The Clinical Impact of Metagenomic Next-Generation Sequencing (mNGS) Test in Hospitalized Patients with Suspected Sepsis: A Multicenter Prospective Study

Autor: Yi-Hui Zuo, Yi-Xing Wu, Wei-Ping Hu, Yan Chen, Yu-Ping Li, Zhen-Ju Song, Zhe Luo, Min-Jie Ju, Min-Hua Shi, Shu-Yun Xu, Hua Zhou, Xiang Li, Zhi-Jun Jie, Xue-Dong Liu, Jing Zhang
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Diagnostics, Vol 13, Iss 2, p 323 (2023)
Druh dokumentu: article
ISSN: 13020323
2075-4418
DOI: 10.3390/diagnostics13020323
Popis: Background: Metagenomic Next Generation Sequencing (mNGS) has the potential to detect pathogens rapidly. We aimed to assess the diagnostic performance of mNGS in hospitalized patients with suspected sepsis and evaluate its role in guiding antimicrobial therapy. Methods: A multicenter, prospective cohort study was performed. We enrolled patients with suspected sepsis, collected clinical characteristics and blood samples, and recorded the 30-day survival. Diagnostic efficacy of mNGS test and blood culture was compared, and the clinical impact of mNGS on antibiotic regimen modification was analyzed. Results: A total of 277 patients were enrolled, and 162 were diagnosed with sepsis. The mortality was 44.8% (121/270). The mNGS test exhibited shorter turn-out time (27.0 (26.0, 29.0) vs. 96.0 (72.0, 140.3) hours, p < 0.001) and higher sensitivity (90.5% vs. 36.0%, p < 0.001) compared with blood culture, especially for fungal infections. The mNGS test showed better performance for patients with mild symptoms, prior antibiotic use, and early stage of infection than blood culture, and was capable of guiding antibiotic regimen modification and improving prognosis. Higher reads of pathogens detected by mNGS were related to 30-day mortality (p = 0.002). Conclusions: Blood mNGS testing might be helpful for early etiological diagnosis of patients with suspected sepsis, guiding the antibiotic regimen modification and improving prognosis.
Databáze: Directory of Open Access Journals
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