Nucleic Acid Amplification tests (NAAT)

Streptococcus pneumoniae | 6 studies | 2,221 individuals

Sensitivity for Streptococcus pneumoniae NAAT tests, was 96% (CI, 93% to 98%) while specificity was 91% (CI, 71% to 98%).

Mycoplasma pneumoniae | 25 studies | 9,229 individuals

Mycoplasma pneumoniae was evaluated by PCR and by non-PCR assays (loop mediated isothermal amplification, LAMP, and isothermal amplification technology), reporting a similar sensitivity [87% (CI, 73% to 95%) and 83% (CI, 60% to 94%), respectively] and specificity [98% (CI, 97% to 99%) and 98% (CI, 95% to 99%), respectively].

Influenza | 89 studies | 43,762 individuals

The pooled sensitivity of PCR for Influenza A/B was 94% (CI, 90% to 96%) and specificity was 98% (CI, 97% to 99%).

The most frequently reported commercial tests were different Cepheid tests and Biofire. Other non-PCR based NAATs (23 studies, 4,863 patients) included mainly isothermal nicking enzyme amplification-ID NOW (formerly Alere i), isothermal nucleic acid amplification, RT LAMP, and rod-shaped gold nanoparticles.

Their pooled sensitivity and specificity values were 92% (CI, 88% to 94%) and 98% (CI, 95% to 99%), respectively.

Respiratory Syncytial Virus (RSV) | 43 studies | 19,919 individuals

The PCR for the diagnosis of RSV was evaluated in 38 studies (18,833 individuals) with a sensitivity of 93% (CI, 89% to 96%) and a specificity of 99% (CI, 98% to 99%). Five studies assessed non-PCR methods (1,086 individuals) with a pooled sensitivity of 94% (CI, 71% to 99%) and a specificity of 97% (CI, 64% to 100%). Specificity was high in all subgroups, but sensitivity was higher in studies evaluating RSV PCR as a standalone test (97%, CI 93% to 99%) and with real-time PCR (97%, CI 95% to 98%).

Human-metapneumovirus (hMPV) | 17 studies | 8,061 individuals

Overall, diagnostic accuracy of PCR for hMPV was 88% (CI, 80% to 94%) for sensitivity, with specificity of 99% (CI, 98% to 100%). Subgroup analysis showed a possible source of heterogeneity depending on the year of study, with sensitivity reported by studies performed after 2011 better compared with previous studies 96% (CI, 90% to 98%) vs 83% (CI, 71% to 91%)]

Meta-analysis results visualisation