Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya

Abstract Pneumonia remains a major cause of mortality and morbidity. Most molecular diagnoses of viruses rely on polymerase chain reaction (PCR) assays that however can fail due to primer mismatch. We investigated the performance of routine virus diagnostics in Kilifi, Kenya, using random-primed vir...

Full description

Bibliographic Details
Main Authors: My V. T. Phan, Charles N. Agoti, Patrick K. Munywoki, Grieven P. Otieno, Mwanajuma Ngama, Paul Kellam, Matthew Cotten, D. James Nokes
Format: Article
Language:English
Published: Nature Portfolio 2022-01-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-03987-1
_version_ 1798033452984958976
author My V. T. Phan
Charles N. Agoti
Patrick K. Munywoki
Grieven P. Otieno
Mwanajuma Ngama
Paul Kellam
Matthew Cotten
D. James Nokes
author_facet My V. T. Phan
Charles N. Agoti
Patrick K. Munywoki
Grieven P. Otieno
Mwanajuma Ngama
Paul Kellam
Matthew Cotten
D. James Nokes
author_sort My V. T. Phan
collection DOAJ
description Abstract Pneumonia remains a major cause of mortality and morbidity. Most molecular diagnoses of viruses rely on polymerase chain reaction (PCR) assays that however can fail due to primer mismatch. We investigated the performance of routine virus diagnostics in Kilifi, Kenya, using random-primed viral next generation sequencing (viral NGS) on respiratory samples which tested negative for the common viral respiratory pathogens by a local standard diagnostic panel. Among 95 hospitalised pneumonia patients and 95 household-cohort individuals, analysis of viral NGS identified at least one respiratory-associated virus in 35 (37%) and 23 (24%) samples, respectively. The majority (66%; 42/64) belonged to the Picornaviridae family. The NGS data analysis identified a number of viruses that were missed by the diagnostic panel (rhinovirus, human metapneumovirus, respiratory syncytial virus and parainfluenza virus), and these failures could be attributed to PCR primer/probe binding site mismatches. Unexpected viruses identified included parvovirus B19, enterovirus D68, coxsackievirus A16 and A24 and rubella virus. The regular application of such viral NGS could help evaluate assay performance, identify molecular causes of missed diagnoses and reveal gaps in the respiratory virus set used for local screening assays. The results can provide actionable information to improve the local pneumonia diagnostics and reveal locally important viral pathogens.
first_indexed 2024-04-11T20:30:36Z
format Article
id doaj.art-b8674ec557a840ed853590141e4613ce
institution Directory Open Access Journal
issn 2045-2322
language English
last_indexed 2024-04-11T20:30:36Z
publishDate 2022-01-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj.art-b8674ec557a840ed853590141e4613ce2022-12-22T04:04:31ZengNature PortfolioScientific Reports2045-23222022-01-0112111110.1038/s41598-021-03987-1Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from KenyaMy V. T. Phan0Charles N. Agoti1Patrick K. Munywoki2Grieven P. Otieno3Mwanajuma Ngama4Paul Kellam5Matthew Cotten6D. James Nokes7Virus Genomics, Wellcome Trust Sanger InstituteEpidemiology and Demography Department, KEMRI –Wellcome Trust Research ProgrammeEpidemiology and Demography Department, KEMRI –Wellcome Trust Research ProgrammeEpidemiology and Demography Department, KEMRI –Wellcome Trust Research ProgrammeEpidemiology and Demography Department, KEMRI –Wellcome Trust Research ProgrammeVirus Genomics, Wellcome Trust Sanger InstituteVirus Genomics, Wellcome Trust Sanger InstituteEpidemiology and Demography Department, KEMRI –Wellcome Trust Research ProgrammeAbstract Pneumonia remains a major cause of mortality and morbidity. Most molecular diagnoses of viruses rely on polymerase chain reaction (PCR) assays that however can fail due to primer mismatch. We investigated the performance of routine virus diagnostics in Kilifi, Kenya, using random-primed viral next generation sequencing (viral NGS) on respiratory samples which tested negative for the common viral respiratory pathogens by a local standard diagnostic panel. Among 95 hospitalised pneumonia patients and 95 household-cohort individuals, analysis of viral NGS identified at least one respiratory-associated virus in 35 (37%) and 23 (24%) samples, respectively. The majority (66%; 42/64) belonged to the Picornaviridae family. The NGS data analysis identified a number of viruses that were missed by the diagnostic panel (rhinovirus, human metapneumovirus, respiratory syncytial virus and parainfluenza virus), and these failures could be attributed to PCR primer/probe binding site mismatches. Unexpected viruses identified included parvovirus B19, enterovirus D68, coxsackievirus A16 and A24 and rubella virus. The regular application of such viral NGS could help evaluate assay performance, identify molecular causes of missed diagnoses and reveal gaps in the respiratory virus set used for local screening assays. The results can provide actionable information to improve the local pneumonia diagnostics and reveal locally important viral pathogens.https://doi.org/10.1038/s41598-021-03987-1
spellingShingle My V. T. Phan
Charles N. Agoti
Patrick K. Munywoki
Grieven P. Otieno
Mwanajuma Ngama
Paul Kellam
Matthew Cotten
D. James Nokes
Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya
Scientific Reports
title Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya
title_full Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya
title_fullStr Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya
title_full_unstemmed Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya
title_short Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya
title_sort identification of missed viruses by metagenomic sequencing of clinical respiratory samples from kenya
url https://doi.org/10.1038/s41598-021-03987-1
work_keys_str_mv AT myvtphan identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya
AT charlesnagoti identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya
AT patrickkmunywoki identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya
AT grievenpotieno identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya
AT mwanajumangama identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya
AT paulkellam identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya
AT matthewcotten identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya
AT djamesnokes identificationofmissedvirusesbymetagenomicsequencingofclinicalrespiratorysamplesfromkenya