Abstract
Background: Accurate identification of pathogens is essential for the diagnosis and control of infections. We aimed to compare the diagnostic performance of metagenomic next-generation sequencing (mNGS) and conventional detection methods (CDM) in lung transplant recipients (LTRs). Methods: We retrospectively analyzed 107 LTRs with suspected infection of pulmonary, blood, central nervous system or chest wall between March 2018 and November 2020. Bronchoalveolar lavage fluid and other body fluids were subject to pathogen detection by both mNGS and CDM. Results: Of the 163 specimens, 84 (51.5%) tested positive for both mNGS and culture, 19 (11.7%) of which were completely consistent, 44 (27.0%) were partially congruent, and 21 (12.9%) were discordant (kappa = .215; p = .001). Compared with CDM, mNGS detected a higher diversity of pathogens. Moreover, the turn-around time was significantly shorter for mNGS compared with culture (2.7 ± .4 vs. 5.5 ± 1.6 days, p < .001). As an auxiliary method, treatment strategies were adjusted according to mNGS findings in 31 cases (29.0%), including eight patients with non-infectious diseases, who were finally cured. Conclusion: mNGS can identify pathogens with a shorter turn-around time and therefore provide a more accurate and timely diagnostic information to ascertaining pulmonary infections. mNGS might have a role in differentiating infectious from non-infectious lung diseases in LTRs.
Highlights
Infection is the main cause of death in lung transplant recipients (LTRs), especially at the early postoperative stages [1, 2]
Infection is the predominant cause of death in lung transplant recipients, timely and accurate anti-infection schemes are vital to ensure the best possible treatment outcomes
It is difficult to detect some pathogens using conventional detection methods in clinical practice for various reasons, and conventional culture suffers from the limitations such as being time-consuming
Summary
Infection is the main cause of death in lung transplant recipients (LTRs), especially at the early postoperative stages [1, 2]. Compared with other solid organ transplant (SOT) recipients, LTRs are at significantly higher risk of acquiring infections because the lungs are constantly exposed to the atmospheric environment. This increased risk is further aggravated by the maintenance treatment with high-dose immunosuppressants, the impaired cough reflex, and the decreased mucociliary clearance especially at the early stage after lung transplantation [3, 4]. The timely and accurate initiation of anti-infective treatment is vital to the clinical outcomes, which depends on the rapid and accurate pathogen identification. We aimed to compare the diagnostic performance of metagenomic next-generation sequencing (mNGS) and conventional detection methods (CDM) in lung transplant recipients (LTRs)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
