Metagenomic next-generation sequencing in patients with fever of unknown origin: A comprehensive systematic literature review and meta-analysis.
Diagn Microbiol Infect Dis
; 110(2): 116465, 2024 Oct.
Article
in En
| MEDLINE
| ID: mdl-39059148
ABSTRACT
Metagenomic Next-Generation Sequencing (mNGS) holds promise in diagnosing fever of unknown origin (FUO) by detecting diverse pathogens. We systematically reviewed the literature to evaluate mNGS's accuracy, clinical efficacy, and limitations in FUO diagnosis. Nine studies revealed mNGS's positivity rate ranging from 66.7% to 93.5% for bacterial bloodstream infections and systemic infections. Meta-analysis of three studies involving 857 patients, including 354 with FUO, showed a sensitivity of 0.91 (95% CI 0.87-0.93) and specificity of 0.64 (95% CI 0.58-0.70). Despite lower specificity, mNGS demonstrated a higher Diagnostic Odds Ratio (DOR) of 17.0 (95% CI 4.5-63.4) compared to conventional microbiological tests (CMTs) at 4.7 (95% CI 2.9-7.6). While mNGS offers high sensitivity but low specificity in identifying causative pathogens for FUO, its superior DOR suggests potential for more accurate diagnoses and targeted interventions. Further research is warranted to optimize its clinical application in FUO management.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Sensitivity and Specificity
/
Metagenomics
/
High-Throughput Nucleotide Sequencing
/
Fever of Unknown Origin
Limits:
Humans
Language:
En
Journal:
Diagn Microbiol Infect Dis
/
Diagn. microbiol. infect. dis
/
Diagnostic microbiology and infectious disease
Year:
2024
Document type:
Article
Country of publication:
Estados Unidos