The clinical application of metagenomic next-generation sequencing in sepsis of immunocompromised patients

作者：Xingxing Li, Shunda Liang, Dan Zhang, Miao He, Hong Zhang · 发表于：Frontiers in Cellular and Infection Microbiology · 年份：2023 · DOI：10.3389/fcimb.2023.1170687 · 被引用次数：31 · 研究领域：Pneumocystis jirovecii pneumonia detection and treatment、Bacterial Identification and Susceptibility Testing、Antibiotic Resistance in Bacteria

Background: Metagenomic next-generation sequencing (mNGS) was commonly applied given its ability to identify and type all infections without depending upon culture and to retrieve all DNA with unbiasedness. In this study, we strive to compare outcomes of mNGS with conventional culture methods in adults with sepsis, investigate the differences between the immunocompromised and control group, and assess the clinical effects of mNGS. Methods: In our study, 308 adult sepsis patients were included. We used both mNGS and conventional culture methods to analyze diagnostic results, pathogens, and sample types. The correlation between some laboratory tests and the frequency of pathogens by groups was also analyzed. Furthermore, the clinical impacts of mNGS were estimated. Results: 308 samples were assigned to an immunocompromised group (92/308,29.9%) and a control group (216/308,70.1%). There was the sensitivity of mNGS considered greater than that of the culture method in all samples (88.0% vs 26.3%; P < 0.001), in the immunocompromised group (91.3% vs 26.1%; P < 0.001), and the control group (86.6% vs 26.4%; P < 0.001), particularly in all sample types of blood (P < 0.001), BALF (P < 0.001), CSF (P < 0.001), sputum (P < 0.001) and ascitic fluid (P = 0.008). When examining the mNGS results between groups, Pneumocystis jirovecii (P < 0.001), Mucoraceae (P = 0.014), and Klebsiella (P = 0.045) all showed significant differences. On the whole, mNGS detected more pathogens than culture me...