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[Application of metagenomic next-generation sequencing technology in preterm infants with sepsis following antibiotic

Chun-Yan Lou1, Yu-Ning Liu1, Xuan Zhang1

  • 1Department of Neonatology, Henan Provincial People's Hospital/Zhengzhou University People's Hospital, Zhengzhou 450003, China.

Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics
|May 27, 2024
PubMed
Abstract

Insights

Metagenomic next-generation sequencing (mNGS) offers a higher pathogen detection rate for sepsis in preterm infants than blood culture, even after antibiotic use. This advanced diagnostic tool aids in timely and effective treatment adjustments.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Sepsis is a critical concern in preterm infants, often complicated by prior antibiotic exposure.
  • Accurate etiological diagnosis is essential for guiding appropriate antimicrobial therapy in this vulnerable population.
  • Traditional diagnostic methods like blood culture have limitations, especially in infants receiving antibiotics.

Purpose of the Study:

  • To evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) for sepsis in preterm infants.
  • To compare the pathogen detection rates of mNGS versus blood culture in preterm infants with sepsis, particularly after antibiotic treatment.

Main Methods:

  • Retrospective analysis of 45 preterm infants diagnosed with sepsis.
  • All infants received at least 3 days of antibiotic treatment prior to testing.
  • Comparison of pathogen detection by blood culture and blood mNGS.

Main Results:

  • Blood mNGS demonstrated a significantly higher pathogen detection rate (44%) compared to blood culture (4%).
  • mNGS identified a diverse range of pathogens, including bacteria and fungi, irrespective of antibiotic treatment duration (>10 days or ≤10 days).
  • Treatment plan adjustments based on mNGS results led to an 85% effectiveness rate.

Conclusions:

  • Blood mNGS is a more sensitive diagnostic tool for identifying pathogens in preterm infants with sepsis, even post-antibiotic exposure.
  • The effectiveness of mNGS is not diminished by the duration of prior antibiotic use.
  • mNGS should be considered for etiological diagnosis when clinical suspicion of sepsis is high, but blood cultures are negative.
Keywords:
AntibioticBlood cultureMetagenomic next-generation sequencing technologyPreterm infantSepsis

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