Department of Infectious Diseases, Zhejiang Hospital, 1229 Gudun Road, Xihu District, Hangzhou, 310013, Zhejiang Province, People's Republic of China.
Department of Respiratory Diseases, Zhejiang Hospital, 1229 Gudun Road, Xihu District, Hangzhou, 310013, Zhejiang Province, People's Republic of China.
BMC Infect Dis. 2023 Jul 10;23(1):455. doi: 10.1186/s12879-023-08440-4.
Pneumocystis jirovecii pneumonia (PJP) can be a life-threatening opportunistic infection. We aimed to evaluate the diagnostic accuracy of metagenomic next-generation sequencing (mNGS) for PJP.
A comprehensive electronic literature search of Web of Knowledge, PubMed, Cochrane Library, CNKI and Wanfang data was performed. Bivariate analysis was conducted to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), the area under the summary receiver operator characteristic (SROC) curve and the Q-point value (Q*).
The literature search resulted in 9 studies with a total of 1343 patients, including 418 cases diagnosed with PJP and 925 controls. The pooled sensitivity of mNGS for diagnosis of PJP was 0.974 [95% confidence interval (CI), 0.953-0.987]. The pooled specificity was 0.943 (95% CI, 0.926-0.957), the DOR was 431.58 (95% CI, 186.77-997.27), the area under the SROC curve was 0.987, and the Q* was 0.951. The I test indicated no heterogeneity between studies. The Deek funnel test suggested no potential publication bias. Subgroup analyses showed that the area under the SROC curve of mNGS for diagnosis of PJP in immunocompromised and non-HIV patients was 0.9852 and 0.979, respectively.
Current evidence indicates that mNGS exhibits excellent accuracy for the diagnosis of PJP. The mNGS is a promising tool for assessment of PJP in both immunocompromised and non-HIV patients.
肺孢子菌肺炎（PJP）是一种危及生命的机会性感染。本研究旨在评估宏基因组下一代测序（mNGS）对 PJP 的诊断准确性。
对 Web of Knowledge、PubMed、Cochrane Library、CNKI 和万方数据库进行全面的电子文献检索。采用双变量分析计算汇总敏感性、特异性、诊断比值比（DOR）、汇总受试者工作特征（SROC）曲线下面积和 Q*值。
文献检索共纳入 9 项研究，共计 1343 例患者，其中 418 例诊断为 PJP，925 例为对照。mNGS 诊断 PJP 的汇总敏感性为 0.974（95%置信区间 [CI]：0.953-0.987）。汇总特异性为 0.943（95% CI：0.926-0.957），DOR 为 431.58（95% CI：186.77-997.27），SROC 曲线下面积为 0.987，Q*值为 0.951。I²检验提示各研究间无异质性。Deek 漏斗图检验提示无潜在发表偏倚。亚组分析显示，mNGS 诊断免疫抑制和非 HIV 患者 PJP 的 SROC 曲线下面积分别为 0.9852 和 0.979。
目前的证据表明，mNGS 对 PJP 的诊断具有优异的准确性。mNGS 是评估免疫抑制和非 HIV 患者 PJP 的一种很有前途的工具。
