Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe Pneumonia
Shixiao Li,1 Peng Zhou,2 Lihong Yang,1 Tianbin Tang,1 Jiajia Qin,1 Jiao Qian,1 Shen Bo,1 Sufei Yu1 1Department of Clinical Microbiology Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, People’s Republic of China; 2Department of Pharmacy,...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-08-01
|
| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/clinical-value-of-sampling-time-of-metagenomic-next-generation-sequenc-peer-reviewed-fulltext-article-IDR |
| _version_ | 1797742667361157120 |
|---|---|
| author | Li S Zhou P Yang L Tang T Qin J Qian J Bo S Yu S |
| author_facet | Li S Zhou P Yang L Tang T Qin J Qian J Bo S Yu S |
| author_sort | Li S |
| collection | DOAJ |
| description | Shixiao Li,1 Peng Zhou,2 Lihong Yang,1 Tianbin Tang,1 Jiajia Qin,1 Jiao Qian,1 Shen Bo,1 Sufei Yu1 1Department of Clinical Microbiology Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, People’s Republic of China; 2Department of Pharmacy, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Sufei Yu, Email ysf5236791@163.comObjective: Severe pneumonia is a common infectious disease with high morbidity and mortality. Early etiological diagnosis is crucial for improving the prognosis. The aim of this study is to evaluate the clinical value of sampling time of mNGS in patients with severe pneumonia.Methods: This retrospective study enrolled 105 patients with severe pneumonia. mNGS was performed on bronchoalveolar lavage fluid (BALF). Patients were divided into the sampling time ≤ 72h vs sampling time > 72h groups and survivors vs non-survivors groups according to their sampling time and prognosis. Clinical characteristics, the adjustment of antibiotics and clinical prognostic value were evaluated.Results: Our study showed that, early sampling of mNGS can significantly shorten the mechanical ventilation time (p = 0.007) and hospitalization time (p = 0.004). In the non-survivors group, CURB-65, SOFA, and APACHE II scores were higher. Age (OR: 1.051, 95% CI: 1.004– 1.100, p = 0.034), chronic respiratory diseases (OR: 4.639, 95% CI: 1.260– 17.082, p = 0.021), immunosuppression (OR: 5.008, 95% CI: 1.617– 15.510, p = 0.005) and SOFA score on the day of mNGS sampling (OR: 1.492, 95% CI: 1.212– 1.837, p < 0.001) were independent risk factors of in-hospital mortality. The most common pathogens were Klebsiella pneumoniae and Human gammaherpesvirus 4. The proportion of appropriate and targeted antibiotics adjusted was significantly higher than that in the sampling time > 72h group, and the proportion of antifungal and antiviral agents adjusted was lower. In the early sampling group, it was significantly decreased in the CRP, PCT level and NEU% at discharge.Conclusion: This study demonstrated that early sampling of mNGS could shorten the time of mechanical ventilation and hospitalization of patients with severe pneumonia. Patients with higher SOFA score on the day of sampling had a poorer prognosis. It emphasizes that early sampling of mNGS has a positive value.Keywords: metagenomic next generation sequencing, severe pneumonia, sampling time, mortality |
| first_indexed | 2024-03-12T14:43:50Z |
| format | Article |
| id | doaj.art-4c5b6a2a1302498ba8c72bfde1a6649a |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-03-12T14:43:50Z |
| publishDate | 2023-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-4c5b6a2a1302498ba8c72bfde1a6649a2023-08-16T02:32:30ZengDove Medical PressInfection and Drug Resistance1178-69732023-08-01Volume 165263527485883Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe PneumoniaLi SZhou PYang LTang TQin JQian JBo SYu SShixiao Li,1 Peng Zhou,2 Lihong Yang,1 Tianbin Tang,1 Jiajia Qin,1 Jiao Qian,1 Shen Bo,1 Sufei Yu1 1Department of Clinical Microbiology Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, People’s Republic of China; 2Department of Pharmacy, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Sufei Yu, Email ysf5236791@163.comObjective: Severe pneumonia is a common infectious disease with high morbidity and mortality. Early etiological diagnosis is crucial for improving the prognosis. The aim of this study is to evaluate the clinical value of sampling time of mNGS in patients with severe pneumonia.Methods: This retrospective study enrolled 105 patients with severe pneumonia. mNGS was performed on bronchoalveolar lavage fluid (BALF). Patients were divided into the sampling time ≤ 72h vs sampling time > 72h groups and survivors vs non-survivors groups according to their sampling time and prognosis. Clinical characteristics, the adjustment of antibiotics and clinical prognostic value were evaluated.Results: Our study showed that, early sampling of mNGS can significantly shorten the mechanical ventilation time (p = 0.007) and hospitalization time (p = 0.004). In the non-survivors group, CURB-65, SOFA, and APACHE II scores were higher. Age (OR: 1.051, 95% CI: 1.004– 1.100, p = 0.034), chronic respiratory diseases (OR: 4.639, 95% CI: 1.260– 17.082, p = 0.021), immunosuppression (OR: 5.008, 95% CI: 1.617– 15.510, p = 0.005) and SOFA score on the day of mNGS sampling (OR: 1.492, 95% CI: 1.212– 1.837, p < 0.001) were independent risk factors of in-hospital mortality. The most common pathogens were Klebsiella pneumoniae and Human gammaherpesvirus 4. The proportion of appropriate and targeted antibiotics adjusted was significantly higher than that in the sampling time > 72h group, and the proportion of antifungal and antiviral agents adjusted was lower. In the early sampling group, it was significantly decreased in the CRP, PCT level and NEU% at discharge.Conclusion: This study demonstrated that early sampling of mNGS could shorten the time of mechanical ventilation and hospitalization of patients with severe pneumonia. Patients with higher SOFA score on the day of sampling had a poorer prognosis. It emphasizes that early sampling of mNGS has a positive value.Keywords: metagenomic next generation sequencing, severe pneumonia, sampling time, mortalityhttps://www.dovepress.com/clinical-value-of-sampling-time-of-metagenomic-next-generation-sequenc-peer-reviewed-fulltext-article-IDRmetagenomic next generation sequencingsevere pneumoniasampling timemortality |
| spellingShingle | Li S Zhou P Yang L Tang T Qin J Qian J Bo S Yu S Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe Pneumonia Infection and Drug Resistance metagenomic next generation sequencing severe pneumonia sampling time mortality |
| title | Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe Pneumonia |
| title_full | Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe Pneumonia |
| title_fullStr | Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe Pneumonia |
| title_full_unstemmed | Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe Pneumonia |
| title_short | Clinical Value of Sampling Time of Metagenomic Next-Generation Sequencing in Patients with Severe Pneumonia |
| title_sort | clinical value of sampling time of metagenomic next generation sequencing in patients with severe pneumonia |
| topic | metagenomic next generation sequencing severe pneumonia sampling time mortality |
| url | https://www.dovepress.com/clinical-value-of-sampling-time-of-metagenomic-next-generation-sequenc-peer-reviewed-fulltext-article-IDR |
| work_keys_str_mv | AT lis clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia AT zhoup clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia AT yangl clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia AT tangt clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia AT qinj clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia AT qianj clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia AT bos clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia AT yus clinicalvalueofsamplingtimeofmetagenomicnextgenerationsequencinginpatientswithseverepneumonia |