基因组下一代测序与传染病传统微生物学测试之间的一致性:系统性审查和元分析
Chengxi Liu1, Xiao Song1, Jihai Liu1
1Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, NO. 1 Shuai Fu Yuan,Dongcheng District, Beijing, 100730, China.
Critical care (London, England)
|February 3, 2025
概括
甲基因组下一代测序 (mNGS) 与毒症诊断的传统病原体测试具有中等一致性. 无菌样本和免疫能力较强的患者获得了更高的一致性,突出了改善病原体检测的领域.
科学领域:
- 传染病诊断 传染病诊断 传染病诊断
- 基因组医学是基因组医学.
- 临床微生物学 临床微生物学
背景情况:
- 准确的病原体识别对于管理败血症和败血症休克至关重要.
- 与传统方法相比,甲基因组下一代测序 (mNGS) 提供了先进的病原体检测能力.
- 在mNGS和传统的诊断测试之间的一致性需要彻底调查.
研究的目的:
- 评估mNGS与传统病原体检测技术之间的一致性.
- 确定影响临床环境中mNGS与传统方法之间一致性的因素.
主要方法:
- 一项系统性审查和对比mNGS和传统病原体测试的研究的元分析.
- 在主要的科学数据库 (PubMed,Embase,Scopus,Web of Science,Cochrane Library) 进行的搜索.
- 使用QUADAS-2工具进行卡帕一致性分析和质量评估.
主要成果:
- 对27项涉及4112个人的研究分析显示,聚合kappa一致性为0.319 (中等一致).
- 脑脊液样本显示出最高的一致性 (kappa = 0.500).
- 与免疫能力较强的个体 (kappa = 0.321) 相比,免疫功能低下的患者表现出较低的稳定性 (kappa = 0.294).
结论:
- mNGS与传统的病原体测试显示出中等程度的一致性,这表明这些方法之间存在复杂的相互作用.
- 与无菌样本类型相比,无菌样本类型的一致性更高.
- 免疫功能受损可能会降低mNGS和传统诊断方法之间的一致性,需要在败血症和败血症休克背景下进行进一步的研究.
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