Abstract
Background: Sepsis remains a common but fatal complication among patients with immune suppression. We aimed to investigate the performance of metagenomic next-generation sequencing (mNGS) compared with standard microbiological diagnostics in patients with hematologic malignancies. Methods: We performed a prospective study from June 2019 to December 2019. Adult patients with hematologic malignancies and a clinical diagnosis of sepsis were enrolled. Conventional diagnostic methods included blood cultures, serum galactomannan for Aspergillus, cryptococcal antigen and cytomegalovirus (CMV) viral loads. Blood samples for mNGS were collected within 24 h after hypotension developed. Results: Of 24 patients enrolled, mNGS and conventional diagnostic methods (blood cultures, serology testing and virus RT-PCR) reached comparable positive results in 9 cases. Of ten patients, mNGS was able to identify additional pathogens compared with conventional methods; most of the pathogens were virus. Conclusion: Our results show that mNGS may serve as adjunctive diagnostic tool for the identification of pathogens of hematologic patients with clinically sepsis.
Highlights
Introduction iationsSeptic shock in patients with hematologic malignancies are common and could carry high risk for mortality [1]
The diagnosis of sepsis was based on the quick sequential organ failure assessment score from the 2016 international consensus for sepsis and septic shock [15]
Infectious disease physicians were consulted to visit the enrolled patients with an aim to exclude non-infectious processes, such as congestive heart failure, hypovolemia, and rheumatic or endocrine disorders. Only those who were documented with a body temperature of more than 38 degrees Celsius and an episode of systolic pressure below 100 mmHg were included in order to strengthen the diagnostic accuracy of sepsis
Summary
Introduction iationsSeptic shock in patients with hematologic malignancies are common and could carry high risk for mortality [1]. The limitations of conventional culture methodologies have challenged physicians to make a precise diagnosis and de-escalate antimicrobial agents appropriately. We aimed to investigate the performance of metagenomic next-generation sequencing (mNGS) compared with standard microbiological diagnostics in patients with hematologic malignancies. Adult patients with hematologic malignancies and a clinical diagnosis of sepsis were enrolled. Conventional diagnostic methods included blood cultures, serum galactomannan for Aspergillus, cryptococcal antigen and cytomegalovirus (CMV) viral loads. Results: Of 24 patients enrolled, mNGS and conventional diagnostic methods (blood cultures, serology testing and virus RT-PCR) reached comparable positive results in 9 cases. MNGS was able to identify additional pathogens compared with conventional methods; most of the pathogens were virus. Conclusion: Our results show that mNGS may serve as adjunctive diagnostic tool for the identification of pathogens of hematologic patients with clinically sepsis
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