Recently, molecular assays have been demonstrated to be reliable for rapid detection of carbapenemase-producing Enterobacteriaceae (CPE) directly from positive blood cultures, reducing significantly the time for identification. Few studies have tested their performance on rectal swabs and no comprehensive conclusions have been reached regarding their utility for infection control management. Our aim was to review and assess the overall diagnostic test accuracy of polymerase chain reaction for the detection of CPE in rectal swabs. The electronic database PubMed was searched, up to October 1st, 2019, without language restriction or publication date restrictions. First, the concepts of the research questions were defined: 'carbapenemase-producing Enterobacteriaceae', 'molecular testing', 'test detection', and 'rectal screening'. Two reviewers independently screened studies, extracted data, and assessed quality using the QUADAS-2 instrument. Statistical analyses were carried out in Stata software using the bivariate model. In all, 143 articles were screened and 16 studies were included. Five (31%) of the studies were conducted in the context of a CPE outbreak; one study (6%) included patients pre-identified with CPE in clinical samples (blood or tracheal secretions), whereas the rest (63%) collected rectal swabs from patients considered at high risk of colonization. The molecular assays evaluated had a relatively good sensitivity of 0.95 (95% confidence interval (CI): 0.902-0.989), and an excellent specificity of 0.994 (95% CI: 0.965-1). Molecular techniques seem to be a useful, accurate diagnostic tool in screening for carriage of CPE in contact patients around a fortuitous discovery of a non-isolated hospitalized carrier patient.

中文翻译：

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从直肠拭子直接筛选产碳青霉烯酶的肠杆菌科的聚合酶链反应分析的评估：诊断性荟萃分析。

最近，已证明分子测定可直接从阳性血液培养物中快速快速检测生产碳青霉烯酶的肠杆菌科（CPE），从而大大减少了鉴定时间。很少有研究测试它们在直肠拭子上的性能，并且尚未就其在感染控制管理中的效用得出全面的结论。我们的目的是审查和评估用于检测直肠拭子中CPE的聚合酶链反应的总体诊断测试准确性。搜索电子数据库PubMed直至2019年10月1日，没有语言限制或发布日期限制。首先，对研究问题的概念进行了定义：“产生卡培南酶的肠杆菌科”，“分子检测”，“检测检测”和“ 直肠筛查”。两名审稿人使用QUADAS-2仪器独立筛选研究，提取数据并评估质量。使用双变量模型在Stata软件中进行统计分析。总共筛选了143篇文章，包括16项研究。五项（31％）的研究是在CPE爆发的背景下进行的；一项研究（6％）在临床样本（血液或气管分泌物）中包括了预先确定为CPE的患者，而其余（63％）则从被认为具有高定植风险的患者中收集了直肠拭子。评估的分子测定法具有0.95（95％置信区间（CI）：0.902-0.989）的相对较好的敏感性，以及0.994（95％CI：0.965-1）的优异特异性。分子技术似乎是有用的，