AUTHOR=Wang Xiao , Zhang Huiye , Zhang Nan , Zhang Shan , Shuai Yanrong , Miao Xiaojuan , Liu Yilan , Qiu Ling , Ren Shihui , Lai Sihan , Han Ying , Yao Hao , Zhang Xupai , Fan Fangyi , Sun Haoping , Yi Hai 

TITLE=Application value of metagenomic next-generation sequencing in hematological patients with high-risk febrile neutropenia

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2024.1366908

DOI=10.3389/fcimb.2024.1366908

ISSN=2235-2988

ABSTRACT=<sec><title>Background</title><p>Metagenomic next-generation sequencing (mNGS) is a novel non-invasive and comprehensive technique for etiological diagnosis of infectious diseases. However, its practical significance has been seldom reported in the context of hematological patients with high-risk febrile neutropenia, a unique patient group characterized by neutropenia and compromised immune responses.</p></sec><sec><title>Methods</title><p>This retrospective study evaluated the results of plasma cfDNA sequencing in 164 hematological patients with high-risk febrile neutropenia. We assessed the diagnostic efficacy and clinical impact of mNGS, comparing it with conventional microbiological tests.</p></sec><sec><title>Results</title><p>mNGS identified 68 different pathogens in 111 patients, whereas conventional methods detected only 17 pathogen types in 36 patients. mNGS exhibited a significantly higher positive detection rate than conventional methods (67.7% <italic>vs</italic>. 22.0%, <italic>P</italic> &lt; 0.001). This improvement was consistent across bacterial (30.5% <italic>vs</italic>. 9.1%), fungal (19.5% <italic>vs</italic>. 4.3%), and viral (37.2% <italic>vs</italic>. 9.1%) infections (<italic>P</italic> &lt; 0.001 for all comparisons). The anti-infective treatment strategies were adjusted for 51.2% (84/164) of the patients based on the mNGS results.</p></sec><sec><title>Conclusions</title><p>mNGS of plasma cfDNA offers substantial promise for the early detection of pathogens and the timely optimization of anti-infective therapies in hematological patients with high-risk febrile neutropenia.</p></sec>