Comparative of clinical performance between next-generation sequencing and standard blood culture diagnostic method in patients suffering from sepsis

Lee, Ing-Kit; Chang, Jen‐Ping; Huang, Wen-Chi; Tai, Chien-Hsiang; Wu, Huang-Tu; Chi, Chih-Hung

doi:10.1016/j.jmii.2022.07.011

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…Among infected patients, the positive rate of mNGS was 58.4%, while conventional culture yielded a positive rate of 21.6%. The results were the similar as in previous research [ 12 , 15 , 21 ]. There are several reasons for the higher positive rate of mNGS.…”

Section: Discussionsupporting

confidence: 91%

“…Across all patients, the positive rate of mNGS was 36.41%, which was lower than previously reported [ 15 , 19 , 20 ]. This discrepancy can be attributed to the specific definition of mNGS positivity employed in our study, which required the identification of pathogens through mNGS and subsequent clinical confirmation.…”

Section: Discussioncontrasting

confidence: 73%

“…Secondly, most of our patients have previously been hospitalized and given antibiotics, which can reduce the positive rates of culture [ 7 , 22 ]. Lastly, infectious diseases do not always lend themselves to conventional culture methods, such as fastidious bacteria, anaerobic bacteria and pneumocystis [ 15 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of metagenomic next-generation sequencing and conventional culture for the diagnostic performance in febrile patients with suspected infections

Yang,

Xu,

Yan

et al. 2024

BMC Infect Dis

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Background Timely and accurate identification of pathogens is crucial for appropriate treatment and prognosis of infectious diseases. As an increasingly popular pathogen detection method, the performance of metagenomic next-generation sequencing (mNGS) in detecting pathogens in febrile patients with suspected infection requires further exploration. Methods This study included 368 febrile patients with suspected infections who were admitted to the Infectious Disease Department of Qilu Hospital, Shandong University between January 5, 2021 and April 14, 2023. Both mNGS testing and conventional culture were performed in all patients. Clinical data of enrolled patients were collected, and the diagnostic performances of mNGS and culture were compared. Results Of the 368 enrolled patients, 231 were finally diagnosed with infection and 137 were with diseases other than infection. The sensitivity (58.01% vs. 21.65%, p < 0.001) and negative predictive value (54.67% vs. 42.9%) of mNGS were superior to those of culture. In contrast, the culture exhibited higher specificity (99.27% vs. 85.40%, p < 0.001) and positive predictive value (98.84% vs. 87.01%) than mNGS. Among infected patients with positive mNGS results, 64 received adjusted antibiotic therapy including treatment transitions, antibiotic downgrading, and combination therapy. Among them, 9 had additional antifungal drugs and 21 patients had a treatment turning point based on the mNGS results and these patients recovered and discharged due to timely antibiotic adjustment. Both positive rates of puncture fluid mNGS and tissue mNGS were higher than those of culture in the patients who had prior antibiotic use, and this difference was statistically significant (p = 0.000). Conclusion mNGS is more sensitive and accurate than traditional culture, making it ideal for identifying pathogens and screening infectious diseases, especially for those with uncultivated or difficult-to-cultivate species. Early diagnosis allows for prompt treatment with targeted antibiotics, and mNGS is recommended when samples are limited.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 73%

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Comparison of metagenomic next-generation sequencing and conventional culture for the diagnostic performance in febrile patients with suspected infections

Yang,

Xu,

Yan

et al. 2024

BMC Infect Dis

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“…Blood culture is the "gold standard" for the clinical diagnosis of bloodstream infection, but the test is time-consuming and easily contaminated during the culture process, which affects the accuracy of the results and causes patients to miss the best treatment time, thus affecting the diagnosis and control of patients' conditions. 8,17,18 The results of this study showed that 141 strains of pathogenic bacteria were isolated from 63 samples of suspected infection sites of patients with sepsis combined with pneumonia, among which Klebsiella pneumoniae, Acinetobacter baumannii, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecium, Escherichia coli, Legionella pneumophila, Serratia marcescens, and Haemophilus influenzae were predominant, which may be related to personal hygiene problems, bacterial multidrug resistance, extensive use of antibiotics, low immune function and impaired defense of the body. [19][20][21] Moreover, our results showed that mNGS has good clinical performance than CMT.…”

