Luo X Y, Yao Y C, Ma R, Wang H F, Bai L, Han W, Cheng Y F, Tang F F, Huang X J, Sun Y Q
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2025 Jul 14;46(7):636-641. doi: 10.3760/cma.j.cn121090-20241224-00586.
To evaluate the diagnostic value of targeted next-generation sequencing (tNGS) of throat swab samples for detecting community-acquired respiratory viruses (CARV) in patients with hematological diseases. Clinical and laboratory data from 64 episodes involving patients with hematological diseases and suspected infections-who underwent both pharyngeal swab tNGS and CARV polymerase chain reaction (PCR) testing concurrently-were retrospectively analyzed. The cases were drawn from the Department of Hematology, Peking University People's Hospital, between September 2023 and April 2024. Concordance between tNGS and CARV PCR results, as well as the diagnostic performance of tNGS in detecting CARV, were evaluated. Among the 64 episodes, 29 were clinically diagnosed with respiratory tract infections, including one case of cytomegalovirus pneumonia and 28 CARV-positive cases. The remaining 35 episodes involved patients with fever or respiratory symptoms attributed to other causes, including 14 with extrapulmonary infections and 21 with noninfectious etiologies. The median follow-up duration was 215.5 days (range: 7-271 days). PCR detected 24 strains of seven CARV types, whereas tNGS detected 25 strains of eight CARV types. Using PCR results as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of tNGS were 85.0%, 88.6%, 77.3%, 92.9%, and 87.5%, respectively. The two methods showed good concordance (Kappa=0.717, <0.001) . Pharyngeal swab tNGS may serve as a viable alternative to PCR for diagnosing CARV infections in patients with hematological diseases.
评估咽喉拭子样本的靶向二代测序（tNGS）对检测血液病患者社区获得性呼吸道病毒（CARV）的诊断价值。回顾性分析了64例血液病患者疑似感染病例的临床和实验室数据，这些患者同时接受了咽拭子tNGS检测和CARV聚合酶链反应（PCR）检测。病例来自北京大学人民医院血液科，时间跨度为2023年9月至2024年4月。评估了tNGS与CARV PCR结果之间的一致性，以及tNGS检测CARV的诊断性能。在这64例病例中，29例临床诊断为呼吸道感染，包括1例巨细胞病毒肺炎和28例CARV阳性病例。其余35例病例涉及因其他原因出现发热或呼吸道症状的患者，其中14例为肺外感染，21例为非感染性病因。中位随访时间为215.5天（范围：7 - 271天）。PCR检测到7种CARV类型的24株病毒，而tNGS检测到8种CARV类型的25株病毒。以PCR结果作为参考标准，tNGS的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为85.0%、88.6%、77.3%、92.9%和87.5%。两种方法显示出良好的一致性（Kappa = 0.717，<0.001）。咽拭子tNGS可作为诊断血液病患者CARV感染的一种可行替代方法，替代PCR检测。
