Meta-analysis of Next-generation Sequencing in the Etiological Diagnosis of Sepsis Patients / 医学研究杂志

ABSTRACT

Objective To systematically evaluate the application value of next-generation sequencing technology in the etiological diagnosis of patients with sepsis.Methods Databases such as PubMed,Embase,Web of Science,The Cochrane Library,VIP,CNKI,WanFang Data Knowledge Service platform and SinoMed were searched from January 2018 to September 2022.The positive rate of sepsis detection,pathogen detection time,virus detection rate,28 days mortality rate and length of stay in intensive care unit(ICU)were com-pared between next-generation sequencing technology and traditional etiological detection method.Meta-analysis was performed using Review Manager 5.4.1 software,and funnel plot was pictured to analyze the publication bias of the included literatures.Results A total of 18 literatures were included.The results of Meta-analysis showed that the positive rate of next-generation sequencing group was 72.3％(1403/1941),which was significantly higher than that of the traditional etiological detection group[28.4％(556/1958),OR=7.03,95％CI:4.52-10.95,P＜0.01];the time of pathogen detection was significantly lower than that of traditional etiological detec-tion group(OR=-34.22,95％CI:-41.95--26.48,P＜0.01);the virus detection rate was significantly higher than that of tradi-tional etiological detection group(OR=57.82,95％CI:19.27-173.46,P＜0.01);the length of stay in ICU was significantly lower than that of traditional etiological detection group(WMD=-9.37,95％CI:-16.28--2.46,P＜0.01);there was no significant difference in 28 days mortality between the two groups(OR=0.43,95％CI:0.02-8.47,P=0.58).Conclusion Compared with tra-ditional etiological detection methods,next-generation sequencing technology can improve the positive rate of pathogen detection and vi-rus detection in sepsis patients,shorten the time of pathogen physical examination and the length of stay in ICU,and has higher applica-tion value for the diagnosis and treatment of sepsis.