A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections

IntroductionThe application value of metagenomic next-generation sequencing (mNGS) in detecting pathogenic bacteria was evaluated to promote the rational and accurate use of antibiotics. A total of 180 patients with severe infections were included in this study.MethodsBased on their different sympto...

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Main Authors: Fei Hou, Yanting Qiao, Yuanyuan Qiao, Ya Shi, Mingrui Chen, Min Kong, Xiaohang Hu, Liqing Jiang, Xiaowei Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1530486/full
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author Fei Hou
Fei Hou
Yanting Qiao
Yuanyuan Qiao
Ya Shi
Mingrui Chen
Min Kong
Min Kong
Xiaohang Hu
Liqing Jiang
Xiaowei Liu
author_facet Fei Hou
Fei Hou
Yanting Qiao
Yuanyuan Qiao
Ya Shi
Mingrui Chen
Min Kong
Min Kong
Xiaohang Hu
Liqing Jiang
Xiaowei Liu
author_sort Fei Hou
collection DOAJ
description IntroductionThe application value of metagenomic next-generation sequencing (mNGS) in detecting pathogenic bacteria was evaluated to promote the rational and accurate use of antibiotics. A total of 180 patients with severe infections were included in this study.MethodsBased on their different symptoms, bronchoalveolar lavage fluid (BALF) or blood samples were collected for conventional microbiological testing (CMT) and mNGS.ResultsThe results indicated that the etiological diagnosis rate of mNGS (78.89%) was significantly higher than that of CMT (20%) (p<0.001). Notably, mNGS exhibited greater sensitivity towards rare pathogens such as Chlamydia pneumoniae, Mycobacterium tuberculosis complex, and Legionella pneumophila, which were undetectable by CMT. Additionally, 64 cases underwent blood culture, BALF culture, and mNGS testing. Analysis revealed that the positive rate of blood culture (3.1%) was lower than that of BALF (25%), and the positive rate of CMT from both types was significantly lower than that of mNGS (89.1%) (p<0.001). In this study, 168 mNGS results were accepted, and 116 patients had their antibiotic therapy adjustment based on mNGS. Paired analysis indicated that white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP), and neutrophil (NEU) percentage provided valuable therapeutic guidance. The survival rate of patients was 55.36%, influenced by patient physical condition and age.DiscussionOur data indicated that mNGS had significant auxiliary value in the clinical diagnosis and treatment for critically ill patients, especially for those with negative CMT results and clinically undefined infections. mNGS could broaden the detection scope, especially for special pathogens, and improve the detection rate, providing powerful assistance for early clinical diagnosis and treatment.
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spelling doaj-art-3c2da8342a944baeb42e09c32f51afa82025-08-20T02:26:20ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-04-011510.3389/fcimb.2025.15304861530486A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infectionsFei Hou0Fei Hou1Yanting Qiao2Yuanyuan Qiao3Ya Shi4Mingrui Chen5Min Kong6Min Kong7Xiaohang Hu8Liqing Jiang9Xiaowei Liu10Medical Laboratory of Jining Medical University, Jining Medical University, Jining, Shandong, ChinaDepartment of Clinical Laboratory, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaMedical Laboratory of Jining Medical University, Jining Medical University, Jining, Shandong, ChinaDepartment of Clinical Laboratory, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Clinical Laboratory, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Clinical Laboratory, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Jining Medical University, Jining, Shandong, ChinaIntroductionThe application value of metagenomic next-generation sequencing (mNGS) in detecting pathogenic bacteria was evaluated to promote the rational and accurate use of antibiotics. A total of 180 patients with severe infections were included in this study.MethodsBased on their different symptoms, bronchoalveolar lavage fluid (BALF) or blood samples were collected for conventional microbiological testing (CMT) and mNGS.ResultsThe results indicated that the etiological diagnosis rate of mNGS (78.89%) was significantly higher than that of CMT (20%) (p<0.001). Notably, mNGS exhibited greater sensitivity towards rare pathogens such as Chlamydia pneumoniae, Mycobacterium tuberculosis complex, and Legionella pneumophila, which were undetectable by CMT. Additionally, 64 cases underwent blood culture, BALF culture, and mNGS testing. Analysis revealed that the positive rate of blood culture (3.1%) was lower than that of BALF (25%), and the positive rate of CMT from both types was significantly lower than that of mNGS (89.1%) (p<0.001). In this study, 168 mNGS results were accepted, and 116 patients had their antibiotic therapy adjustment based on mNGS. Paired analysis indicated that white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP), and neutrophil (NEU) percentage provided valuable therapeutic guidance. The survival rate of patients was 55.36%, influenced by patient physical condition and age.DiscussionOur data indicated that mNGS had significant auxiliary value in the clinical diagnosis and treatment for critically ill patients, especially for those with negative CMT results and clinically undefined infections. mNGS could broaden the detection scope, especially for special pathogens, and improve the detection rate, providing powerful assistance for early clinical diagnosis and treatment.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1530486/fullmetagenomic next-generation sequencingdetection of pathogenssevere infectionsbronchial alveolar lavage fluidbloodconventional microbiological testing
spellingShingle Fei Hou
Fei Hou
Yanting Qiao
Yuanyuan Qiao
Ya Shi
Mingrui Chen
Min Kong
Min Kong
Xiaohang Hu
Liqing Jiang
Xiaowei Liu
A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections
Frontiers in Cellular and Infection Microbiology
metagenomic next-generation sequencing
detection of pathogens
severe infections
bronchial alveolar lavage fluid
blood
conventional microbiological testing
title A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections
title_full A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections
title_fullStr A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections
title_full_unstemmed A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections
title_short A retrospective analysis comparing metagenomic next-generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections
title_sort retrospective analysis comparing metagenomic next generation sequencing with conventional microbiology testing for the identification of pathogens in patients with severe infections
topic metagenomic next-generation sequencing
detection of pathogens
severe infections
bronchial alveolar lavage fluid
blood
conventional microbiological testing
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1530486/full
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