Value of digital PCR in the early diagnosis of sepsis: A systematic review and meta-analysis

ElsevierVolume 72, December 2022, 154138Journal of Critical CareHighlights•

Digital PCR is an exciting and fairly new tool in the world of clinical infectious disease management.

It is important to keep evaluating its place and role in the diagnosis and management of infectious diseases.

This paper made a good attempt at evaluating the currently available literature by using a meta-analysis approach.

AbstractBackground

We systematically assessed whether a digital polymerase chain reaction (PCR) could detect pathogenic microorganisms in patients with sepsis early and accurately.

Methods

We searched the Cochrane Library, MEDLINE, Embase, CNKI, CBM, and Wanfang Data databases for eligible studies to compare the detection of pathogenic microorganisms in blood samples by digital PCR with the gold standard. The Quality Assessment of Diagnostic Accuracy Studies 2 was used to evaluate bias risk, and a random-effects meta-analysis approach was used for sensitivity and specificity calculations.

Results

Among the eight articles, there were eight identified studies with a total of 1278 subjects. The pooled sensitivity of digital PCR was 94% (95% confidence interval [CI], 85%–98%), the specificity was 87% (95% CI, 76%–94%), the positive likelihood ratio was 7.3 (95% CI, 3.8–14.2), the negative likelihood ratio was 0.07 (95% CI, 0.03–0.17), the positive predictive value was 84.7%, the negative predictive value was 89.2%, the diagnostic odds ratio was 105 (95% CI, 37–303), and the area under the receiver operating characteristic curve was 0.97 (95% CI, 0.95–1.00). Digital PCR can shorten the detection time of pathogenic microorganisms in patients with sepsis.

Conclusions

Digital PCR can detect pathogenic microorganisms in patients with sepsis earlier than blood culture. Therefore, digital PCR can be used as a potential strategy for the detection of pathogenic microorganisms in patients with sepsis.

Keywords

Digital PCR

Sepsis

Pathogenic microorganisms

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