Role and Clinical Application of Metagenomic Next-Generation Sequencing in Immunocompromised Patients With Acute Respiratory Failure During Veno-Venous Extracorporeal Membrane Oxygenation

Zhao, Yangchao; Ding, Yan-Zhong; Zhao, Xi; Fu, Guowei; Huang, Mingjun; Li, Xingxing; Sun, Qianqian; Kan, Ya-Bai; Li, Jun; Wang, Shi-Lei; Ma, Wentao; Xu, Qing‐Long; Liu, Qilong; Li, Hongbin

doi:10.3389/fcimb.2022.877205

Cited by 5 publications

(4 citation statements)

References 28 publications

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Section: Discussionmentioning

confidence: 99%

Spinal infections? mNGS combined with microculture and pathology for answers

Chen,

Liu,

Huang

et al. 2024

Preprint

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Background This study focuses on the efficacy of genome sequencing technology (mNGS) in diagnosing infections of the spine and the development of therapeutic regimens combining mNGS, microbiological cultures, and pathological investigations to provide new perspectives for the treatment of spinal infections. Methods Data were collected on 108 patients with suspected spinal infections between January 2022 and December 2023. Lesion tissues were obtained through C-arm assisted puncture or open surgery for mNGS, conventional microbiological culture, or pathological analysis. Treatment plans involving personalized antimicrobial therapy were tailored based on mNGS findings, microbial cultures, and pathological analysis, with a follow-up evaluation 7 days postoperatively. The sensitivity and specificity of mNGS for detecting spinal infection pathogens, as well as its impact on treatment and prognosis, were assessed based on the final clinical outcomes. Results In the diagnosis of spinal infections, the positive detection rate of mNGS (61.20%) was significantly higher than that of conventional microbiological culture (30.80%) and PCT (28%). The sensitivity (79.41%) and negative predictive value (63.16%) of mNGS were substantially greater than those of cultures (25% and 22.58%, respectively), with no significant difference in specificity and positive predictive value. Seven days post-surgery, a notable reduction in the percentage of neutrophils (NEUT%) was observed, while decreases in white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were not statistically significant. At the last follow-up, there was a significant decrease in all patients' Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores. Conclusion The efficacy of mNGS technology surpasses traditional microbiological culture in pathogen detection, exhibiting superior performance particularly in identifying rare and critical pathogens. Treatment protocols combining mNGS, microbiological cultures and pathological examinations are effective in the treatment of spinal infections and provide a valuable clinical reference.

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Section: Discussionmentioning

confidence: 99%

Spinal infections? mNGS combined with microculture and pathology for answers

Chen,

Liu,

Huang

et al. 2024

Preprint

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“…In the early stages of disease diagnosis, mNGS offers rapid and accurate information, assisting clinicians in devising early, targeted antibiotic treatments to prevent antibiotic misuse. 31 , 32 In this study, antibiotic regimens were adjusted for 27 patients diagnosed with infections based on mNGS results. Furthermore, studies indicate that combining mNGS with microbiological culture and pathological examination can more effectively bolster clinicians’ confidence when making decisions, as compared to relying solely on mNGS results.…”

Section: Discussionmentioning

confidence: 99%

Spinal Infections? mNGS Combined with Microculture and Pathology for Answers

Chen,

Liu,

Huang

et al. 2024

IDR

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Introduction This study evaluates the efficacy of metagenomic next-generation sequencing (mNGS) in diagnosing spinal infections and developing therapeutic regimens that combine mNGS, microbiological cultures, and pathological investigations. Methods Data were collected from 108 patients with suspected spinal infections between January 2022 and December 2023. Lesion tissues were obtained via C-arm assisted puncture or open surgery for mNGS, conventional microbiological culture, and pathological analysis. Personalized antimicrobial therapies were tailored based on these findings, with follow-up evaluations 7 days postoperatively. The sensitivity and specificity of mNGS were assessed, along with its impact on treatment and prognosis. Results mNGS showed a significantly higher positive detection rate (61.20%) compared to conventional microbiological culture (30.80%) and PCT (28%). mNGS demonstrated greater sensitivity (79.41%) and negative predictive value (63.16%) than cultures (25% and 22.58%, respectively), with no significant difference in specificity and positive predictive value. Seven days post-surgery, a significant reduction in neutrophil percentage (NEUT%) was observed, though decreases in white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were not statistically significant. At the last follow-up, significant improved in Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores were noted. Conclusion mNGS outperforms traditional microbiological culture in pathogen detection, especially for rare and critical pathogens. Treatment protocols combining mNGS, microbiological cultures, and pathological examinations are effective and provide valuable clinical insights for treating spinal infections.

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“…With these technical advances have come increasing case reports and series identifying unusual or unexpected pathogens [22][23][24][25][26][27][28], comparative evaluations [29][30][31] and literature reviews [32 & ,33] demonstrating the value of RMg in a realworld adult and paediatric setting. Many were retrospective or observational, but some informed treatment in real time [34] and the protocol for a randomised multicentre clinical trial has been published [35 & ].…”

Section: The Respiratory Metagenomics Propositionmentioning

confidence: 99%

Respiratory metagenomics: route to routine service

Edgeworth

2023

Current Opinion in Infectious Diseases

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Purpose of reviewThe coronavirus disease 2019 pandemic demonstrated broad utility of pathogen sequencing with rapid methodological progress alongside global distribution of sequencing infrastructure. This review considers implications for now moving clinical metagenomics into routine service, with respiratory metagenomics as the exemplar use-case.Recent findingsRespiratory metagenomic workflows have completed proof-of-concept, providing organism identification and many genotypic antimicrobial resistance determinants from clinical samples in <6 h. This enables rapid escalation or de-escalation of empiric therapy for patient benefit and reducing selection of antimicrobial resistance, with genomic-typing available in the same time-frame. Attention is now focussed on demonstrating clinical, health-economic, accreditation, and regulatory requirements. More fundamentally, pathogen sequencing challenges the traditional culture-orientated time frame of microbiology laboratories, which through automation and centralisation risks becoming increasingly separated from the clinical setting. It presents an alternative future where infection experts are brought together around a single genetic output in an acute timeframe, aligning the microbiology target operating model with the wider human genomic and digital strategy.SummaryPathogen sequencing is a transformational proposition for microbiology laboratories and their infectious diseases, infection control, and public health partners. Healthcare systems that link output from routine clinical metagenomic sequencing, with pandemic and antimicrobial resistance surveillance, will create valuable tools for protecting their population against future infectious diseases threats.

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Role and Clinical Application of Metagenomic Next-Generation Sequencing in Immunocompromised Patients With Acute Respiratory Failure During Veno-Venous Extracorporeal Membrane Oxygenation

Cited by 5 publications

References 28 publications

Spinal infections? mNGS combined with microculture and pathology for answers

Spinal infections? mNGS combined with microculture and pathology for answers

Spinal Infections? mNGS Combined with Microculture and Pathology for Answers

Respiratory metagenomics: route to routine service

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