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Case Report: Metagenomic next-generation sequencing assists in dynamic pathogen monitoring: powerful tool for

Yaoguang Li1,2, Jun Lei1,2, Zhigang Ren2

  • 1Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Frontiers in Cellular and Infection Microbiology
|September 25, 2023
PubMed
Abstract

Insights

Metagenomic next-generation sequencing (mNGS) rapidly diagnosed severe pneumonia in a teen, enabling timely treatment adjustments. This advanced diagnostic tool, combined with extracorporeal membrane oxygenation (ECMO), proved crucial for patient recovery.

Area of Science:

  • Critical care medicine
  • Infectious diseases
  • Genomics

Background:

  • Severe community-acquired pneumonia (sCAP) presents significant mortality risks and necessitates intensive care unit (ICU) admission.
  • Patients with sCAP are susceptible to hospital-acquired infections.
  • Metagenomic next-generation sequencing (mNGS) offers a broad detection spectrum and rapid turnaround time for diagnosing severe infections.

Approach:

  • A 15-year-old male with severe influenza and methicillin-resistant Staphylococcus aureus (MRSA) pneumonia was initially misdiagnosed.
  • Bronchoscopy findings were misleading, complicating the initial diagnosis.
  • Metagenomic next-generation sequencing (mNGS) provided a rapid diagnosis with a 13-hour turnaround time.

Key Points:

  • Metagenomic next-generation sequencing (mNGS) facilitated expedited clinical medication adjustments.
  • Extracorporeal membrane oxygenation (ECMO) provided critical cardiorespiratory support.
  • The patient's vital signs gradually stabilized following targeted anti-infective therapy.

Conclusions:

  • Rapid mNGS application, timely medication adjustments, strong ECMO support, and family compliance were vital for patient recovery.
  • Potential for false-negative or false-positive mNGS results necessitates careful interpretation.
  • Anti-infective medication adjustments require a comprehensive review of the patient's overall clinical status and other diagnostic indicators.
Keywords:
case reportcommunity-acquired pneumoniaextracorporeal membrane oxygenationinfluenzametagenomic next-generation sequencingpathogen detection

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