Abstract
Bloodstream infection is a life-threatening complication in critically ill patients. Multi-drug resistant bacteria or fungi may increase the risk of invasive infections in hospitalized children and are difficult to treat in intensive care units. The purpose of this study was to use metagenomic next-generation sequencing (mNGS) to understand the bloodstream microbiomes of children with suspected sepsis in a pediatric intensive care unit (PICU). mNGS were performed on microbial cell-free nucleic acid from 34 children admitted to PICU, and potentially pathogenic microbes were identified. The associations of serological inflammation indicators, lymphocyte subpopulations, and other clinical phenotypes were also examined. mNGS of blood samples from children in PICU revealed potential eukaryotic microbial pathogens. The abundance of Pneumocystis jirovecii was positively correlated with a decrease in total white blood cell count and immunodeficiency. Hospital-acquired pneumonia patients showed a significant increase in blood bacterial species richness compared with community-acquired pneumonia children. The abundance of bloodstream bacteria was positively correlated with serum procalcitonin level. Microbial genome sequences from potential pathogens were detected in the bloodstream of children with suspected sepsis in PICU, suggesting the presence of bloodstream infections in these children.
Highlights
Pathogenic microbes, including conditional pathogenic microbes, can invade the bloodstream, where they grow and reproduce, resulting in bloodstream infections
Through an in-depth clinical evaluation, we found that a total of 18 children could be diagnosed with pneumonia, seven of which had community-acquired pneumonia (CAP) and six had hospital-acquired pneumonia (HAP)
We found that the abundance of EBV in children in the pediatric intensive care unit (PICU) was positively correlated with their lymphocyte subpopulations, including total white blood cell count (WBC), CD4+ T cell count, CD3+ T cell count, and CD8+ T cell count (Figure 3C and Supplementary Figure 1), but the virus was significantly and positively correlated with serum inflammation indicators, including C-reactive protein (CRP) and IL-6 levels
Summary
Pathogenic microbes, including conditional pathogenic microbes, can invade the bloodstream, where they grow and reproduce, resulting in bloodstream infections. Using the same technology, Li et al (2018) compared the bacterial nucleic acid sequences of the blood of healthy controls and severe acute pancreatitis (SAP) patients, and found that SAP patients showed a significant increase in the abundance of Bacteroides and Pachycephalus and a significant decrease in the abundance of Actinomycetes. Taken together, these studies indicate the presence of a microbiome in the blood, and identifying its composition may provide novel insights into the characteristics and diagnosis of sepsis in patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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.
