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SYSTEMATIC REVIEW article

Front. Bacteriol.
Sec. Pathogenesis, Vaccines, and Immunity of Bacterial Infections
Volume 3 - 2024 | doi: 10.3389/fbrio.2024.1440288

Comparison between metagenomic next-generation sequencing in bronchoalveolar lavage fluid and blood for the diagnostic performance of respiratory tract infection: a meta-analysis

Provisionally accepted
Zhou Sun Zhou Sun 1Guofu Liang Guofu Liang 1Yulin Niu Yulin Niu 2*
  • 1 Guizhou Medical University, Guiyang, China
  • 2 Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China

The final, formatted version of the article will be published soon.

    Objective: Metagenomic next-generation sequencing (mNGS) is emerging to be pivotal in infectious disease diagnosis, particularly in pulmonary infection. However, the utility of bronchoalveolar lavage fluid (BALF) versus blood mNGS remains controversial. Therefore, the current meta-analysis summarized the previous studies regarding BALF or blood mNGS in pulmonary infection, aiming to comprehensively compare the diagnostic efficiency between them.Studies reporting paired BALF and blood mNGS data for pulmonary infection diagnosis were searched in the PubMed, Web of Science, Embase, CNKI, and Wanfang from January 2016 to March 2024.Results: Eleven studies involving 346 assessed patients were eligible and analyzed. The pooled sensitivity, specificity, and area under the curve (AUC) of BALF mNGS were 0.94 [95% confidence interval (CI): 0.90-0.97], 0.27 (95% CI: 0.19-0.36), and 0.86 [standard error (SE): 0.06], respectively. Meanwhile, the pooled sensitivity, specificity, and AUC of blood mNGS were 0.64 (95% CI: 0.56-0.72), 0.69 (95% CI: 0.62-0.76), and 0.81 (SE: 0.05), respectively. By subgroup analyses, the AUCs of BALF mNGS and blood mNGS for viral detection were 0.70 (SE: 0.08) and 0.71 (SE: 0.08), respectively, while the AUCs of BALF mNGS and blood mNGS for nonviral (bacterial or fungal) detection were 0.83 (SE: 0.06) and 0.73 (SE: 0.08), respectively. Moreover, no threshold effect or publication bias existed, and sensitivity analysis revealed that the findings were generally robust.BALF mNGS surpasses blood mNGS for total pathogen detection in pulmonary infection patients, while they share a similar efficiency for viral detection.

    Keywords: pulmonary infection, Bronchoalveolar Lavage Fluid, Blood, metagenomic next-generation sequencing, diagnostic efficiency

    Received: 29 May 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Sun, Liang and Niu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yulin Niu, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.