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. 2024 Apr 19;103(16):e37845.
doi: 10.1097/MD.0000000000037845.

Clinical application of metagenomic next-generation sequencing for the diagnosis of suspected infection in adults: A cross-sectional study

Chunping Sun  1   2 , Chaoe Zhou  1 , Lina Wang  1 , Shanchen Wei  1 , Mingwei Shi  1 , Jun Li  1 , Lianjun Lin  1 , Xinmin Liu  1
Affiliations

Clinical application of metagenomic next-generation sequencing for the diagnosis of suspected infection in adults: A cross-sectional study

Chunping Sun et al. Medicine (Baltimore). .

Abstract

Metagenomic next-generation sequencing (mNGS) has become an available method for pathogen detection. The clinical application of mNGS requires further evaluation. We conducted a cross-sectional study of 104 patients with suspected infection between May 2019 and May 2021. The risk factors associated with infection were analyzed using univariate logistic analysis. The diagnostic performance of pathogens was compared between mNGS and conventional microbiological tests. About 104 patients were assigned into 3 groups: infected group (n = 69), noninfected group (n = 20), and unknown group (n = 15). With the composite reference standard (combined results of all microbiological tests, radiological testing results, and a summary of the hospital stay of the patient) as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value of mNGS was 84.9%, 50.0%, 88.6%, and 42.1%, respectively. Compared with conventional microbiological tests, mNGS could detect more pathogens and had obvious advantages in Mycobacterium tuberculosis, Aspergillus, and virus detection. Moreover, mNGS had distinct benefits in detecting mixed infections. Bacteria-fungi-virus mixed infections were the most common in patients with severe pneumonia. mNGS had a higher sensitivity than conventional microbiological tests, especially for M. tuberculosis, Aspergillus, viruses, and mixed infections. We suggest that mNGS should be used more frequently in the early diagnosis of pathogens in critically ill patients in the future.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
The concordance of mNGS and conventional microbiological tests. mNGS = metagenomic next-generation sequencing.
Figure 2.
Figure 2.
The comparison of diagnostic performance between mNGS and culture. mNGS = metagenomic next-generation sequencing.
Figure 3.
Figure 3.
The overlap of positivity between mNGS and culture for different infectious diseases. mNGS = metagenomic next-generation sequencing.
Figure 4.
Figure 4.
Pathogen distribution in patients with severe pneumonia and patients without severe pneumonia.
See this image and copyright information in PMC

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