MRC-University of Glasgow Centre for Virus Research, Sir Michael Stoker Building, 464 Bearsden Road, Glasgow G61 1QH, UK.
Department of Infectious Diseases, Queen Elizabeth University Hospital, 1345 Govan Rd, Govan, Glasgow G51 4TF, UK.
J Infect. 2019 Oct;79(4):383-388. doi: 10.1016/j.jinf.2019.08.003. Epub 2019 Aug 6.
Travel-associated infections are challenging to diagnose because of the broad spectrum of potential aetiologies. As a proof-of-principle study, we used MNGS to identify viral pathogens in clinical samples from returning travellers in a single center to explore its suitability as a diagnostic tool.
Plasma samples from 40 returning travellers presenting with a fever of ≥38°C were sequenced using MNGS on the Illumina MiSeq platform and compared with standard-of-care diagnostic assays.
In total, 11/40 patients were diagnosed with a viral infection. Standard of care diagnostics revealed 5 viral infections using plasma samples; dengue virus 1 (n = 2), hepatitis E (n = 1), Ebola virus (n = 1) and hepatitis A (n = 1), all of which were detected by MNGS. Three additional patients with Chikungunya virus (n = 2) and mumps virus were diagnosed by MNGS only. Respiratory infections detected by nasal/throat swabs only were not detected by MNGS of plasma. One patient had infection with malaria and mumps virus during the same admission.
MNGS analysis of plasma samples improves the sensitivity of diagnosis of viral infections and has potential as an all-in-one diagnostic test. It can be used to identify infections that have not been considered by the treating physician, co-infections and new or emerging pathogens.
Next generation sequencing (NGS) has potential as an all-in-one diagnostic test. In this study we used NGS to diagnose returning travellers with acute febrile illness in the UK, highlighting cases where the diagnosis was missed using standard methods.
由于潜在病因的广泛范围，旅行相关感染难以诊断。作为一项原理验证研究，我们使用 MNGS 在单个中心从返回旅行者的临床样本中鉴定病毒病原体，以探索其作为诊断工具的适用性。
使用 Illumina MiSeq 平台对 40 名出现≥38°C 发热的返回旅行者的血浆样本进行 MNGS 测序，并与标准护理诊断检测进行比较。
总共 11/40 名患者被诊断为病毒感染。使用血浆样本进行标准护理诊断检测发现 5 种病毒感染；登革热病毒 1 型（n=2）、戊型肝炎（n=1）、埃博拉病毒（n=1）和甲型肝炎（n=1），所有这些都通过 MNGS 检测到。通过 MNGS 仅发现了另外 3 例感染基孔肯雅病毒（n=2）和腮腺炎病毒的患者。仅通过鼻/咽拭子检测到的呼吸道感染未通过 MNGS 检测到血浆。一名患者在同一住院期间感染疟疾和腮腺炎病毒。
MNGS 分析血浆样本可提高病毒感染诊断的灵敏度，并具有作为一种全能诊断测试的潜力。它可用于识别治疗医生未考虑的感染、合并感染以及新出现或新兴的病原体。
下一代测序（NGS）具有作为一种全能诊断测试的潜力。在这项研究中，我们使用 NGS 诊断英国患有急性发热疾病的返回旅行者，突出显示了使用标准方法漏诊的病例。
