Application value of metagenomic next-generation sequencing for infectious pathogens in patients receiving allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.cn112138-20220212-00104
- VernacularTitle:宏基因组高通量测序协助诊断异基因造血干细胞移植术后患者感染病原体的价值分析
- Author:
Jiahui SUN
1
;
Xiaohui ZHANG
;
Xiaodong MO
;
Haixia FU
;
Yuanyuan ZHANG
;
Yuhong CHEN
;
Yao CHEN
;
Yu WANG
;
Xiaojun HUANG
;
Lanping XU
Author Information
1. 北京大学人民医院血液科 北京大学血液病研究所 国家血液系统疾病临床医学研究中心 造血干细胞移植治疗血液病北京市重点实验室，北京 100044
- Keywords:
High-throughput nucleotide sequencing;
Hematopoietic stem cell transplantation;
Infection
- From:
Chinese Journal of Internal Medicine
2022;61(8):928-932
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of Metagenomic Next-Generation sequencing (mNGS) in infectious patients after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:Patients suspected with local or systemic infections were retrospectively included after allo-HSCT in our department from April 2019 to November 2020. Pathogenic microorganisms were tested by mNGS in samples from peripheral blood, cerebrospinal fluid, alveolar lavage Liquid, abscess, etc. Other diagnostic methods such as bacterial/fungal culture, viral PCR detection were simultaneously explored comparing with mNGS results.Results:A total of 112 samples in 83 patients were detected by mNGS, and 34 pathogenic microorganisms were determined. Among these positive samples, 11 strains of bacteria (17 times) with the most common Escherichia coli (4/17) were reported. There were 7 strains of fungi (10 times) detected with primary Candida albicans (7/29). Although arvovirus 30.2% (39/129) were predominantly detected, its diagnostic relevance with infections was not definite. Other pathogenic viruses including cytomegalovirus (CMV) 25.6% (33/129) and Epstein Barr virus (EBV) 14.0% (18/129)were of significance. Comparing with golden diagnostic criteria, the sensitivity of mNGS was 86.5%, and specificity was 45.0%. Regarding single pathogen infection, the consistency of mNGS and conventional methods was 82.9% (29/35), while it was 16/17 in combination infections.Conclusion:mNGS could be a potential method to determine pathogens in patients suspected with infections after allo-HSCT.
