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[Application value of metagenomic next-generation sequencing for pathogen detection in childhood agranulocytosis with
Shan Zhu, Ying Liu, Hai-Yan Luo
1Department of Pediatrics, Xiangya Hospital of Central South University, Changsha 410008, China.
Objectives:
To study the application value of metagenomic next-generation sequencing (mNGS) for pathogen detection in childhood agranulocytosis with fever.
Methods:
A retrospective analysis was performed on the mNGS results of pathogen detection of 116 children with agranulocytosis with fever who were treated from January 2020 to December 2021. Among these children, 38 children with negative mNGS results were enrolled as the negative group, and 78 children with positive results were divided into a bacteria group (n=22), a fungal group (n=23), and a viral group (n=31). Clinical data were compared between groups.
Results:
For the 116 children with agranulocytosis and fever, the median age was 8 years at diagnosis, the median turnaround time of mNGS results was 2 days, and the positive rate of mNGS testing was 67.2% (78/116). Compared with the negative group, the bacterial group had a higher procalcitonin level (P<0.05), the fungal group had higher level of C-reactive protein and positive rate of (1,3)-β-D glucan test/galactomannan test (P<0.05), and the fungal group had a longer duration of fever (P<0.05). Among the 22 positive microbial culture specimens, 9 (41%) were consistent with the mNGS results. Among the 17 positive blood culture specimens, 8 (47%) were consistent with the mNGS results. Treatment was adjusted for 28 children (36%) with the mNGS results, among whom 26 were cured and discharged.
Conclusions:
The mNGS technique has a shorter turnaround time and a higher sensitivity for pathogen detection and can provide evidence for the pathogenic diagnosis of children with agranulocytosis and fever.
Insights
Metagenomic next-generation sequencing (mNGS) offers faster and more sensitive pathogen detection in children with fever and agranulocytosis. This advanced technique aids in timely diagnosis and effective treatment adjustments for better patient outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Molecular Diagnostics
- Genomics
Background:
- Childhood agranulocytosis with fever presents diagnostic challenges.
- Accurate and rapid pathogen identification is crucial for effective management.
Purpose of the Study:
- To evaluate the clinical application value of metagenomic next-generation sequencing (mNGS) for pathogen detection in pediatric patients diagnosed with agranulocytosis and fever.
- To compare the diagnostic performance of mNGS against traditional methods.
Main Methods:
- Retrospective analysis of 116 children with agranulocytosis and fever.
- mNGS was performed for pathogen detection.
- Clinical data and laboratory markers were compared between groups with positive and negative mNGS results.
Main Results:
- mNGS demonstrated a positive detection rate of 67.2% with a median turnaround time of 2 days.
- Specific inflammatory markers (procalcitonin, C-reactive protein) and diagnostic tests ((1,3)-β-D glucan/galactomannan) differed significantly between bacterial and fungal infection groups.
- mNGS results guided treatment adjustments in 36% of cases, leading to successful outcomes in 26 patients.
Conclusions:
- Metagenomic next-generation sequencing (mNGS) provides a valuable tool for rapid and sensitive pathogen detection in children with agranulocytosis and fever.
- The technique supports timely pathogenic diagnosis and informs clinical decision-making, improving treatment efficacy.
