0414
复制
发表时间：
2010-08-01
影响因子：
3.3
通讯作者：
Llanos-Cuentas, Alejandro
中科院分区：
文献类型：
--
作者：
Boggild, Andrea K.;Ramos, Ana P.;Llanos-Cuentas, Alejandro
我们评估了五种诊断方法的性能特点，皮肤利什曼病患者来到利马国立卡耶塔诺埃雷迪亚医院利什曼原虫滑道。秘鲁。入组病变涂片研究。文化微培养聚合酶链反应（PCR）。共纳入145例患者202个皮损，其中114例患者161个皮损符合皮肤利什曼病诊断标准，细菌培养法的敏感性和特异性分别为57.8%（95%可信区间[CI] = 50.2 ~ 65.4%）和100.0%。微量培养法为1000%。71 4%（95% CI = 64.4-78.4%），涂片为100.0%，78.2%（95% CI = 70.6-85.8%）和77.4%（95% CI = 62 7-92 1%），PCR法敏感性为96 9%（95% CI = 94 2-99 6%）和65 9%（95% CI = 51 4-80 4%），明显高于其他方法（P <0 0 0 1）。培养、涂片的敏感性。LST随病变持续时间和外观而变化，PCR提供了优于其他测定的性能，而与患者年龄、性别无关。病变持续时间或外观临床因素影响非分子检测的性能，使临床医生在选择诊断检测时以患者为中心
We evaluated performance characteristics of five diagnostic methods for cutaneous leishmaniasis Patients who came to the Leishmania Chute of Hospital Nacional Cayetano Heredia in Lima. Peru. were enrolled in the study Lesion smears. culture. microculture. polymerise chain reaction (PCR). and leishmanin skin test (LST), were performed A total of 145 patients with 202 lesions were enrolled 114 patients with 161 lesions fulfilled criteria for cutaneous leishmaniasis Sensitivity and specificity were 57 8% (95% confidence interval [CI] = 50 2-65 4%) and 100.0% for culture. 78.3% (95% Cl = 71 9-84 7%) and 100 0% for microculture. 71 4% (95% Cl = 64.4-78.4%) and 100.0% for smears, 78 2% (95% Cl = 70.6-85.8%) and 77.4% (95% Cl = 62 7-92 1%) for LST, and 96 9% (95% Cl = 94 2-99 6%) and 65 9% (95% Cl = 51 4-80 4%) for PCR PCR was more sensitive than the other assays (P < 0.001). Sensitivities of culture, smears. and LST varied by lesion duration and appearance PCR offers performance advantages over other assays, irrespective of patient age, sex. lesion duration, or appearance That clinical factors influence performance of non-molecular assays frets clinicians a patient-focused approach to diagnostic test selection