The application value of metagenomic next-generation sequencing in the pathogen diagnosis of severe infectious diseases in pediatric intensive care unit
Mo Lianqin
Huang Dong
Pan Feifei
Lou Lei
Cheng Xiaorong
Abstract：Objective To explore the application value of metagenomic next-generation sequencing(mNGS)in the pathogen diagnosis of severe infectious diseases in pediatric intensive care unit(PICU).Methods A retrospective analysis was conducted on 86 pediatric patients admitted to the PICU of Guizhou Provincial People's Hospital from October 2021 to July 2023,all of whom underwent microbial culture and mNGS for severe infections.In total,113 specimens were submitted for examination.The differences in pathogen detection rate and pathogenic characteristics between mNGS and microbial culture were compared.Results A total of 113 samples were collected from 86 children.The total pathogen detection rate of mNGS was higher than that of microbial culture method[68.1％(77/113)vs 23.9％(27/113)](P＜0.05).In peripheral blood,sputum and cerebrospinal fluid samples,the pathogen detection rates of mNGS were higher than those of microbial culture method[65.0％(26/40)vs 25.0％(10/40),97.1％(34/35)vs 28.6％(10/35),37.5％(9/24)vs 12.5％(3/24)](all P＜0.05).The most common infection type detected by mNGS was mixed infection(26.5％,30/113),followed by bacterial infection(20.4％,23/113)and viral infection(17.7％,20/113).The most common infection type detected by microbial culture method was bacterial infection(17.7％,20/113),followed by fungal infection(4.4％,5/113).The detection rates of mixed infection and virus infection by mNGS method were higher than those by microbial culture method(both P＜0.05).The detection rates of mNGS for 1 pathogen,2 pathogens,3 or more pathogens,1 type of pathogen(the number of categories refers to bacteria,fungi,viruses,and other 4 categories),and 2 types of pathogens are all higher than those of microbial culture methods(all P＜0.05).31.4％(27/86)of the children had their treatment adjusted based on the results of mNGS and benefited from it.Conclusion mNGS has a higher detection rate than microbial culture in the diagnosis of infectious diseases in PICU,and it has obvious advantages in mixed infections and viral infections,which can be used as a supplement to microbial culture and guide clinical treatment.
Keywords：Pediatric intensive care unitMetagenomic next-generation sequencingSevere infectious diseasesEtiologyChildren
Publication Date：2024-11-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1697-1701 )