Please use this identifier to cite or link to this item: http://localhost:8080/xmlui/handle/123456789/8956
Title: Diagnostic performance and clinical impacts of metagenomic sequencing after allogeneic hematopoietic stem cell transplantation
Authors: Xu, Chun-Hui
Chen, Xin
Zhu, Guo-Qing
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Keywords: Infection
mNGS
Metagenomic sequencing
Diagnosis
Issue Date: Feb-2024
Publisher: Journal of Microbiology, Immunology and Infection
Series/Report no.: Original Article;11-19
Abstract: Background: Metagenomic Next-Generation Sequencing (mNGS) is a rapid, nonculture- based, high-throughput technique for pathogen diagnosis. Despite its numerous advantages, only a few studies have investigated its use in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: We conducted a retrospective analysis of 404 mNGS tests performed on 264 patients after allo-HSCT. The tests were divided into three groups (Phase A, B, C) based on the time spent hospitalized post-transplantation, and we evaluated the analytical performance of mNGS in comparison with conventional microbiological tests (CMT), while also analyzing its clinical utility for clinical impacts. Results: Metagenomic sequencing demonstrated a significantly higher rate of positive microbiological findings as compared to CMT (334/404 (82.7 %) vs. 159/404 (39.4 %), respectively, P < 0.001). The detection rates by both mNGS and CMT varied across the three-phase (mNGS: A-60/89 (67.4 %), B-147/158 (93.0 %), C-125/157 (79.6 %), respectively, P < 0.001; CMT: A-21/ 89 (23.6 %), B-79/158 (50.0 %), C-59/157 (37.6 %), respectively, P < 0.001). The infection sites and types of pathogens were also different across the three phases. Compared to non-GVHD cases, mNGS detected more Aspergillus spp. and Mucorales in GVHD patients (Aspergillus: 12/102 (11.8 %) vs. 8/158 (5.1 %), respectively, P Z 0.048; Mucorales: 6/102 (5.9 %) vs. 2/158 (1.3 %), respectively, PZ 0.035). Forty-five (181/404) percent of mNGS tests yielded a positive impact on the clinical diagnosis, while 24.3 % (98/404) of tests benefited the patients in antimicrobial treatment. Conclusion: mNGS is an indispensable diagnostic tool in identifying pathogens and optimizing antibiotic therapy for hematological patients receiving allo-HSCT.
URI: http://localhost:8080/xmlui/handle/123456789/8956
ISSN: 1684-1182
Appears in Collections:Vol. 57 No. 1 (2024)

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