The Diagnostic Efficacy of Metagenomic Next-Generation Sequencing (mNGS) in Pathogen Identification of Pediatric Pneumonia using Bronchoalveolar Lavage Fluid (BALF): A Systematic Review and Meta-Analysis
Abstract
OBJECTIVE
This meta-analysis evaluates and compares the diagnostic efficacy of metagenomic next-generation sequencing (mNGS) with conventional microbiological tests (CMTs) in diagnosing pediatric pneumonia using bronchoalveolar lavage fluid (BALF).
METHODS
Data were sourced from Embase, Medline (via PubMed), Web of Science, and the Cochrane Library. The pooled positive detection rate (PDR) of pathogens was estimated using fixed-effects or random-effects models. Subgroup analyses explored factors influencing mNGS diagnostic performance. Data analysis was conducted using Review Manager (RevMan) 5.4 and Stata version 16.0.
RESULTS
The pooled PDR of mNGS was 85.83%, which is higher than the pooled PDR of 49.97% for CMTs. A random-effects model indicated that, compared to CMTs, mNGS has a significantly higher PDR in pediatric pneumonia (OR=3.99, 95%CI: 2.12-7.50, P<0.0001, I2=81%). Subgroup analysis indicated that mNGS exhibited greater advantages in the group using the QIAamp kit (OR=5.55, 95% CI: 3.03-10.16, P<0.00001), the group using the Illumina Nextseq platform (OR=4.87, 95% CI: 2.97-7.99, P<0.00001), the DNA-only mNGS group (OR=4.54, 95% CI: 2.73-7.54, P<0.00001), and the non-severe pneumonia group (OR=4.76, 95% CI: 3.51-6.46, P<0.00001). However, when the subgroups were categorized as mixed infections or single-pathogen infections, no statistically significant differences were observed (Mixed: OR=1.77, 95% CI: 0.30-10.56, P=0.53; Single: OR=3.97, 95% CI: 0.42-37.87,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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