Comparison of Next-Generation Sequencing Versus Culture-Based Tests for Sepsis Pathogens Detection in the Intensive Care Unit: A Diagnostic Meta-Analysis

Abstract

BACKGROUND:Early and reliable identification of etiological pathogens is crucial for septic patients. Next-generation sequencing (NGS) technology is a promising method for the etiologic diagnosis of sepsis. MATERIAL AND METHODS:We searched PubMed, Embase, Medline, CENTRAL, and Web of Science from inception until April 30, 2022. We calculated individual and pooled sensitivities, specificities, positive likelihood ratio (LR), and negative LR of these 2 methods through the bivariate mixed-effects model. We evaluated publication bias by the linear regression method and used I2 to test heterogeneity. RESULTS:Searches returned 2519 reports, of which 5 fulfilled the inclusion criteria. For NGS, the pooled sensitivity, specificity, positive LR, and negative LR were 0.83 (95% CI=0.70 to 0.91), 0.67 (95% CI=0.59 to 0.74), 2.53 (95% CI=1.88 to 3.41), and 0.26 (95% CI=0.14 to 0.49), respectively. Conventional culture methods had higher specificities but suboptimal sensitivities, in which pooled sensitivity was 0.47 (95% CI=0.42 to 0.54) and pooled specificity was 0.86 (95% CI 0.79-0.91). There was no remarkable publication bias or heterogeneity among the included studies. CONCLUSIONS:NGS technology is an effective method for the diagnosis of pathogens in septic patients. Compared to traditional culture-based tests, the NGS technique might be more sensitive and could help diagnose multiple types of pathogens in septic patients simultaneously.