A systematic review and meta-analysis of the diagnostic accuracy of metagenomic next-generation sequencing for diagnosing tuberculous meningitis

Frontiers in Immunology

Immunology

Yong-Liang Zhou¹  Fan Hu¹  Wen-Feng Cao¹  Shi-Min Liu¹  An Wen¹  Zheng-Bing Xiang¹  Chao-Qun Luo¹  Er-Ling Leng² 

[1] Department of Neurology, Jiangxi Provincial People’s Hospital (The First Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, China;Department of Neurology, Xiangya Hospital, Central South University, Jiangxi Hospital, National Regional Center for Neurological Diseases, Nanchang, Jiangxi, China;Department of Pediatrics, Jiangxi Provincial People’s Hospital (The First Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, China;

关键词: tuberculous meningitis;    cerebrospinal fluid;    metagenomic next-generation sequencing;    diagnosis;    meta-analysis;   

DOI  :  10.3389/fimmu.2023.1223675

 received in 2023-05-26, accepted in 2023-09-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveThe utility of metagenomic next-generation sequencing (mNGS) in the diagnosis of tuberculous meningitis (TBM) remains uncertain. We performed a meta-analysis to comprehensively evaluate its diagnostic accuracy for the early diagnosis of TBM.MethodsEnglish (PubMed, Medline, Web of Science, Cochrane Library, and Embase) and Chinese (CNKI, Wanfang, and CBM) databases were searched for relevant studies assessing the diagnostic accuracy of mNGS for TBM. Review Manager was used to evaluate the quality of the included studies, and Stata was used to perform the statistical analysis.ResultsOf 495 relevant articles retrieved, eight studies involving 693 participants (348 with and 345 without TBM) met the inclusion criteria and were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver-operating characteristic curve of mNGS for diagnosing TBM were 62% (95% confidence interval [CI]: 0.46–0.76), 99% (95% CI: 0.94–1.00), 139.08 (95% CI: 8.54–2266), 0.38 (95% CI: 0.25–0.58), 364.89 (95% CI: 18.39–7239), and 0.97 (95% CI: 0.95–0.98), respectively.ConclusionsmNGS showed good specificity but moderate sensitivity; therefore, a more sensitive test should be developed to assist in the diagnosis of TBM.

【 授权许可】

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Copyright © 2023 Xiang, Leng, Cao, Liu, Zhou, Luo, Hu and Wen