The clinical significance of metagenomics capture next generation sequencing dynamic detection in acute pancreatitis complicated by prolonged organ failure
SUN Ze-fang
ZHANG Yi-zhi
YU Yan
LI Jia-rong
GUO Rong
LIU Bai-qi
LIN Jia-yan
CAO Xin-tong
CHEN Lu
SHEN Ding-cheng
LIU Zhi-yong
ZHOU Jian-liang
HUANG Geng-wen
Abstract：Objective To evaluate the clinical utility of continuous dynamic testing using the Metagenomic Capture(MetaCAP)next-generation sequencing technique in severe acute pancreatitis(SAP)patients complicated by prolonged organ failure(Pro-OF).Methods A prospective analysis was conducted on 65 SAP patients with Pro-OF from Xiangya Hospital of Central South University and Hunan Medical College General Hospital between January 2024 and September 2025.All patients underwent weekly peripheral blood MetaCAP dynamic detection to assess its di-agnostic efficacy and prognostic value.Results Among the 65 Pro-OF patients,a total of 101 blood MetaCAP tests were performed,with a posi-tivity rate of 51.5％(52/101),significantly higher than the positivity rate of traditional blood culture(25.7％,P=0.005).The overall concordance rate between MetaCAP pathogen detection results and microbiological culture results from various sampling sites was 90.9％,with concordance rates of 85.2％and 67.9％for peripancreatic and respiratory specimens,respectively.When organ failure duration exceeded two weeks,the MetaCAP positivity rate surged from 27.5％to 61.1％,whereas white blood cell count,C-reactive protein,and procalcitonin levels showed no similar trends.In patients undergoing continuous MetaCAP dynamic monitoring,mortality was significantly higher in those with persistently positive results compared to those with persistently negative results(58.8％vs.11.1％,P=0.036).Conclusions In patients with SAP,prolonged duration of organ failure is associated with an increased risk of bloodstream infection(BSI),predominantly originating from peripancreatic and respiratory infections.Continuous dy-namic monitoring of blood samples using MetaCAP not only provides accurate guidance for clinical anti-infective therapy,but also holds significant prognostic value for SAP patients complicated with Pro-OF.
Keywords：severe acute pancreatitisprolonged organ failureperipancreatic infectioninfection detection
Publication Date：2025-10-01
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：6( 1155-1160 )