Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections
Abstract Background Metagenomic next-generation sequencing (mNGS) could improve the diagnosed efficiency of pathogens in bloodstream infections or sepsis. Little is known about the clinical impact of mNGS test when used for the early diagnosis of suspected infections. Herein, our main objective was...
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| Format: | Article |
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BMC
2024-02-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-09043-3 |
| _version_ | 1797275676481421312 |
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| author | Hui Zhang Ruobing Liang Yunzhu Zhu Lifen Hu Han Xia Jiabin Li Ying Ye |
| author_facet | Hui Zhang Ruobing Liang Yunzhu Zhu Lifen Hu Han Xia Jiabin Li Ying Ye |
| author_sort | Hui Zhang |
| collection | DOAJ |
| description | Abstract Background Metagenomic next-generation sequencing (mNGS) could improve the diagnosed efficiency of pathogens in bloodstream infections or sepsis. Little is known about the clinical impact of mNGS test when used for the early diagnosis of suspected infections. Herein, our main objective was to assess the clinical efficacy of utilizing blood samples to perform mNGS for early diagnosis of suspected infections, as well as to evaluate its potential in guiding antimicrobial therapy decisions. Methods In this study, 212 adult hospitalized patients who underwent blood mNGS test in the early stage of suspected infections were enrolled. Diagnostic efficacy of mNGS test and blood culture was compared, and the clinical impact of mNGS on clinical care was analyzed. Results In our study, the total detection rate of blood mNGS was significantly higher than that of culture method (74.4% vs. 12.1%, P < 0.001) in the paired mNGS test and blood culture. Blood stream infection (107, 67.3%) comprised the largest component of all the diseases in our patients, and the detection rate of single blood sample subgroup was similar with that of multiple type of samples subgroup. Among the 187 patients complained with fever, there was no difference in the diagnostic efficacy of mNGS when blood specimens or additional other specimens were used in cases presenting only with fever. While, when patients had other symptoms except fever, the performance of mNGS was superior in cases with specimens of suspected infected sites and blood collected at the same time. Guided by mNGS results, therapeutic regimens for 70.3% cases (149/212) were changed, and the average hospitalized days were significantly shortened in cases with the earlier sampling time of admission. Conclusion In this study, we emphasized the importance of blood mNGS in early infectious patients with mild and non-specific symptoms. Blood mNGS can be used as a supplement to conventional laboratory examination, and should be performed as soon as possible to guide clinicians to perform appropriate anti-infection treatment timely and effectively. Additionally, combining the contemporaneous samples from suspected infection sites could improve disease diagnosis and prognoses. Further research needs to be better validated in large-scale clinical trials to optimize diagnostic protocol, and the cost-utility analysis should be performed. |
| first_indexed | 2024-03-07T15:17:55Z |
| format | Article |
| id | doaj.art-45496a3a1b504510b16c0ff4050a936e |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-07T15:17:55Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-45496a3a1b504510b16c0ff4050a936e2024-03-05T17:48:38ZengBMCBMC Infectious Diseases1471-23342024-02-0124111110.1186/s12879-024-09043-3Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infectionsHui Zhang0Ruobing Liang1Yunzhu Zhu2Lifen Hu3Han Xia4Jiabin Li5Ying Ye6Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Scientific Affaires, Hugobiotech Co., LtdDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Scientific Affaires, Hugobiotech Co., LtdDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityAbstract Background Metagenomic next-generation sequencing (mNGS) could improve the diagnosed efficiency of pathogens in bloodstream infections or sepsis. Little is known about the clinical impact of mNGS test when used for the early diagnosis of suspected infections. Herein, our main objective was to assess the clinical efficacy of utilizing blood samples to perform mNGS for early diagnosis of suspected infections, as well as to evaluate its potential in guiding antimicrobial therapy decisions. Methods In this study, 212 adult hospitalized patients who underwent blood mNGS test in the early stage of suspected infections were enrolled. Diagnostic efficacy of mNGS test and blood culture was compared, and the clinical impact of mNGS on clinical care was analyzed. Results In our study, the total detection rate of blood mNGS was significantly higher than that of culture method (74.4% vs. 12.1%, P < 0.001) in the paired mNGS test and blood culture. Blood stream infection (107, 67.3%) comprised the largest component of all the diseases in our patients, and the detection rate of single blood sample subgroup was similar with that of multiple type of samples subgroup. Among the 187 patients complained with fever, there was no difference in the diagnostic efficacy of mNGS when blood specimens or additional other specimens were used in cases presenting only with fever. While, when patients had other symptoms except fever, the performance of mNGS was superior in cases with specimens of suspected infected sites and blood collected at the same time. Guided by mNGS results, therapeutic regimens for 70.3% cases (149/212) were changed, and the average hospitalized days were significantly shortened in cases with the earlier sampling time of admission. Conclusion In this study, we emphasized the importance of blood mNGS in early infectious patients with mild and non-specific symptoms. Blood mNGS can be used as a supplement to conventional laboratory examination, and should be performed as soon as possible to guide clinicians to perform appropriate anti-infection treatment timely and effectively. Additionally, combining the contemporaneous samples from suspected infection sites could improve disease diagnosis and prognoses. Further research needs to be better validated in large-scale clinical trials to optimize diagnostic protocol, and the cost-utility analysis should be performed.https://doi.org/10.1186/s12879-024-09043-3Plasma cell-free DNAMetagenomic next-generation sequencingEarly diagnosisSuspected infectionsFebrile illness |
| spellingShingle | Hui Zhang Ruobing Liang Yunzhu Zhu Lifen Hu Han Xia Jiabin Li Ying Ye Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections BMC Infectious Diseases Plasma cell-free DNA Metagenomic next-generation sequencing Early diagnosis Suspected infections Febrile illness |
| title | Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections |
| title_full | Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections |
| title_fullStr | Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections |
| title_full_unstemmed | Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections |
| title_short | Metagenomic next-generation sequencing of plasma cell-free DNA improves the early diagnosis of suspected infections |
| title_sort | metagenomic next generation sequencing of plasma cell free dna improves the early diagnosis of suspected infections |
| topic | Plasma cell-free DNA Metagenomic next-generation sequencing Early diagnosis Suspected infections Febrile illness |
| url | https://doi.org/10.1186/s12879-024-09043-3 |
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