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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1443057

Metagenomic Versus Targeted Next-generation Sequencing for Detection of Microorganisms in Bronchoalveolar Lavage Fluid among Renal Transplantation Recipients

Provisionally accepted
Huang Zhaoru Huang Zhaoru 1Bingxue Hu Bingxue Hu 2Jinfeng Li Jinfeng Li 1Min Feng Min Feng 1Zhigang Wang Zhigang Wang 1Fengxiang Huang Fengxiang Huang 1Huan Xu Huan Xu 2Liu Lei Liu Lei 1Wenjun Shang Wenjun Shang 1*
  • 1 First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
  • 2 Vision Medicals Co., Ltd, Guangzhou, China

The final, formatted version of the article will be published soon.

    Background: Metagenomic next-generation sequencing (mNGS) provides untargeted and unbiased pathogens detection, has been extensively applied for improving diagnosis of pulmonary infection. This study aimed to compare the clinical performance between mNGS and targeted NGS (tNGS) for microbial detection and identification in bronchoalveolar lavage fluid (BALF) from kidney transplantation recipients (KTRs).Methods: BALF samples with microbiological results from mNGS and conventional microbiological test (CMT) were included. For tNGS, samples were extracted, amplified by polymerase chain reaction with pathogen-specific primers, and sequenced on an Illumina Nextseq.Results: A total of 99 BALF from 99 KTRs, among which 93 were diagnosed as pulmonary infection, were analyzed. Compared with CMT, both mNGS and tNGS showed higher positive rate and sensitivity (P<0.001) for overall, bacterial and fungal detection. Although the positive rate for mNGS and tNGS was comparable, mNGS significantly outperformed tNGS in sensitivity (100% vs 93.55%, P<0.05), particularly for bacteria and virus (P<0.001). Moreover, the true positive rate for detected microbes of mNGS was superior over that of tNGS (73.97% vs 63.15%, P<0.05), and the difference was also significant when specific for bacteria (94.59% vs 64.81%, P<0.001) and fungi (93.85% vs 72.58%, P<0.01). Additionally, we found that differed from most microbes such as SARS-CoV-2, Aspergillus and EBV, who were predominantly detected from recipients underwent surgery over 3 years, Torque teno virus (TTV) were principally detected from recipients within 1-year post-transplant, and as post-transplantation time increased, the percentage of TTV positive declined.Although tNGS was inferior to mNGS owing to lower sensitivity and true positive rate in identifying respiratory pathogens among KTRs, both considerably outperformed CMT.

    Keywords: Kidney Transplantation, pulmonary infection, metagenomics Next-Generation Sequencing, mNGS, Targeted next-generation sequencing, tNGS, respiratory pathogens, Torque teno virus

    Received: 03 Jun 2024; Accepted: 01 Aug 2024.

    Copyright: © 2024 Zhaoru, Hu, Li, Feng, Wang, Huang, Xu, Lei and Shang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Wenjun Shang, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.