The clinical application of metagenomic next-generation sequencing in infectious diseases at a tertiary hospital in China

Autor: Chuwen Wang, Danying Yan, Jiajia Huang, Naibin Yang, Jiejun Shi, Shou Pan, Gaoqiang Lin, Ying Liu, Yingying Zhang, Xueyan Bian, Qifa Song, Guoqing Qian
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Frontiers in Cellular and Infection Microbiology, Vol 12 (2022)
Druh dokumentu: article
ISSN: 2235-2988
DOI: 10.3389/fcimb.2022.957073
Popis: BackgroundCompared with traditional diagnostic methods (TDMs), rapid diagnostic methods for infectious diseases (IDs) are urgently needed. Metagenomic next-generation sequencing (mNGS) has emerged as a promising diagnostic technology for clinical infections.MethodsThis retrospective observational study was performed at a tertiary hospital in China between May 2019 and August 2022. The chi-square test was used to compare the sensitivity and specificity of mNGS and TDMs. We also performed a subgroup analysis of the different pathogens and samples.ResultsA total of 435 patients with clinical suspicion of infection were enrolled and 372 (85.5%) patients were finally categorized as the ID group. The overall sensitivity of mNGS was significantly higher than that of the TDMs (59.7% vs. 30.1%, P < 0.05). However, there was no significant difference in the overall specificity between the two methods (83.3% vs. 89.6%, P = 0.37). In patients with identified pathogens, the positive rates of mNGS for detecting bacteria (88.7%), fungi (87.9%), viruses (96.9%), and Nontuberculous mycobacteria (NTM; 100%) were significantly higher than those of TDMs (P < 0.05). The positive rate of mNGS for detecting Mycobacterium tuberculosis was not superior to that of TDMs (77.3% vs. 54.5%, P = 0.11). The sensitivity rates of mNGS for pathogen identification in bronchoalveolar lavage fluid, blood, cerebrospinal fluid, pleural fluid, and tissue were 72.6%, 39.3%, 37.5%, 35.0% and 80.0%, respectively.ConclusionWith the potential for screening multiple clinical samples, mNGS has an overall advantage over TDMs. It can effectively identify pathogens, especially those that are difficult to identify using TDMs, such as NTM, chlamydia, and parasites.
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