新一代宏基因组测序对自发性细菌性腹膜炎的诊断效果:系统回顾和荟萃分析。

IF 1.9 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Chen Wang, Hongru Zhang, Jingya Liu
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引用次数: 0

摘要

目的:本研究的目的是评估宏基因组新一代测序(mNGS)鉴定自发性细菌性腹膜炎(SBP)患者病原体的准确性和可靠性及其对抗生素治疗决策的影响。方法:检索截至2023年7月31日的电子数据库。研究报告了mNGS诊断收缩压的敏感性和特异性。使用随机或固定效应模型。采用卡方检验和I²统计量评估异质性。结果:在75项确定的研究中,4项研究共纳入420例收缩压患者。mNGS在腹水中的总敏感性为94% (95% CI: 86-97%),特异性为81% (95% CI: 71-89%)。AUC为0.95 (95% CI: 0.92-0.96),诊断准确率高。mNGS鉴定出的最常见病原体是革兰氏阳性菌(36%),其次是革兰氏阴性菌(29%)、病毒(22%)和真菌(11%)。结论:mNGS对收缩压患者的病原菌检测具有较高的诊断准确性,对优化抗菌药物治疗具有重要价值。它能够识别广泛的病原体,使其成为临床管理收缩压的一个很有前途的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The diagnostic efficacy of metagenomic next-generation sequencing in spontaneous bacterial peritonitis: System review and meta-analysis.

Objective: The objective of this research is to assess the accuracy and reliability of metagenomic next-generation sequencing (mNGS) in identifying pathogens in spontaneous bacterial peritonitis (SBP) patients and its impact on antibiotic treatment decisions.

Methods: Electronic databases were searched up to July 31, 2023. Studies reporting mNGS diagnostic sensitivity and specificity in SBP were included. Random or fixed-effects models were used. Heterogeneity was assessed using Chi-squared test and I2 statistics.

Results: Out of 75 identified studies, four studies with a total of 420 SBP patients were included. The pooled sensitivity for mNGS in ascites was 94% (95% CI: 86-97%), and specificity was 81% (95% CI: 71-89%). The AUC was calculated to be 0.95 (95% CI: 0.92-0.96), indicating high diagnostic accuracy. The most common pathogens identified by mNGS were Gram-positive bacteria (36%), followed by Gram-negative bacteria (29%), viruses (22%), and fungi (11%).

Conclusion: mNGS shows high diagnostic accuracy in detecting pathogens in SBP patients, offering significant value in optimizing antimicrobial therapy. Its ability to identify a broad spectrum of pathogens makes it a promising tool in clinical management of SBP.

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来源期刊
Gastroenterologia y hepatologia
Gastroenterologia y hepatologia GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
1.50
自引率
10.50%
发文量
147
审稿时长
48 days
期刊介绍: Gastroenterology and Hepatology is the first journal to cover the latest advances in pathology of the gastrointestinal tract, liver, pancreas, and bile ducts, making it an indispensable tool for gastroenterologists, hepatologists, internists and general practitioners.
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