Abstract:

Objective To evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) on cerebrospinal fluid for detecting tuberculous meningitis (TBM). Methods Literature on diagnosing TBM by mNGS assay on cerebrospinal fluid were collected by searching PubMed, Embase, Cochrane Library, CNKI, WanFang and VIP databases, enrolling literature recorded from database establishment to April 30, 2021.Both Chinese and English key words were “metagenomic next-generation sequencing”“mNGS”“next-generation sequencing”“tuberculosis”“tuberculosis meningitis” and “tuberculous meningitis”. Then two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of included studies. MetaDisc 1.4 were used to conduct meta-analysis. Results Six hundred and twenty-eight articles were retrieved, and 7 articles were finally included according to the inclusion and exclusion criteria, involving 477 cases among whom 231 cases were diagnosed as TBM patients. Meta analysis showed that the pooled sensitivity and specificity of mNGS on cerebrospinal fluid in the diagnosis of TBM were 62.0% (95.0%CI: 55.0%-68.0%) and 97.0% (95.0%CI: 94.0%-99.0%), while the pooled positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 10.57 (95%CI:4.84-23.11), 0.41 (95%CI:0.27-0.60), 21.39 (95%CI:10.18-44.95) respectively. The pooled area under the curve of receiver operating characteristic was 0.956. Conclusion mNGS on cerebrospinal fluid plays a valuable role in the diagnosis of TBM and can be used as an effective method for rapid diagnosis.

Key words: Metagenomic next-generation sequencing, Tuberculosis, meningeal, Diagnosis, Meta-analysis