Comparison of pathogen detection consistency between metagenomic next-generation sequencing and blood culture in patients with suspected bloodstream infection

Abstract

The application of metagenomic next-generation sequencing (mNGS) has gradually been carried out by clinical practitioner. However, few studies have compared it with blood cultures in patients suffering from suspected bloodstream infections. The purpose of this study was to compare the detection of pathogenic microorganisms by these two assays in patients with suspected bloodstream infection. We retrospectively studied patients with fever, chills, antibiotic use for more than 3 days, suspected bloodstream infection, and admission to the emergency department of Ruijin Hospital from January 2020 to June 2022. All patients had blood drawn on the same day for blood mNGS and blood cultures. Clinical and laboratory parameters were collected on the day blood was drawn. The detection of pathogenic microorganisms by the two methods was compared. Risk factors and in-hospital mortality in patients with bloodstream infections were analysed separately for these two assays. In all 99 patients, the pathogenic microorganisms detection rate in blood mNGS was significantly higher than that in blood culture. Blood mNGS was consistent with blood culture in only 12.00% of all positive bacterial and fungal test results. The level of CRP is related to bacteraemia, fungaemia and viraemia detected by blood mNGS. No clear risk factors could be found in patients with a positive blood culture. In critically ill patients, both tests failed to improve patient outcomes. In patients with suspected bloodstream infection, mNGS is not yet a complete replacement for blood cultures.

The clinical importance of metagenomic next-generation sequencing in detecting disease-causing microorganisms in cases of sepsis acquired in the community or hospital setting

“…In cases of CAS and HAS, K. pneumoniae and A. baumannii were the bacteria most commonly identified using the methods mentioned. These results align with previous studies but highlight the superior sensitivity of mNGS over traditional culture for bacterial detection in sepsis (Geng et al, 2021 ; Sun et al, 2022 ; Qin et al, 2023 ; Zhou et al, 2023 ).…”

Performance of next-generation sequencing for diagnosis of blood infections by Klebsiella pneumoniae

“…As a possible explanation for the higher detection rate, the cohort of the present study was limited to patients with highly suspected BSIs and positive mNGS results. However, the detection rate was still lower for BC than mNGS (71%) after clinical analysis, consistent with previous reports (Long et al, 2016;Grumaz et al, 2019;Zhou et al, 2023). In addition to BC, OC methods are used for clinical diagnosis of many specimens of the respiratory tract, urine, cerebrospinal fluid, pus, and thoracoabdominal fluid, and those relatively sterile specimens have a higher evidence level for infection diagnosis Luo et al, 2023).…”

“…Based on virulence factors, Kp is commonly classified as classic or hypervirulent (Liu and Guo, 2018;Zhu et al, 2021;Lin et al, 2022). Routine culture methods for detection of Kp BSIs have relatively low positivity rates (10% to 30%) and are time-consuming (Zhou et al, 2023). As compared to traditional cultural methods, the benefits of mNGS include a high positivity rate, wide coverage, short turnaround time, and high throughput.…”

Evaluation of Nanopore Sequencing for Diagnosing Pulmonary Tuberculosis Using Negative Smear Clinical Specimens

“…13 Genetic sequencing is widely used in the field of infectious diseases and offers unique advantages for the rapid diagnosis of TB. 13,14 The utilization of next-generation sequencing (NGS) in TB has demonstrated remarkable diagnostic efficacy, thereby greatly improving TB diagnosis. 15 Nanopore sequencing is a unique and scalable technology that monitors changes in the current of nucleic acids as they pass through nanopore proteins.…”