Wei Lingyu, Luo Jieyu, Wu Weiwei, Yin Jia, Sun Zaiyuan, Xu Xue, Gong Wenqian, Xu Jia
Department of Emergency, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
Dinfectome Inc., Nanjing, Jiangsu, 210044, China.
Heliyon. 2024 Aug 8;10(16):e35802. doi: 10.1016/j.heliyon.2024.e35802. eCollection 2024 Aug 30.
To explore the value of metagenomic next-generation sequencing (mNGS) and culture in microbial diagnosis of patients with acute infection.
We retrospectively analyzed 206 specimens from 163 patients who were admitted to the emergency department of The First Affiliated Hospital of Sun Yat-sen University between July 2020, and July 2021. We evaluated the diagnostic efficacy of mNGS and in-hospital traditional culture.
The total positive rate of mNGS was significantly higher than that culture methods (71.4 % vs 40.8 %, < 0.001), while the sensitivity and accuracy of mNGS were found to be 92.9 % and 88.2 % respectively. However, culture exhibited superior specificity with a value of 92.6 % compared to 75.9 % for mNGS. The detection efficiency of mNGS and culture for fungi was comparable, but mNGS showed superior performance for bacterial detection. In the analysis of sepsis samples, mNGS outperformed traditional culture methods in diagnosing various types of samples, especially for sputum and bronchoalveolar lavage fluid. Among the identified infections, bacterial infections were the most common single infection (37.5 %). Additionally, bacterial-fungal infections represented the most prevalent form of mixed infection (77.3 %). and were identified as the predominant pathogens in the survival and death groups, respectively. No significant differences in microbial diversity were observed.
Compared to culture methods, mNGS demonstrates superior positive rates, sensitivity, and accuracy in the rapid detection of acute infections, particularly in critically ill patients such as those with sepsis. This capability establishes a foundation for the swift and precise identification of pathogens, allowing for the analysis of clinical indicators and patient prognosis based on the extensive data generated from mNGS.
探讨宏基因组下一代测序（mNGS）和培养在急性感染患者微生物诊断中的价值。
回顾性分析2020年7月至2021年7月在中山大学附属第一医院急诊科住院的163例患者的206份标本。我们评估了mNGS和院内传统培养的诊断效能。
mNGS的总阳性率显著高于培养方法（71.4%对40.8%，<0.001），而mNGS的敏感性和准确性分别为92.9%和88.2%。然而，培养显示出更高的特异性，为92.6%，而mNGS为75.9%。mNGS和培养对真菌的检测效率相当，但mNGS在细菌检测方面表现更优。在脓毒症样本分析中，mNGS在诊断各类样本方面优于传统培养方法，尤其是痰液和支气管肺泡灌洗液。在已识别的感染中，细菌感染是最常见的单一感染（37.5%）。此外，细菌-真菌混合感染是最普遍的混合感染形式（77.3%）。 和 分别被确定为生存组和死亡组中的主要病原体。未观察到微生物多样性的显著差异。
与培养方法相比，mNGS在急性感染的快速检测中显示出更高的阳性率、敏感性和准确性，特别是在脓毒症等重症患者中。这一能力为快速准确地识别病原体奠定了基础，有助于根据mNGS产生的大量数据分析临床指标和患者预后。
