Metagenomic Next-Generation Sequencing (mNGS) for Detecting Pathogens and Antimicrobial Resistance Genes (ARGs), and Guiding Antimicrobial Therapy in Cancer Patients from Southwest China

作者：Zhao Qian, Wan Qian, Siwei Wang, Pei Zhao, Yi Li, S. Xu, Chen Chen · 发表于：Journal of Global Antimicrobial Resistance · 年份：2026 · DOI：10.1016/j.jgar.2026.07.026 · 研究领域：Antibiotic Resistance in Bacteria、Neutropenia and Cancer Infections、Pneumocystis jirovecii pneumonia detection and treatment

BACKGROUND: Cancer patients often face etiological diagnosis challenges due to repeated hospitalizations, antibiotic exposure, and conventional microbiology tests (CMTs) limitations (low positivity, long turnaround). Metagenomic next-generation sequencing (mNGS) enables rapid and accurate pathogen detection, however, its clinical utility in cancer patients requires further investigation. METHODS: Two years of mNGS results and clinical data of cancer patients in Sichuan Cancer Hospital were collected. The pathogens and antimicrobial resistance genes (ARGs) were analyzed. The diagnostic performance was evaluated via sensitivity, specificity, accuracy, positive and negative predictive value. The clinical significance in guiding antimicrobial therapy was assessed by comparing outcomes between mNGS-guided and empirical therapy groups. Multivariable logistic regression analysis was performed to explore risk factors for multidrug-resistant organisms (MDROs) and opportunistic pathogens infections in cancer population. RESULTS: The study included 340 mNGS results from 267 cancer patients. Streptococcus pneumoniae, Pseudomonas aeruginosa, Candida albicans and Epstein-Barr virus were the most common Gram-positive and Gram-negative bacteria, fungus and virus, respectively. The main ARGs were ESBLs and aminoglycoside resistance genes. mNGS showed high pathogen diagnostic sensitivity (97.50%) and moderate ARGs diagnostic sensitivity (64.29%). The mNGS-guided group had lower mortality (29.5...