Clinical values of metagenomic next-generation sequencing in patients with severe pneumonia: a systematic review and meta-analysis

作者：Minjie Lv, Changjun Zhu, Chenghua Zhu, Jing Yao, Lixu Xie, Changwen Zhang, Jianling Huang, Xingran Du, Ganzhu Feng · 发表于：Frontiers in Cellular and Infection Microbiology · 年份：2023 · DOI：10.3389/fcimb.2023.1106859 · 被引用次数：49 · 研究领域：Sepsis Diagnosis and Treatment、Nosocomial Infections in ICU、Pneumonia and Respiratory Infections

Background Clinical values of metagenomic next-generation sequencing (mNGS) in patients with severe pneumonia remain controversial. Therefore, we conduct this meta-analysis to evaluate the diagnostic performance of mNGS for pathogen detection and its role in the prognosis of severe pneumonia. Methods We systematically searched the literature published in PubMed, Embase, Cochrane Library, Web of Science, Clinical Trials.gov, CNKI, Wanfang Data, and CBM from the inception to the 28th September 2022. Relevant trials comparing mNGS with conventional methods applied to patients with severe pneumonia were included. The primary outcomes of this study were the pathogen-positive rate, the 28-day mortality, and the 90-day mortality; secondary outcomes included the duration of mechanical ventilation, the length of hospital stay, and the length of stay in the ICU. Results Totally, 24 publications with 3220 patients met the inclusion criteria and were enrolled in this study. Compared with conventional methods (45.78%, 705/1540), mNGS (80.48%, 1233/1532) significantly increased the positive rate of pathogen detection [ OR = 6.81, 95% CI (4.59, 10.11, P < 0.001]. The pooled 28-day and 90-day mortality in mNGS group were 15.08% (38/252) and 22.36% (36/161), respectively, which were significantly lower than those in conventional methods group 33.05% (117/354) [ OR = 0.35, 95% CI (0.23, 0.55), P < 0.001, I 2 = 0%] and 43.43%(109/251) [ OR = 0.34, 95% CI (0.21, 0.54), P < 0...