Clinical assessment of the utility of metagenomic next-generation sequencing in pediatric patients of hematology department.

Abstract

INTRODUCTION:

Metagenomic Next-Generation Sequencing (mNGS) is an emerging technique for microbial identification and diagnosis of infectious diseases. The clinical utility of mNGS, especially its real-world impact on antimicrobial treatment and patient outcome has not been systematically evaluated.

METHODS:

We prospectively assessed the effectiveness of mNGS in 70 febrile inpatients with suspected infections at Hematology department of the Children's Hospital, National Clinical Research Center for Child Health. 69/70 patients were given empirical antibiotics prior to mNGS. A total of 104 samples (62 plasma, 34 throat swabs, 4 bone marrow, 4 bronchoalveolar lavage) were collected on day 1-28 (mean 6.9) following symptom onset and underwent mNGS testing.

RESULTS:

Traditional microbiological tests discovered causal microorganisms in 5/70 (7.14%) patients, which were also detected by mNGS. In addition, mNGS reported possible pathogens when routine tests were negative. Antibiotics were adjusted accordingly in 55/70 (78.6%) patients that led to improvement/relief of symptoms within 3 days. In contrast, mNGS results were considered irrelevant in 15/70 (21.4%) patients by a board of clinicians, based on biochemical, serological, imaging evidence, and experiences.

CONCLUSION:

mNGS expanded the capacity of pathogen detection and made a positive impact on clinical management of suspected infections through (a) differential diagnosis which may rule out infectious diseases and (b) adjustment or de-escalation of empirical antibiotics.

• Authors: Heping Shen, Diying Shen, Hua Song, Xueqin Wu, Cong Xu, Guangyu Su, Chao Liu, Jingying Zhang
• Journal: International journal of laboratory hematology (Int J Lab Hematol) Vol. 43 Issue 2 Pg. 244-249 (Apr 2021) ISSN: 1751-553X [Electronic] England
• PMID: 33099872 (Publication Type: Journal Article)
• Copyright: © 2020 John Wiley & Sons Ltd.

Chemical References

• Biomarkers

Topics

• Adolescent
• Biomarkers
• Child
• Child, Preschool
• Communicable Diseases (diagnosis, etiology)
• Cross Infection (diagnosis, etiology)
• Diagnostic Tests, Routine
• Disease Management
• Disease Susceptibility
• Female
• Hematologic Diseases (complications)
• High-Throughput Nucleotide Sequencing (methods)
• Humans
• Male
• Metagenome
• Metagenomics (methods)