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Metagenomic Next-Generation Sequencing for the Microbiological Diagnosis of Abdominal Sepsis Patients
Dongkai Li1, Wei Gai2, Jiahui Zhang1
1Department of Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China.
Objectives:
For patients with intra-abdominal infection (IAI), the rapid and accurate identification of pathogens remains a challenge. Metagenomic next-generation sequencing (mNGS) is a novel technique for infectious diseases, but its application in IAI is limited. In this study, we compared the microbiological diagnostic ability of plasma mNGS with that of conventional peritoneal drainage (PD) culture in critical care settings.
Methods:
From January 2018 to December 2020, a prospective observational study was performed at a tertiary teaching hospital in China and data on 109 abdominal sepsis patients were collected. The pathogen detection performance of plasma mNGS and PD culture method were compared.
Measurements And Results:
Ninety-two positive cases detected on PD culture, while plasma mNGS detected 61 positive cases. Forty-five patients (44.0%) had at least one matched pair of plasma mNGS and PD culture results. Compared with PD culture, the plasma mNGS was more rapid (27.1 ± 4.0 vs. 68.9 ± 22.3 h, p < 0.05). The patients received initial antibiotic treatment matched with mNGS detection showed better clinical outcomes.
Conclusion:
For abdominal sepsis patients, plasma mNGS can provide early, noninvasive, and rapid microbiological diagnosis. Compared with conventional PD smear, culture, and blood culture methods, plasma mNGS promote the rapid detection of pathogenic bacteria.
Insights
Plasma metagenomic next-generation sequencing (mNGS) offers a faster, noninvasive method for identifying pathogens in abdominal sepsis patients. This rapid diagnosis using plasma mNGS can lead to improved clinical outcomes compared to traditional culture methods.
Area of Science:
- Infectious Diseases
- Microbiology
- Genomics
Background:
- Accurate pathogen identification in intra-abdominal infections (IAI) is critical for effective treatment.
- Conventional diagnostic methods for IAI can be slow and invasive.
- Metagenomic next-generation sequencing (mNGS) presents a promising alternative for pathogen detection.
Purpose of the Study:
- To compare the diagnostic performance of plasma mNGS with conventional peritoneal drainage (PD) culture for identifying pathogens in patients with IAI.
- To evaluate the speed and clinical impact of plasma mNGS in critical care settings for abdominal sepsis.
Main Methods:
- A prospective observational study involving 109 abdominal sepsis patients was conducted between January 2018 and December 2020.
- Pathogen detection was performed using both plasma mNGS and conventional PD culture.
- The study compared the sensitivity, specificity, and turnaround time of both methods.
Main Results:
- Plasma mNGS identified 61 positive cases, while PD culture identified 92 positive cases.
- A matched pair of results was obtained for 45 patients (44.0%).
- Plasma mNGS provided significantly faster results (27.1 ± 4.0 hours) compared to PD culture (68.9 ± 22.3 hours), p < 0.05. Patients receiving antibiotics guided by mNGS showed better clinical outcomes.
Conclusions:
- Plasma mNGS enables early, noninvasive, and rapid microbiological diagnosis in patients with abdominal sepsis.
- Compared to conventional methods like PD smear, culture, and blood culture, plasma mNGS accelerates the detection of pathogenic bacteria.
- The findings suggest plasma mNGS is a valuable tool for improving the management of IAI in critical care.
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