Fifty-one studies were included in the review (at least 5,552 patients; 23 studies did not report the number of patients). Several studies included more than one sample per patient.
A majority of the included studies provided information on the composition of the sample (57%) and eligibility criteria (92%), but incorporation bias was present in 51% of studies and only 8% provided CIs or standard errors.
All pooled estimates were statistically heterogeneous.
Qualitative culture of catheter segment (6 studies): the sensitivity was 0.87 (95% CI: 0.79, 0.96), the specificity was 0.75 (95% CI: 0.72, 0.78) and Q* was 0.76 (95% CI: 0.64, 0.88).
Semi-quantitative culture of catheter segment (19 studies): the sensitivity was 0.83 (95% CI: 0.79, 0.87), the specificity was 0.86 (95% CI: 0.85, 0.87) and Q* was 0.84 (95% CI: 0.80, 0.88).
Quantitative culture of catheter segment (14 studies): the sensitivity was 0.82 (95% CI: 0.78, 0.86), the specificity was 0.89 (95% CI: 0.87, 0.91) and Q* was 0.87 (95% CI: 0.81, 0.93).
IVD-drawn qualitative blood culture (7 studies): the sensitivity was 0.91 (95% CI: 0.84, 0.98), the specificity was 0.86 (95% CI: 0.83, 0.89) and Q* was 0.86 (95% CI: 0.80, 0.92).
IVD-drawn quantitative blood culture (7 studies): the sensitivity was 0.84 (95% CI: 0.80, 0.89), the specificity was 0.90 (95% CI: 0.88, 0.92) and Q* was 0.89 (95% CI: 0.79, 0.99).
Paired quantitative blood cultures (10 studies): the sensitivity was 0.79 (95% CI: 0.74, 0.84), the specificity was 0.99 (95% CI: 0.98, 1.0) and Q* was 0.94 (95% CI: 0.88, 1.0).
Acridine orange leukocyte cytospin test (5 studies): the sensitivity was 0.87 (95% CI: 0.80, 0.94), the specificity was 0.93 (95% CI: 0.89, 0.97) and Q* was 0.89 (95% CI: 0.79, 0.91).
Differential time to positivity (10 studies): the sensitivity was 0.89 (95% CI: 0.86, 0.92), the specificity was 0.83 (95% CI: 0.79, 0.87) and Q* was 0.85 (95% CI: 0.81, 0.97).
The overall sensitivities and specificities were also reported.