Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis
Abstract Background Despite the increasing use of metagenomic next-generation sequencing (mNGS) in sepsis, identifying clinically relevant pathogens remains challenging. This study was aimed to evaluate the clinical utility of simultaneous plasma and bronchoalveolar lavage fluid (BALF) detection usi...
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BMC
2024-12-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-10292-5 |
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| author | Jiayan Li Dongxu Pan Yuxin Guo Bo Zhang Xinglin Lu Chen Deng Feifei Xu Zongnan Lv Qinhe Chen Yafeng Zheng Shuhao Nong Lihua Su Rongfa Qin Fufu Jiang Wei Gai Gang Qin |
| author_facet | Jiayan Li Dongxu Pan Yuxin Guo Bo Zhang Xinglin Lu Chen Deng Feifei Xu Zongnan Lv Qinhe Chen Yafeng Zheng Shuhao Nong Lihua Su Rongfa Qin Fufu Jiang Wei Gai Gang Qin |
| author_sort | Jiayan Li |
| collection | DOAJ |
| description | Abstract Background Despite the increasing use of metagenomic next-generation sequencing (mNGS) in sepsis, identifying clinically relevant pathogens remains challenging. This study was aimed to evaluate the clinical utility of simultaneous plasma and bronchoalveolar lavage fluid (BALF) detection using mNGS. Methods This retrospective study enrolled 95 patients with pneumonia-derived sepsis (PDS) admitted to the intensive care unit (ICU) between October 2021 and January 2023. Patients were divided into two groups: mNGS group (n = 60) and the non-mNGS group (n = 35), based on whether simultaneous plasma and BALF mNGS were conducted. All patients underwent conventional microbiological tests (CMT), including bacterial/fungal culture of peripheral blood and BALF, as well as sputum culture, detection of 1, 3-beta-D- glucan in BALF and RT-PCR testing. The clinical data of the enrolled patients were collected, and the detection performance and prognosis of plasma mNGS, BALF mNGS and CMT were compared. Results The mNGS group exhibited a lower mortality rate than the non-mNGS group (35.0% vs. 57.1%, P = 0.034). Simultaneous detection in dual-sample resulted in a higher proportion of microorganisms identified as definite causes of sepsis alert compared to detection in either plasma or BALF alone (55.6% vs. 20.8% vs. 18.8%, P<0.001). Acinetobacter baumannii, Stenotrophomonas maltophilia, Candida albicans, and human mastadenovirus B were the primary strains responsible for infections in PDS patients. Patients with lower white blood cells and neutrophil indices had a greater consistency in dual-sample mNGS. Patients in the mNGS group had more antibiotic adjustments compared to the non-mNGS group (85.71% vs. 33.33%, P<0.001). The percentage of neutrophils was a risk factor for mortality in PDS patients (P = 0.002). Conclusion Dual sample mNGS has the advantage of detecting and determining the pathogenicity of more pathogens and has the potential to improve the prognosis of patients with PDS. |
| format | Article |
| id | doaj-art-4edc97f1d56f4fa4904317c64b6358e6 |
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| publishDate | 2024-12-01 |
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| spelling | doaj-art-4edc97f1d56f4fa4904317c64b6358e62025-08-20T02:20:38ZengBMCBMC Infectious Diseases1471-23342024-12-0124111310.1186/s12879-024-10292-5Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsisJiayan Li0Dongxu Pan1Yuxin Guo2Bo Zhang3Xinglin Lu4Chen Deng5Feifei Xu6Zongnan Lv7Qinhe Chen8Yafeng Zheng9Shuhao Nong10Lihua Su11Rongfa Qin12Fufu Jiang13Wei Gai14Gang Qin15Department of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionWillingMed Technology (Beijing) Co., LtdDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionWillingMed Technology (Beijing) Co., LtdDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionWillingMed Technology (Beijing) Co., LtdDepartment of Intensive Care Unit, National Hospital of Guangxi Zhuang Autonomous RegionAbstract Background Despite the increasing use of metagenomic next-generation sequencing (mNGS) in sepsis, identifying clinically relevant pathogens remains challenging. This study was aimed to evaluate the clinical utility of simultaneous plasma and bronchoalveolar lavage fluid (BALF) detection using mNGS. Methods This retrospective study enrolled 95 patients with pneumonia-derived sepsis (PDS) admitted to the intensive care unit (ICU) between October 2021 and January 2023. Patients were divided into two groups: mNGS group (n = 60) and the non-mNGS group (n = 35), based on whether simultaneous plasma and BALF mNGS were conducted. All patients underwent conventional microbiological tests (CMT), including bacterial/fungal culture of peripheral blood and BALF, as well as sputum culture, detection of 1, 3-beta-D- glucan in BALF and RT-PCR testing. The clinical data of the enrolled patients were collected, and the detection performance and prognosis of plasma mNGS, BALF mNGS and CMT were compared. Results The mNGS group exhibited a lower mortality rate than the non-mNGS group (35.0% vs. 57.1%, P = 0.034). Simultaneous detection in dual-sample resulted in a higher proportion of microorganisms identified as definite causes of sepsis alert compared to detection in either plasma or BALF alone (55.6% vs. 20.8% vs. 18.8%, P<0.001). Acinetobacter baumannii, Stenotrophomonas maltophilia, Candida albicans, and human mastadenovirus B were the primary strains responsible for infections in PDS patients. Patients with lower white blood cells and neutrophil indices had a greater consistency in dual-sample mNGS. Patients in the mNGS group had more antibiotic adjustments compared to the non-mNGS group (85.71% vs. 33.33%, P<0.001). The percentage of neutrophils was a risk factor for mortality in PDS patients (P = 0.002). Conclusion Dual sample mNGS has the advantage of detecting and determining the pathogenicity of more pathogens and has the potential to improve the prognosis of patients with PDS.https://doi.org/10.1186/s12879-024-10292-5Metagenomic next-generation sequencingPneumonia-derived sepsisDual sample mNGSClinical value |
| spellingShingle | Jiayan Li Dongxu Pan Yuxin Guo Bo Zhang Xinglin Lu Chen Deng Feifei Xu Zongnan Lv Qinhe Chen Yafeng Zheng Shuhao Nong Lihua Su Rongfa Qin Fufu Jiang Wei Gai Gang Qin Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis BMC Infectious Diseases Metagenomic next-generation sequencing Pneumonia-derived sepsis Dual sample mNGS Clinical value |
| title | Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis |
| title_full | Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis |
| title_fullStr | Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis |
| title_full_unstemmed | Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis |
| title_short | Clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia-derived sepsis |
| title_sort | clinical application value of simultaneous plasma and bronchoalveolar lavage fluid metagenomic next generation sequencing in patients with pneumonia derived sepsis |
| topic | Metagenomic next-generation sequencing Pneumonia-derived sepsis Dual sample mNGS Clinical value |
| url | https://doi.org/10.1186/s12879-024-10292-5 |
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