Liu Huiting, Xu Tianzhen, Fu Hongxin, Dai Bohao, Xie Yirui
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The Department of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China.
Infect Drug Resist. 2025 May 8;18:2389-2399. doi: 10.2147/IDR.S509665. eCollection 2025.
Bloodstream infections (BSI) are common complications in HIV-infected patients and are prone to septic shock and death. This study aimed to analyze the application of blood metagenomic next-generation sequencing (mNGS) in HIV-infected patients with BSI.
Fifty-four HIV-infected patients with suspected BSI were hospitalized at the First Affiliated Hospital of the Zhejiang University School of Medicine between August 2020 and June 2023. Blood mNGS and blood culture (BC) results were retrospectively reviewed and compared to the application value of BSI.
The mNGS was more sensitive for detecting pathogens (82.4% versus 35.3%; P < 0.05), and when combining blood mNGS with culture results, the sensitivity increased to 88.2%. The detection rate of mNGS for blood-mixed infection was significantly higher than that of BC (P < 0.05). Among the positive results for fungi and bacteria detected by mNGS, 13.5% of the pathogenic microorganisms were consistent with the results of BC.
The mNGS combined with BC can improve pathogen detection sensitivity and the comprehensive identification of pathogenic microorganisms in HIV-infected patients with BSI.
血流感染（BSI）是HIV感染患者常见的并发症，易发生感染性休克和死亡。本研究旨在分析血液宏基因组下一代测序（mNGS）在HIV感染合并BSI患者中的应用。
回顾性分析2020年8月至2023年6月在浙江大学医学院附属第一医院住院的54例疑似BSI的HIV感染患者。回顾性分析血液mNGS和血培养（BC）结果，并比较其对BSI的应用价值。
mNGS检测病原体的敏感性更高（82.4%对35.3%；P<0.05），将血液mNGS与培养结果相结合时，敏感性提高到88.2%。mNGS对血液混合感染的检出率显著高于BC（P<0.05）。在mNGS检测出的真菌和细菌阳性结果中，13.5%的致病微生物与BC结果一致。
mNGS联合BC可提高HIV感染合并BSI患者病原体检测的敏感性和致病微生物的综合鉴定能力。
