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Chinese Journal of Antituberculosis ›› 2022, Vol. 44 ›› Issue (12): 1327-1337.doi: 10.19982/j.issn.1000-6621.20220303

• Original Articles • Previous Articles     Next Articles

Meta-analysis of the diagnostic value of metagenomic next-generation sequencing and GeneXpert MTB/RIF in tuberculosis

Wang Yajuan, Cao Xinyi, Liu Shengming()   

  1. Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Ji’nan University, Guangzhou 510630,China
  • Received:2022-08-08 Online:2022-12-10 Published:2022-12-02
  • Contact: Liu Shengming E-mail:tlsm@jnu.edu.cn

Abstract:

Objective: To compare the diagnostic efficacy of metagenomic next-generation sequencing (mNGS) and GeneXpert MTB/RIF (Xpert) for tuberculosis using meta-analysis. Methods: Literatures about the diagnostic accuracy of mNGS and Xpert for tuberculosis were systematically searched in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Wanfang and VIP databases from the establishment to July 5, 2022. According to the inclusion and exclusion criteria, two reviewers independently conducted the screening and inclusion of literatures, data extraction, risk of bias evaluation, as well as analysis for the diagnostic performance of mNGS and Xpert. Results: Twelve literatures with a total of 1344 samples were ultimately included. As the meta-analysis showed, the pooled sensitivity, specificity, diagnostic odds ratio and AUC of mNGS in tuberculosis diagnosis were 63.4%, 99.8%, 58.6 and 0.931, respectively, which of Xpert were 50.3%, 99.9%, 23.8 and 0.860, respectively, while those of the parallel diagnosis of mNGS and Xpert were 68.7%, 99.8%, 91.2 and 0.978, respectively. Meanwhile, the sensitivities of mNGS on cerebrospinal fluid and other extra-pulmonary or multi-site specimens were 64.6% and 60.8%, respectively, and those of Xpert were 41.8% and 50.8%, respectively. Conclusion: Both mNGS and Xpert performed well in the diagnosis of tuberculosis. The sensitivities of mNGS single detection and detection combined with Xpert were higher than that of Xpert single detection, but there is no difference in the specificities. The combined detection with mNGS is expected to improve the detection rate of Xpert negative but clinically suspected tuberculosis infection, especially the pathogen of extrapulmonary tuberculosis.

Key words: Tuberculosis, Metagenomic next-generation sequencing, Molecular diagnostic techniques, Comparative study, Meta-analysis

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