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Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases

PURPOSE: To analyze the contribution of metagenomic next-generation sequencing (mNGS) in the guidance of clinical treatment and outcomes of infection during myelosuppression among children with hematological and neoplastic diseases. PATIENTS AND METHODS: The clinical data and results of mNGS assay o...

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Autores principales: Fu, Yang, Zhu, Xiaohua, Cao, Ping, Shen, Chen, Qian, Xiaowen, Miao, Hui, Yu, Yi, Wang, Hongsheng, Zhai, Xiaowen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482462/
https://www.ncbi.nlm.nih.gov/pubmed/36124109
http://dx.doi.org/10.2147/IDR.S379582
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author Fu, Yang
Zhu, Xiaohua
Cao, Ping
Shen, Chen
Qian, Xiaowen
Miao, Hui
Yu, Yi
Wang, Hongsheng
Zhai, Xiaowen
author_facet Fu, Yang
Zhu, Xiaohua
Cao, Ping
Shen, Chen
Qian, Xiaowen
Miao, Hui
Yu, Yi
Wang, Hongsheng
Zhai, Xiaowen
author_sort Fu, Yang
collection PubMed
description PURPOSE: To analyze the contribution of metagenomic next-generation sequencing (mNGS) in the guidance of clinical treatment and outcomes of infection during myelosuppression among children with hematological and neoplastic diseases. PATIENTS AND METHODS: The clinical data and results of mNGS assay of febrile patients suspected of infection were retrospectively collected. The characteristics of pathogenic microorganisms and clinical course of myelosuppressed children with hematological diseases were summarized. RESULTS: Our study included 70 patients (45 males) with a median age of 5 years (range: 0.5 to 13 y). During the study period, there were 96 events of suspected infection. According to comprehensive clinical diagnosis, 73 blood infections, 43 pneumonia and 2 urinary tract infections occurred. The positive rate of mNGS was significantly higher than that of traditional microbial detection (83.3% vs 17.7%). The main pathogens detected by mNGS were Pseudomonas aeruginosa, Acinetobacter, human herpesvirus, Candida and Aspergillus. The average duration of fever was 4.9 days and 11.6 days (P < 0.05), and the average cost of anti-infection treatment was RMB ¥28,077 and 39,898 (P < 0.05) among children received mNGS within 48 hours and more than 48 hours after the onset of infection symptoms. CONCLUSION: mNGS contributes to clinical management of children with infection during myelosuppression, especially among patients with negative traditional microbial detection. Early implementation of mNGS in children with symptoms has a tendency to reduce the time of infection, fever and the cost of treatment.
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spelling pubmed-94824622022-09-18 Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases Fu, Yang Zhu, Xiaohua Cao, Ping Shen, Chen Qian, Xiaowen Miao, Hui Yu, Yi Wang, Hongsheng Zhai, Xiaowen Infect Drug Resist Original Research PURPOSE: To analyze the contribution of metagenomic next-generation sequencing (mNGS) in the guidance of clinical treatment and outcomes of infection during myelosuppression among children with hematological and neoplastic diseases. PATIENTS AND METHODS: The clinical data and results of mNGS assay of febrile patients suspected of infection were retrospectively collected. The characteristics of pathogenic microorganisms and clinical course of myelosuppressed children with hematological diseases were summarized. RESULTS: Our study included 70 patients (45 males) with a median age of 5 years (range: 0.5 to 13 y). During the study period, there were 96 events of suspected infection. According to comprehensive clinical diagnosis, 73 blood infections, 43 pneumonia and 2 urinary tract infections occurred. The positive rate of mNGS was significantly higher than that of traditional microbial detection (83.3% vs 17.7%). The main pathogens detected by mNGS were Pseudomonas aeruginosa, Acinetobacter, human herpesvirus, Candida and Aspergillus. The average duration of fever was 4.9 days and 11.6 days (P < 0.05), and the average cost of anti-infection treatment was RMB ¥28,077 and 39,898 (P < 0.05) among children received mNGS within 48 hours and more than 48 hours after the onset of infection symptoms. CONCLUSION: mNGS contributes to clinical management of children with infection during myelosuppression, especially among patients with negative traditional microbial detection. Early implementation of mNGS in children with symptoms has a tendency to reduce the time of infection, fever and the cost of treatment. Dove 2022-09-13 /pmc/articles/PMC9482462/ /pubmed/36124109 http://dx.doi.org/10.2147/IDR.S379582 Text en © 2022 Fu et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Fu, Yang
Zhu, Xiaohua
Cao, Ping
Shen, Chen
Qian, Xiaowen
Miao, Hui
Yu, Yi
Wang, Hongsheng
Zhai, Xiaowen
Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases
title Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases
title_full Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases
title_fullStr Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases
title_full_unstemmed Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases
title_short Metagenomic Next-Generation Sequencing in the Diagnosis of Infectious Fever During Myelosuppression Among Pediatric Patients with Hematological and Neoplastic Diseases
title_sort metagenomic next-generation sequencing in the diagnosis of infectious fever during myelosuppression among pediatric patients with hematological and neoplastic diseases
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482462/
https://www.ncbi.nlm.nih.gov/pubmed/36124109
http://dx.doi.org/10.2147/IDR.S379582
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