Metagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation
Abstract Introduction Unbiased metagenomic next-generation sequencing (mNGS) has been used for infection diagnosis. In this study, we explored the clinical diagnosis value of mNGS for pulmonary complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods From August 20...
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| Language: | English |
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Adis, Springer Healthcare
2023-08-01
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| Series: | Infectious Diseases and Therapy |
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| Online Access: | https://doi.org/10.1007/s40121-023-00850-w |
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| author | Zaihong Shen Ying Wang Aihua Bao Jun Yang Xi Sun Yu Cai Liping Wan Chongmei Huang Xiaowei Xu Jiahua Niu Xinxin Xia Chang Shen Yu Wei Huiying Qiu Kun Zhou Min Zhang Yin Tong Xianmin Song |
| author_facet | Zaihong Shen Ying Wang Aihua Bao Jun Yang Xi Sun Yu Cai Liping Wan Chongmei Huang Xiaowei Xu Jiahua Niu Xinxin Xia Chang Shen Yu Wei Huiying Qiu Kun Zhou Min Zhang Yin Tong Xianmin Song |
| author_sort | Zaihong Shen |
| collection | DOAJ |
| description | Abstract Introduction Unbiased metagenomic next-generation sequencing (mNGS) has been used for infection diagnosis. In this study, we explored the clinical diagnosis value of mNGS for pulmonary complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods From August 2019 to June 2021, a prospective study was performed to comparatively analyze the pathogenic results of mNGS and conventional tests for bronchoalveolar lavage fluid (BALF) from 134 cases involving 101 patients with pulmonary complications after allo-HSCT. Results More pathogens were identified by mNGS than with conventional tests (226 vs 120). For bacteria, the diagnostic sensitivity (P = 0.144) and specificity (P = 0.687) were similar between the two methods. For fungus except Pneumocystis jirovecii (PJ), conventional tests had a significantly higher sensitivity (P = 0.013) with a similarly high specificity (P = 0.109). The sensitivities for bacteria and fungi could be increased with the combination of the two methods. As for PJ, both the sensitivity (100%) and specificity (99.12%) of mNGS were very high. For viruses, the sensitivity of mNGS was significantly higher (P = 0.021) and the negative predictive value (NPV) was 95.74% (84.27–99.26%). Pulmonary infection complications accounted for 90.30% and bacterium was the most common pathogen whether in single infection (63.43%) or mixed infection (81.08%). The 6-month overall survival (OS) of 88.89% in the early group (mNGS ≤ 7 days) was significantly higher than that of 65.52% (HR 0.287, 95% CI 0.101–0.819, P = 0.006) in the late group (mNGS > 7 days). Conclusions mNGS for BALF could facilitate accurate and fast diagnosis for pulmonary complications. Early mNGS could improve the prognosis of patients with pulmonary complications after allo-HSCT. Trial Registration ClinicalTrials.gov identifier, NCT 04051372. |
| first_indexed | 2024-03-12T00:02:26Z |
| format | Article |
| id | doaj.art-b2a853b350a3456698a438f2d7b39166 |
| institution | Directory Open Access Journal |
| issn | 2193-8229 2193-6382 |
| language | English |
| last_indexed | 2024-03-12T00:02:26Z |
| publishDate | 2023-08-01 |
| publisher | Adis, Springer Healthcare |
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| series | Infectious Diseases and Therapy |
| spelling | doaj.art-b2a853b350a3456698a438f2d7b391662023-09-17T11:22:22ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822023-08-011282103211510.1007/s40121-023-00850-wMetagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell TransplantationZaihong Shen0Ying Wang1Aihua Bao2Jun Yang3Xi Sun4Yu Cai5Liping Wan6Chongmei Huang7Xiaowei Xu8Jiahua Niu9Xinxin Xia10Chang Shen11Yu Wei12Huiying Qiu13Kun Zhou14Min Zhang15Yin Tong16Xianmin Song17Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineAbstract Introduction Unbiased metagenomic next-generation sequencing (mNGS) has been used for infection diagnosis. In this study, we explored the clinical diagnosis value of mNGS for pulmonary complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods From August 2019 to June 2021, a prospective study was performed to comparatively analyze the pathogenic results of mNGS and conventional tests for bronchoalveolar lavage fluid (BALF) from 134 cases involving 101 patients with pulmonary complications after allo-HSCT. Results More pathogens were identified by mNGS than with conventional tests (226 vs 120). For bacteria, the diagnostic sensitivity (P = 0.144) and specificity (P = 0.687) were similar between the two methods. For fungus except Pneumocystis jirovecii (PJ), conventional tests had a significantly higher sensitivity (P = 0.013) with a similarly high specificity (P = 0.109). The sensitivities for bacteria and fungi could be increased with the combination of the two methods. As for PJ, both the sensitivity (100%) and specificity (99.12%) of mNGS were very high. For viruses, the sensitivity of mNGS was significantly higher (P = 0.021) and the negative predictive value (NPV) was 95.74% (84.27–99.26%). Pulmonary infection complications accounted for 90.30% and bacterium was the most common pathogen whether in single infection (63.43%) or mixed infection (81.08%). The 6-month overall survival (OS) of 88.89% in the early group (mNGS ≤ 7 days) was significantly higher than that of 65.52% (HR 0.287, 95% CI 0.101–0.819, P = 0.006) in the late group (mNGS > 7 days). Conclusions mNGS for BALF could facilitate accurate and fast diagnosis for pulmonary complications. Early mNGS could improve the prognosis of patients with pulmonary complications after allo-HSCT. Trial Registration ClinicalTrials.gov identifier, NCT 04051372.https://doi.org/10.1007/s40121-023-00850-wMetagenomic next-generation sequencing (mNGS)Pulmonary complicationAllogeneic hematopoietic stem cell transplantationBronchoalveolar lavage fluid |
| spellingShingle | Zaihong Shen Ying Wang Aihua Bao Jun Yang Xi Sun Yu Cai Liping Wan Chongmei Huang Xiaowei Xu Jiahua Niu Xinxin Xia Chang Shen Yu Wei Huiying Qiu Kun Zhou Min Zhang Yin Tong Xianmin Song Metagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation Infectious Diseases and Therapy Metagenomic next-generation sequencing (mNGS) Pulmonary complication Allogeneic hematopoietic stem cell transplantation Bronchoalveolar lavage fluid |
| title | Metagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation |
| title_full | Metagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation |
| title_fullStr | Metagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation |
| title_full_unstemmed | Metagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation |
| title_short | Metagenomic Next-Generation Sequencing for Pathogens in Bronchoalveolar Lavage Fluid Improves the Survival of Patients with Pulmonary Complications After Allogeneic Hematopoietic Stem Cell Transplantation |
| title_sort | metagenomic next generation sequencing for pathogens in bronchoalveolar lavage fluid improves the survival of patients with pulmonary complications after allogeneic hematopoietic stem cell transplantation |
| topic | Metagenomic next-generation sequencing (mNGS) Pulmonary complication Allogeneic hematopoietic stem cell transplantation Bronchoalveolar lavage fluid |
| url | https://doi.org/10.1007/s40121-023-00850-w |
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