Evaluating Rapid Diagnostics for Severe Infections and Sepsis: A Systematic Review and Meta-analysis on behalf of the Hellenic Microbiological Society and the Hellenic Society of Chemotherapy
- Journal
- International journal of antimicrobial agents (Q1)
- Published
- 17 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Evdoxia Kyriazopoulou, Konstantinos Patras, Simeon Metallidis, Konstantina Gartzonika, Karolina Akinosoglou, Maria Orfanidou, et al.
- PMID
- 42468648
- DOI
- 10.1016/j.ijantimicag.2026.107937
Why clinicians should know about it
- Picked for Critical Care and Intensive Care Medicine (top studies of the week, 19 July 2026): Rapid diagnostics for sepsis systematic review
- Picked for Infectious Diseases (top studies of the week, 19 July 2026).
- Picked for Microbiology (medical) (top studies of the week, 19 July 2026).
Abstract
BACKGROUND: The diagnostic accuracy and clinical benefit of molecular methods for pathogen identification and antimicrobial susceptibility testing were assessed through a systematic review and meta-analysis. METHODS: The protocol was prospectively registered with PROSPERO (CRD420251044218). A comprehensive search of MEDLINE (via PubMed), the Cochrane Library, and ClinicalTrials.gov was conducted to identify randomized controlled trials, non-controlled trials, and observational studies. The review investigated rapid diagnostic tests performed on blood samples for pathogen identification and susceptibility testing. The primary outcomes were Diagnostic Test Accuracy (DTA) for microbiological evaluation and time to pathogen identification, as well as to optimal/ adjusted/ appropriate antimicrobial treatment for clinical assessment. Secondary outcomes included 30-day mortality and total hospitalization cost. A random-effects model was used for quantitative synthesis. RESULTS: Of 1353 articles retrieved, 49 and 33 records were included in microbiological and clinical analysis. Pooled bivariate sensitivity for pathogen identification ranged from 0.97 to 0.98 (95% CIs approximately 0.94-0.99), with specificity consistently 0.99-1.00 across Gram-negative bacteria, Gram-positive bacteria, and yeasts. The mean time difference for pathogen identification was -21.43 hours (95% CI -29.15 to -13.72; P<0.0001; I2 = 99%), and for optimal/ adjusted/ appropriate treatment -13.78 hours (95% CI -18.06 to -9.5; P<0.0001; I2 = 97%). Total hospitalization costs were reduced; 30-day mortality was indifferent (OR 0.97; 95% CI, 0.88 to 1.07; I2 = 23%). CONCLUSION: Evidence indicates that early, actionable diagnostics, particularly those from positive blood cultures, are essential to effective sepsis care.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.