The diagnostic efficacy of metagenomic next-generation sequencing in spontaneous bacterial peritonitis: System review and meta-analysis.

OBJECTIVE

The objective of this research is to assess the accuracy and reliability of metagenomic next-generation sequencing (mNGS) in identifying pathogens in spontaneous bacterial peritonitis (SBP) patients and its impact on antibiotic treatment decisions.

METHODS

Electronic databases were searched up to July 31, 2023. Studies reporting mNGS diagnostic sensitivity and specificity in SBP were included. Random or fixed-effects models were used. Heterogeneity was assessed using Chi-squared test and I2 statistics.

RESULTS

Out of 75 identified studies, four studies with a total of 420 SBP patients were included. The pooled sensitivity for mNGS in ascites was 94% (95% CI: 86-97%), and specificity was 81% (95% CI: 71-89%). The AUC was calculated to be 0.95 (95% CI: 0.92-0.96), indicating high diagnostic accuracy. The most common pathogens identified by mNGS were Gram-positive bacteria (36%), followed by Gram-negative bacteria (29%), viruses (22%), and fungi (11%).

CONCLUSION

mNGS shows high diagnostic accuracy in detecting pathogens in SBP patients, offering significant value in optimizing antimicrobial therapy. Its ability to identify a broad spectrum of pathogens makes it a promising tool in clinical management of SBP.