Section: Discussionmentioning

confidence: 99%

Pathogenic Profile Characteristics and Clinical Risk Factor Analysis of Patients Who Died from Sepsis Combined with Pulmonary Infection by Metagenomic Next-Generation Sequencing

Chen,

Lin,

Shi

et al. 2023

IDR

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Sepsis is one of the major diseases that seriously threatens human health, and its incidence and in-hospital morbidity and mortality rates remain high. Applying metagenomic next-generation sequencing (mNGS) technology to analyze the differences in pathogenic profiles and clinical factors in patients surviving and dying from sepsis combined with pulmonary infections provides diagnostic value and application for clinical purposes. Methods: Sixty-three BALF samples from patients with sepsis combined with pulmonary infection from Fuqing Hospital Affiliated to Fujian Medical University were collected, and all of them were tested by simultaneous mNGS and conventional microbial combined test (CMT) to compare the pathogenic profiles and clinical indices of patients who survived and died of sepsis combined with pulmonary infection and to further compare the diagnostic differences between mNGS and CMT in patients who survived and died of sepsis combined with pulmonary infection. We analyzed the diagnostic value of mNGS for sepsis combined with pulmonary infection. Results: A total of 141 strains of pathogens were isolated from 63 samples of patients with sepsis combined with pneumonia at suspected infection sites, Klebsiella pneumoniae, Acinetobacter baumannii, and Stenotrophomonas maltophilia are predominant, and higher ApacheII, LAC, P and PT are all risk factors affecting the death of septic patients. Conclusion: Applying the mNGS method to patients with sepsis combined with pneumonia can improve the positive detection rate of pathogenic microorganisms and focus on death-related risk factors such as pathogenic bacteria species as well as clinical laboratory indices, which can guide clinicians to take appropriate measures to treat patients with sepsis and reduce the occurrence of death.

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“…Various testing assays are available to detect the presence of sepsis and monitor its progression [7]. To overcome the limitations of blood culture in detecting sepsis, especially in culture-negative sepsis, some newer molecular techniques such as polymerase chain reaction (PCR) and next-generation sequencing (NGS) have been shown to be most promising methods to improve sensitivity and reducing the time required for diagnosis [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Exploring Extended White Blood Cell Parameters for the Evaluation of Sepsis among Patients Admitted to Intensive Care Units

Tan²,

Mazlan

et al. 2023

Diagnostics

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Sepsis is a major cause of mortality and morbidity in intensive care units. This case–control study aimed to investigate the haematology cell population data and extended inflammatory parameters for sepsis management. The study included three groups of patients: sepsis, non-sepsis, and healthy controls. Patients suspected of having sepsis underwent a Sequential Organ Failure Assessment (SOFA) evaluation and had blood drawn for blood cultures, complete peripheral blood counts (CBC), and measurements of various markers such as C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). We observed significant changes in numerous CBC parameters and extended inflammation parameters (EIPs), in addition to significant biochemical analysis markers CRP and IL-6 in sepsis cohorts. Multiple logistic regression analyses showed that combining different CBC parameters and EIPs were effective to profile these patients. Two different models have been developed using white blood cell counts and their extended parameters. Our findings indicate that the absolute counts of white blood cells, and the EIPs which reflect their activation states, are important for the prediction and assessment of sepsis, as the body responds to an insult that triggers an immune response. In an emergency situation, having timely updates on patient conditions becomes crucial for guiding the management process. Identifying trends in these specific patient groups will aid early diagnosis, complementing clinical signs and symptoms, especially as CBC is the most commonly ordered test in a diagnostic workup.

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Comparative of clinical performance between next-generation sequencing and standard blood culture diagnostic method in patients suffering from sepsis

Cited by 10 publications

References 32 publications

Comparison of metagenomic next-generation sequencing and conventional culture for the diagnostic performance in febrile patients with suspected infections

Comparison of metagenomic next-generation sequencing and conventional culture for the diagnostic performance in febrile patients with suspected infections

Pathogenic Profile Characteristics and Clinical Risk Factor Analysis of Patients Who Died from Sepsis Combined with Pulmonary Infection by Metagenomic Next-Generation Sequencing

Exploring Extended White Blood Cell Parameters for the Evaluation of Sepsis among Patients Admitted to Intensive Care Units

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