Pathogen detection by targeted next-generation sequencing test in adult hematological malignancies patients with suspected infections

作者：Jin-Hui Xu, Ya-Bin Cui, Lijie Wang, Huijie Nan, Pei-Yao Yang, Yanliang Bai, Ming-Yue Shi · 发表于：Frontiers in Medicine · 年份：2024 · DOI：10.3389/fmed.2024.1443596 · 被引用次数：9 · 研究领域：Neutropenia and Cancer Infections、Hematological disorders and diagnostics、Pneumocystis jirovecii pneumonia detection and treatment

Background Infections in patients with hematological malignancies (HM) are a significant cause of morbidity and mortality. Timely and effective empirical anti-infective treatment can reduce the infection-related mortality rate. Targeted next-generation sequencing (tNGS) offers a rapid diagnostic approach for identifying diverse pathogens in these patients. However, relevant research is still limited to adult patients with HM. Methods We conducted a retrospective analysis of adult HM patients admitted to our hospital from March 2023 to September 2023, focusing on their clinical characteristics and the results of both tNGS and conventional microbiological tests (CMTs). We evaluated the performance of tNGS and CMTs in pathogenic diagnosis and described the distribution characteristics of pathogens in adult HM patients with infections. Results The study included 209 samples collected from 137 patients. Results showed that the overall pathogen detection rate differed significantly between tNGS and CMTs (60.3% vs. 24.4%, p < 0.001). The sensitivity (69.7% vs. 35.9%), negative predictive value (NPV) (48.2% vs. 42.4%), and accuracy (66.5% vs. 56.5%) of pathogen detection were notably superior with tNGS compared to CMTs. Among the 142 samples with clinically diagnosed infections, tNGS combined with CMTs identified a definite or probable microbial etiology in 114 samples (80.3%). Of the 36 samples with concordant positive results from both tNGS and CMTs, 72.2% (26/36) exhibited ...