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

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