Application of metagenomics next-generation sequencing in monitoring Legionella pneumophila infection after allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.issn.1009-9921.2019.12.008
- VernacularTitle: 宏基因组测序技术监测异基因造血干细胞移植后嗜肺军团菌感染
- Author:
Lili YUAN
1
;
Huizheng ZHAO
2
;
Jianping ZHANG
3
;
Fang WANG
1
;
Nannan LI
3
;
Xingzhen ZHAO
1
;
Xue CHEN
1
;
Yang ZHANG
1
;
Daijing NIE
1
;
Panxiang CAO
1
;
Mangju WANG
4
;
Ming LIU
1
;
Mingyue LIU
1
;
Hongxing LIU
5
Author Information
1. Department of Laboratory Medicine, Hebei Yanda Lu Daopei Hospital, Langfang 065201, China
2. Department of Pathology & Laboratory Medicine, Beijing Lu Daopei Hospital, Beijing 100176, China
3. Department of Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang 065201, China
4. Department of Hematology, Peking University First Hospital, Beijing 100034, China
5. Beijing Lu Daopei Institute of Hematology, Beijing 100176, China
- Publication Type:Journal Article
- Keywords:
High-throughput nucleotide sequencing;
Metagenome;
Hematopoietic stem cell transplantation;
Legionella pneumophila
- From:
Journal of Leukemia & Lymphoma
2019;28(12):734-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application of metagenomic next-generation sequencing (mNGS) in detection of the rare or difficult-to-cultivate pathogens.
Methods:One patient with acute lymphoblastic leukemia who went through allogeneic hematopoietic stem cell transplantation (allo-HSCT) developed symptoms of infection after transplantation. Conventional microbial culture, polymerase chain reaction (PCR), and mNGS combined with biological information analysis were performed with plasma and cerebrospinal fluid samples, the anti-infective treatment was adjusted according to the test results, and the efficacy was assessed.
Results:No suspected pathogens were detected by microbial culture and PCR in the cerebrospinal fluid and plasma samples since the patient developed infection symptoms. However, Legionella pneumophila was analyzed by mNGS in the cerebrospinal fluid specimen on day 23 after allo-HSCT (reads count: 19 655), and it was considered as the principal pathogen after comprehensively evaluating the patient's clinical manifestations and the test results. Then the antimicrobial treatments were adjusted according to the patient's clinical manifestations and laboratory test results, and the number of gene sequences of Legionella pneumophila was monitored by mNGS method. Azithromycin, tigecycline, and other antibiotics effective for Legionella pneumophila were used after detecting this pathogen. A total of 15 mNGS analysis were performed during the 5-month period, and the highest number of Legionella pneumophila sequences monitored in the cerebrospinal fluid was 2 226, the lowest was 253 and eventually turned negative. The clinical symptoms and treatment outcomes were consistent with the mNGS monitoring results.
Conclusions:The mNGS technology has significant value in detection of the rare and difficult-to-cultivate pathogens. The mNGS technology provides a valuable supplement to microbial culture and PCR methods.
