Journal article
Metagenomic next-generation sequencing in patients with fever of unknown origin: A comprehensive systematic literature review and meta-analysis
Diagnostic microbiology and infectious disease, Vol.110(2), 116465
10/2024
DOI: 10.1016/j.diagmicrobio.2024.116465
PMID: 39059148
Abstract
•mNGS shows promise in diagnosing fever of unknown origin (FUO).•Nine studies reviewed; mNGS positive rates from 66.7% to 93.5%.•Pooled sensitivity for mNGS: 0.91, specificity: 0.64.•mNGS diagnostic odds ratio (DOR): 17 vs. CMTs DOR: 4.7.•High sensitivity but lower specificity; needs further research.
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.
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Details
- Title: Subtitle
- Metagenomic next-generation sequencing in patients with fever of unknown origin: A comprehensive systematic literature review and meta-analysis
- Creators
- Alexandre R. Marra - Hospital Israelita Albert EinsteinGabriel O.V. Lopes - Hospital Israelita Albert EinsteinIsabele Pardo - Hospital Israelita Albert EinsteinMariana Kim Hsieh - University of IowaTakaaki Kobayashi - University of IowaPedro S. Marra - University of California, San FranciscoJonas Marschall - Washington University in St. LouisJoão Renato Rebello Pinho - Hospital Israelita Albert EinsteinDeyvid Emanuel Amgarten - Hospital Israelita Albert EinsteinFernanda de Mello Malta - Hospital Israelita Albert EinsteinNathalia Villa dos Santos - Hospital Israelita Albert EinsteinMichael B. Edmond - West Virginia University
- Resource Type
- Journal article
- Publication Details
- Diagnostic microbiology and infectious disease, Vol.110(2), 116465
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.diagmicrobio.2024.116465
- PMID
- 39059148
- ISSN
- 0732-8893
- eISSN
- 1879-0070
- Language
- English
- Date published
- 10/2024
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984688444302771
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