The clinical value of valve metagenomic next-generation sequencing when applied to the etiological diagnosis of infective endocarditis

作者：Sishi Cai, Ye Yang, Jue Pan, Qing Miao, Wenting Jin, Yuyan Ma, Chunmei Zhou, Xiaodong Gao, Chunsheng Wang, Bijie Hu · 发表于：Annals of Translational Medicine · 年份：2021 · DOI：10.21037/atm-21-2488 · 被引用次数：16 · 研究领域：Infective Endocarditis Diagnosis and Management、Bacterial Identification and Susceptibility Testing、Orthopedic Infections and Treatments

BACKGROUND: Metagenomic next-generation sequencing (mNGS) is widely applied in the etiological diagnosis of infectious diseases. However, the clinical practice of mNGS in infective endocarditis (IE) is relatively less studied. This research aimed to assess the etiological diagnostic value of valve mNGS in IE. METHODS: We retrospectively analyzed 49 IE patients who underwent cardiac valve surgery in Zhongshan Hospital, Fudan University, Shanghai from 1 June 2018 to 30 November 2020. Among these IE patients, 28 were culture positive and 21 were culture negative. The culture results of the culture-positive IE patients were set as gold standard to assess the sensitivity and specificity of valve mNGS in the etiological diagnosis of IE. We studied the positive detection rate of pathogens by valve mNGS among the culture-negative IE patients. During the same period, we also collected the resected valves of 8 patients with non-infective valvular diseases for mNGS as negative controls. RESULTS: The valve mNGS results of the culture-positive IE patients were the exact same as their culture results. Both the sensitivity and specificity of valve mNGS were 100%. The positive detection rate of pathogens by valve mNGS was 100% among the culture-negative IE patients. The stringent mapped reads number of genera (SMRNG), relative abundance of genera, stringent mapped reads number of species (SMRN), relative abundance of species, and coverage rate of valve mNGS results were significantly higher ...