Potential clinical impact of metagenomic next-generation sequencing of plasma for cervical spine injury with sepsis in intensive care unit: A retrospective study

Clinical efficacy of metagenomic next-generation sequencing for the detection of pathogens in peritoneal dialysis-related peritonitis: a prospective cohort study

BACKGROUND

Metagenomic next-generation sequencing (mNGS) has been reported to improve pathogen identification in infectious diseases. This prospective cohort study aimed to explore the etiological diagnostic value of mNGS in peritoneal dialysis (PD)-related peritonitis.

METHODS

Patients with PD-related peritonitis were consecutively recruited at the Nephrology Department of Nanjing Drum Tower Hospital. PD effluent samples for mNGS and culture were collected simultaneously. The positive rate, detection time, and consistency of mNGS and culture were compared.

RESULTS

From August 1, 2021 to August 31, 2022, 38 patients with 41 episodes of PD-related peritonitis were enrolled. The positive rate of mNGS was higher than that of culture, although not statistically significant (92.7% vs 78.0%, P = 0.109). The average reporting time of mNGS was significantly shorter than that of culture (30.4 ± 10.5 vs 86.9 ± 22.2 h, P < 0.001). mNGS identified more co-pathogens and unusual pathogens than culture, with multiple pathogens being detected in nearly half of the samples. Among the 30 samples that tested positive by both methods, 27 (90%) showed completely (13 cases) or partly (14 cases) matched results between mNGS and culture. Fourteen patients (with 14 episodes of peritonitis) had used antibiotics within 2 weeks before specimen collection. Antibiotic usage led to a significant decrease in the culture-positive rate (57.1% vs 88.9%, P = 0.042), while the mNGS-positive rate remained unaffected (92.9% vs 92.6%, P = 1.000).

CONCLUSIONS

This study revealed that mNGS exhibited higher sensitivity and shorter reporting time compared to culture in detecting pathogens in PD-related peritonitis. For samples that yielded positive results by both methods, the consistency between mNGS and culture was substantial. mNGS may offer a novel approach for the etiological diagnosis of PD-associated peritonitis, particularly in cases involving prior antibiotic use and unusual pathogens.

Diagnostic Efficacy of Metagenomic Next-Generation Sequencing in Patients with Spinal Infections: A Retrospective Study

Purpose

Early diagnosis of spinal infections remains challenging, and emerging metagenomic next-generation sequencing (mNGS) technology holds promise in addressing this issue. The aim of this study is to investigate the diagnostic efficacy of mNGS in spinal infections.

Patients and Methods

A total of 78 cases with suspected spinal infections were enrolled in this study, all of whom underwent laboratory, histopathological and mNGS examinations upon admission. Lesion samples were obtained by surgical or C-arm-guided puncture. Sensitivity, specificity, positive predictive value and negative predictive value of culture and mNGS were calculated for statistical analysis.

Results

With histopathological results as the reference, the included 78 patients were categorized into 50 cases in the spinal infection group and 28 cases in the aseptic group. The sensitivity (84%) and negative predictive value (77.14%) of mNGS were significantly higher than those of culture (32% and 44.26%, respectively), whereas no significant differences were observed in terms of specificity and positive predictive value. In the subgroup analysis for Mycobacterium tuberculosis, the sensitivity of mNGS (90.91%) and T-spot (90.91%) was significantly higher than that of culture (0). Additionally, mNGS demonstrated markedly higher specificity (100%) compared to T-spot (85.07%).

Conclusion

This study underscores the substantial advantages of mNGS in terms of diagnostic accuracy and bacterial coverage for spinal infections. The findings provide compelling clinical evidence that supports the enhanced diagnostic efficacy of mNGS.