Metagenomic next-generation sequencing for accurate diagnosis and management of lower respiratory tract infections.
Int J Infect Dis
; 122: 921-929, 2022 Sep.
Article
en En
| MEDLINE
| ID: mdl-35908723
ABSTRACT
OBJECTIVES:
This study aimed to evaluate the clinical value of metagenomic next-generation sequencing (mNGS) in patients with suspected lower respiratory tract infections.METHODS:
This retrospective study reviewed patients with suspected lower respiratory tract infections at the Wuhan Union Hospital. Data including demographic, laboratory, and radiological profiles; treatment; and outcomes were recorded and analyzed.RESULTS:
mNGS identified pathogenic microbes in 100/140 (71.4%) patients, although 135 (96.4%) had received empiric antibiotic treatment before the mNGS tests. Single bacterial infection (35/100, 35%) was the most common type of infection in patients with positive mNGS results, followed by single fungal infection (14/100, 14%), bacterial-viral coinfection (14/100, 14%), single viral infection (12/100, 12%), bacterial-fungal coinfection (9/100, 9%), fungal-viral coinfection (9/100, 9%), and bacterial-fungal-viral coinfection (7/100, 7%). Moreover, compared with culture test, mNGS showed higher sensitivity (63/85, 74.1% vs 22/85, 25.9% P = 0.001) and lower processing time (24 hours vs 48 hours). Antibiotic treatment was adjusted or confirmed based on the mNGS results in 123 (87.9%) patients, including five (3.6%), 33 (23.6%), and 85 (60.7%) patients, in whom treatment was downgraded, upgraded, and unchanged, respectively. Almost all patients, regardless of escalation, de-escalation, or no change in treatment, showed significant improvement in clinical symptoms and inflammatory indicators. In addition, 17 (12.1%) patients were referred to Wuhan Pulmonary Hospital for further treatment because of confirmed or suspected tuberculosis.CONCLUSION:
mNGS could be a promising technique for microbiological diagnosis and antibiotic management, potentially improving outcomes for patients.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Infecciones del Sistema Respiratorio
/
Coinfección
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Idioma:
En
Revista:
Int J Infect Dis
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
Año:
2022
Tipo del documento:
Article