Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, United States of America.
Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi, United States of America.
PLoS One. 2022 Jun 16;17(6):e0269405. doi: 10.1371/journal.pone.0269405. eCollection 2022.
Despite diagnostic advances in microbiology, the etiology of neutropenic fever remains elusive in most cases. In this study, we evaluated the utility of a metagenomic shotgun sequencing based assay for detection of bacteria and viruses in blood samples of patients with febrile neutropenia. We prospectively enrolled 20 acute leukemia patients and obtained blood from these patients at three time points: 1) anytime from onset of neutropenia until before development of neutropenic fever, 2) within 24 hours of onset of neutropenic fever, 3) 5-7 days after onset of neutropenic fever. Blood samples underwent sample preparation, sequencing and analysis using the iDTECT® Dx Blood v1® platform (PathoQuest, Paris, France). Clinically relevant viruses or bacteria were detected in three cases each by metagenomic shotgun sequencing and blood cultures, albeit with no concordance between the two. Further optimization of sample preparation methods and sequencing platforms is needed before widespread adoption of this technology into clinical practice.
尽管在微生物学方面取得了诊断上的进展，但大多数情况下，中性粒细胞减少性发热的病因仍难以确定。在这项研究中，我们评估了宏基因组鸟枪法测序检测血液样本中细菌和病毒的方法在发热性中性粒细胞减少症患者中的应用。我们前瞻性地招募了 20 例急性白血病患者，并在三个时间点采集了这些患者的血液：1）从中性粒细胞减少开始到中性粒细胞减少性发热发生前的任何时间，2）中性粒细胞减少性发热发生后 24 小时内，3）中性粒细胞减少性发热发生后 5-7 天。使用 iDTECT®Dx Blood v1®平台（PathoQuest，法国巴黎）对血液样本进行样品制备、测序和分析。通过宏基因组鸟枪法测序和血液培养，各检测到 3 例有临床意义的病毒或细菌，尽管两种方法之间没有一致性。在将这项技术广泛应用于临床实践之前，需要进一步优化样品制备方法和测序平台。
