Wu Hao, Cao Hongliang, Gao Xin, Shi Chengdong, Wang Lei, Gao Baoshan
Department of Urology II, The First Hospital of Jilin University, Changchun, China.
Front Cell Infect Microbiol. 2025 Jan 7;14:1473068. doi: 10.3389/fcimb.2024.1473068. eCollection 2024.
Kidney transplantation (KT) is a life-saving treatment for patients with end-stage renal disease, but post-transplant infections remain one of the most significant challenges. These infections, caused by a variety of pathogens, can lead to prolonged hospitalization, graft dysfunction, and even mortality, particularly in immunocompromised patients. Traditional diagnostic methods often fail to identify the causative organisms in a timely manner, leading to delays in treatment and poorer patient outcomes. This review explores the application of metagenomic next-generation sequencing (mNGS) in the diagnosis of post-KT infections. mNGS allows for the rapid, comprehensive detection of a wide range of pathogens, including bacteria, viruses, fungi, and parasites, without the need for culture-based techniques. We discuss the advantages of mNGS in early and accurate pathogen identification, its role in improving patient management, and the potential challenges in its clinical implementation. Additionally, we consider the future prospects of mNGS in overcoming current diagnostic limitations and its potential for guiding targeted therapies, particularly in detecting antimicrobial resistance and emerging pathogens. This review emphasizes the promise of mNGS as an essential tool in improving the diagnosis and treatment of infections in KT recipients.
肾移植（KT）是终末期肾病患者的一种挽救生命的治疗方法，但移植后感染仍然是最重大的挑战之一。这些由多种病原体引起的感染可导致住院时间延长、移植物功能障碍，甚至死亡，尤其是在免疫功能低下的患者中。传统的诊断方法往往无法及时识别病原体，导致治疗延误和患者预后较差。本综述探讨了宏基因组下一代测序（mNGS）在肾移植后感染诊断中的应用。mNGS能够快速、全面地检测包括细菌、病毒、真菌和寄生虫在内的多种病原体，而无需基于培养的技术。我们讨论了mNGS在早期准确识别病原体方面的优势、其在改善患者管理中的作用以及临床应用中潜在的挑战。此外，我们还考虑了mNGS在克服当前诊断局限性方面的未来前景及其指导靶向治疗的潜力，特别是在检测抗菌药物耐药性和新出现的病原体方面。本综述强调了mNGS作为改善肾移植受者感染诊断和治疗的重要工具的前景。
