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Diagnostic Value and Clinical Application of Metagenomic Next-Generation Sequencing for Infections in Critically Ill Patients.

Authors :
He, Yuxi
Geng, Shike
Mei, Qing
Zhang, Lei
Yang, Tianjun
Zhu, Chunyan
Fan, Xiaoqin
Wang, Yinzhong
Tong, Fei
Gao, Yu
Fang, Xiaowei
Bao, Renren
Sheng, Ximei
Pan, Aijun
Source :
Infection & Drug Resistance; Sep2023, Vol. 16, p6309-6322, 14p
Publication Year :
2023

Abstract

To evaluate the diagnostic value and clinical application of metagenomic next-generation sequencing (mNGS) for infections in critically ill patients.Methods: Comparison of diagnostic performance of mNGS and conventional microbiological testing for pathogens was analyzed in 234 patients. The differences between immunocompetent and immunocompromised individuals in mNGS-guided anti-infective treatment adjustment were also analyzed.Results: The sensitivity and specificity of mNGS for bacterial and fungal detection were 96.6% (95% confidence interval [CI], 93.5%– 99.6%) and 83.1% (95% CI, 75.2%– 91.1%), and 85.7% (95% CI, 71.9%– 99.5%) and 93.2% (95% CI, 89.7%– 96.7%), respectively. Overall, 152 viruses were detected by mNGS, but in which 28 viruses were considered causative agents. The proportion of mNGS-guided beneficial anti-infective therapy adjustments in the immunocompromised group was greater than in the immunocompetent group (48.5% vs 30.1%; P=0.008). In addition, mNGS-guided anti-infective regimens with peripheral blood and BALF specimens had the highest proportion (39.0%; 40.0%), but the proportion of patients not helpful due to peripheral blood mNGS was also as high as 22.0%.Conclusion: mNGS might be a promising technology to provide precision medicine for critically ill patients with infection. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
11786973
Volume :
16
Database :
Complementary Index
Journal :
Infection & Drug Resistance
Publication Type :
Academic Journal
Accession number :
173802760
Full Text :
https://doi.org/10.2147/IDR.S424802