Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 28;24(1):1475.
doi: 10.1186/s12879-024-10383-3.

Onco-mNGS facilitates rapid and precise identification of the etiology of fever of unknown origin: a single-centre prospective study in North China

Bingbing Liu #  1 , Tengfei Yu #  2   3 , Ruotong Ren #  4   2   5 , Na Wu  1 , Nanshu Xing  1 , Jingya Wang  1 , Wenjie Wu  2 , Xuefang Cao  2 , Jingping Zhang  6
Affiliations

Onco-mNGS facilitates rapid and precise identification of the etiology of fever of unknown origin: a single-centre prospective study in North China

Bingbing Liu et al. BMC Infect Dis. .

Abstract

Objectives: Delayed diagnosis of patients with Fever of Unknown Origin has long been a daunting clinical challenge. Onco-mNGS, which can accurately diagnose infectious agents and identify suspected tumor signatures by analyzing host chromosome copy number changes, has been widely used to assist identifying complex etiologies. However, the application of Onco-mNGS to improve FUO etiological screening has never been studied before.

Methods: In this single-centre prospective study, we included 65 patients with classic FUO, who were randomly divided into control group (sample cultivation) and mNGS group (cultivation + Onco-mNGS). We analyzed the infectious agents and symbiotic microbiological, tumor and clinical data of both groups.

Results: Infection-related pathogenic detection efficiency rose from 25% (control group) to 48.48% (experimental group). Seven patients with chromosome copy number changes had later been confirmed tumors, indicating a 100% of clinical concordance rate of Onco-mNGS for tumors. In addition, the time frame for diagnosing or ruling out infection/tumor with Onco-mNGS had greatly reduced to approximately 2 days, which was 7.34 days earlier than that in the control group.

Conclusions: Onco-mNGS is an ideal rapid diagnostic aid to assist improving the early diagnostic efficiency of FUO-associated diseases.

Keywords: Diagnostic criteria; Etiology; Fever of unknown origin; Onco-mNGS.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The studies involving human participants were reviewed and approved by the board of Ethics at The First Hospital of China Medical University. The patients provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. The study was conducted in accordance with the International Conference on Harmonization, Good Clinical Practice Guidelines, and the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of Research, Clinical grouping and patient distribution. A Flowchart of this research, B Sample types in Control group, C Sample types in Experimental group, D Patient distribution with four different etiologies in two groups
Fig. 2
Fig. 2
Comparison of the efficacy of Onco-mNGS and conventional culture methods for pathogenicity detection in the experimental group. A Analysis of responsible pathogens detected by Onco-mNGS and conventional culture methods, B The distribution pattern of bacteria, fungi and virus identified by Onco-mNGS in patients with different etiology, C Difference analysis of the abundance and frequency in three different types of responsible pathogens (bacteria, fungi, and viruses) identified by Onco-mNGS. Infection, n = 8; Tumor, n = 9; Other, n = 4; ND, n = 3. p < 0.05, *, p < 0.01, **
Fig. 3
Fig. 3
Analysis of empirical antibiotic use in experimental group. A Most patients in both experimental group and control group used antibiotics empirically, B Among the empirical anti-infective cases, 4 cases were positive from traditional culture, and 13 cases were positive from Onco-mNGS, C Analysis of consistency between culture and Onco-mNGS detection results and clinical diagnosis in empirical anti-infective cases
Fig. 4
Fig. 4
CNV analysis in patients with tumor etiology of FUO. A Abnormal CNV signals in tumor patients and their pathological findings: T-3 was bone biopsy, T-8 was bone marrow biopsy, B Chromosome variation types of 7 CNV positive patients, C The chromosomal variation types of different cancer species showed the solid tumor has more variation sites
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Wright WF, Mulders-Manders CM, Auwaerter PG, Bleeker-Rovers CP. Fever of Unknown Origin (FUO) - A Call for New Research Standards and Updated Clinical Management. Am J Med. 2022;135:173–8. - PubMed
    1. Haidar G, Singh N. Fever of Unknown Origin. N Engl J Med. 2022;386:463–77. - PubMed
    1. Zhai YZ, Chen X, Liu X, Zhang ZQ, Xiao HJ, Liu G. Clinical analysis of 215 consecutive cases with fever of unknown origin: A cohort study. Medicine (Baltimore). 2018;97: e10986. - PMC - PubMed
    1. Zhou G, Zhou Y, Zhong C, Ye H, Liu Z, Liu Y, Tang G, Qu J, Lv X. Retrospective analysis of 1,641 cases of classic fever of unknown origin. Ann Transl Med. 2020;8:690. - PMC - PubMed
    1. Gaeta GB, Fusco FM, Nardiello S. Fever of unknown origin: a systematic review of the literature for 1995–2004. Nucl Med Commun. 2006;27:205–11. - PubMed

LinkOut - more resources