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. 2024 Feb 29;13(2):260-270.
doi: 10.21037/tp-23-341. Epub 2024 Feb 26.

Application value of metagenomics next-generation sequencing in the diagnosis of respiratory virus infection after congenital heart surgery

Xiu-Hua Chen  1 , Si-Jia Zhou  1 , Ying-Ying Liu  1 , Hua Cao  1 , Yi-Rong Zheng #  1 , Qiang Chen #  1
Affiliations

Application value of metagenomics next-generation sequencing in the diagnosis of respiratory virus infection after congenital heart surgery

Xiu-Hua Chen et al. Transl Pediatr. .

Abstract

Background: Timely and accurate pathogen diagnosis can be challenging in children who contract a respiratory virus following congenital heart surgery (CHS). This often results in suboptimal drug use and treatment delays. Metagenomics next-generation sequencing (mNGS) is a swift, efficient, and unbiased method for obtaining microbial nucleic acid sequences. This technology holds promise as a comprehensive diagnostic tool, especially for pathogens undetectable by traditional methods. However, the efficacy of mNGS in the context of congenital heart disease infections remains uncertain. This study aimed to explore the diagnostic value of mNGS for respiratory virus infections post-CHS.

Methods: We conducted a retrospective analysis of patients who developed respiratory tract infections post-CHS and were admitted to our cardiac center between July 2021 and December 2022. The patients were categorized into the following two groups based on the diagnostic method used: (I) the mNGS group (comprising 62 patients); and (II) the conventional microbiological test (CMT) group (comprising 70 patients). Bronchoalveolar lavage fluid (BALF) samples from these patients were tested to identify pathogens.

Results: The mNGS group had significantly higher detection rates for both viral infections and mixed viral infections than the CMT group (56.45% vs. 17.14%, P<0.001, and 80.00% vs. 16.67%, P<0.001, respectively). In the mNGS group, 19.35% of the patients received antiviral therapy, and 61.29% received an anti-infective regimen adjustment. Conversely, in the CMT group, only 4.29% received antiviral therapy, and 28.57% received an anti-infective regimen adjustment. A higher percentage of patients showed improved respiratory symptoms in the mNGS group than the CMT group (74.19% vs. 44.29%, P=0.001). Additionally, the mNGS group had a shorter duration of mechanical ventilation and a reduced length of stay in the cardiac intensive care unit than the CMT group (P=0.012).

Conclusions: Using mNGS for BALF enhances the detection of respiratory viral infections and coexisting viral infections post-CHS. This facilitates more precise treatment strategies and could potentially lead to improved patient outcomes.

Keywords: Metagenomics next-generation sequencing (mNGS); congenital heart surgery (CHS); respiratory infection; virus.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-23-341/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The workflow for mNGS. RNA, ribonucleic acid; DNA, deoxyribonucleic acid; cDNA, complementary DNA; mNGS, metagenomic next-generation sequencing.
Figure 2
Figure 2
Virus infection types in the mNGS group. mNGS, metagenomic next-generation sequencing.
See this image and copyright information in PMC

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