Value of targeted next-generation sequencing in pathogen detection for neonates with respiratory distress syndrome: a prospective randomized controlled trial.
10.7499/j.issn.1008-8830.2502073
- Author:
Hai-Hong ZHANG
1
;
Xia OU-YANG
1
;
Xian-Ping LIU
1
;
Shao-Ru HUANG
1
;
Yun-Feng LIN
1
Author Information
1. Department of Neonatology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center; College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University), Fuzhou 350001, China.
- Publication Type:English Abstract
- Keywords:
Bronchoalveolar lavage fluid;
Neonatal respiratory distress syndrome;
Neonate;
Targeted next-generation sequencing
- MeSH:
Humans;
Prospective Studies;
Infant, Newborn;
Female;
Respiratory Distress Syndrome, Newborn/etiology*;
Male;
High-Throughput Nucleotide Sequencing/methods*
- From:
Chinese Journal of Contemporary Pediatrics
2025;27(10):1191-1198
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the application value of targeted next-generation sequencing (tNGS) in the etiological diagnosis of moderate to severe respiratory distress syndrome (RDS) in neonates.
METHODS:A prospective randomized controlled trial was conducted, enrolling 81 term and late-preterm neonates with moderate to severe RDS admitted to Fujian Children's Hospital between December 2023 and December 2024. Patients were randomly assigned to the conventional microbiological test (CMT) group (n=42) or the tNGS group (n=39). For routine pathogen detection, bronchoalveolar lavage fluid was obtained via bronchoscopy, and lower respiratory tract specimens were collected via the endotracheal tube; all specimens underwent culture, and some specimens additionally underwent polymerase chain reaction or antigen testing. In the tNGS group, tNGS was performed in addition to routine pathogen detection on the same specimen types. The detection rate of pathogens, the detection rate of co-infections, and the duration of antibiotic use were compared between the two groups.
RESULTS:The pathogen detection rate in the tNGS group (18/39, 46%) was significantly higher than that in the CMT group (8/42, 19%) (P=0.009). The co-infection detection rate was 13% (5/39) in the tNGS group, while no co-infections were identified in the CMT group (P=0.024). Regarding treatment, the duration of antibiotic use in the tNGS group was shorter than that in the CMT group [(12±4) days vs (15±5) days, P=0.003].
CONCLUSIONS:tNGS significantly improves the pathogen detection rate in neonates with moderate to severe RDS and offers advantages in the rapid identification of co-infections and reduction of antibiotic treatment duration, suggesting it has clinical utility and potential for wider adoption.
