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Potential utility of metagenomic sequencing for improving etiologic diagnosis of infective endocarditis

Wai-Sing Chan1, Chun-Hang Au1, Henry Chi-Ming Leung2,3

  • 1Department of Pathology, Hong Kong Sanatorium & Hospital, Hong Kong, PR China.

Future Cardiology
|November 7, 2019
PubMed

Insights

Metagenomic sequencing aids in diagnosing infective endocarditis (IE) caused by difficult-to-grow bacteria. This advanced technique identifies pathogens and antibiotic resistance genes, improving diagnostic workflows when standard tests are inconclusive.

Area of Science:

  • Microbiology
  • Genomics
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) poses diagnostic challenges, particularly when caused by fastidious bacteria.
  • Conventional diagnostic methods may not always identify the causative agents of IE.
  • Metagenomic sequencing offers a potential alternative for pathogen detection.

Purpose of the Study:

  • To evaluate the utility of metagenomic sequencing in diagnosing IE caused by fastidious bacteria.
  • To assess the effectiveness of both Illumina MiSeq and Nanopore MinION platforms for IE diagnosis.

Main Methods:

  • Plasma and heart valve samples from two IE patients were analyzed using metagenomic sequencing.
  • Patients were infected with *Bartonella quintana* and *Propionibacterium* species.
  • Sequencing was performed using Illumina MiSeq and Nanopore MinION technologies.

Main Results:

  • *Bartonella quintana* was detected in plasma samples from patient 1.
  • *Propionibacterium* species were identified in plasma samples from patient 2.
  • Near-complete bacterial genomes (>98%) were recovered from heart valves, revealing antibiotic resistance markers.
  • Real-time sequencing identified pathogens within 16 minutes.

Conclusions:

  • Metagenomic sequencing can significantly improve the etiologic diagnosis of infective endocarditis.
  • This method is particularly valuable when conventional diagnostic tests are negative or inconclusive.
  • Metagenomic sequencing provides rapid pathogen identification and antibiotic resistance profiling.
Keywords:
Bartonella quintanaIllumina MiSeqNGSNanopore MinIONPropionibacteriumetiologic diagnosisheart valveinfective endocarditismetagenomic sequencingplasma

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