AI Article Synopsis
- This study examines the diagnostic accuracy of metagenomic next-generation sequencing (mNGS) in plasma versus blood cell samples for diagnosing febrile diseases in immunocompromised children.
- Results showed that mNGS using plasma had a significantly higher positivity rate (84.4%) compared to blood cells (46.9%), but also a higher false-positive rate.
- Combining both sample types increased the detection rate of causative pathogens to 60.2%, but this enhanced sensitivity came at the cost of decreased specificity.
Article Abstract
Background: Metagenomic next-generation sequencing (mNGS) of plasma DNA has become an attractive diagnostic method for infectious diseases; however, the rate of false-positive results is high. This study aims to evaluate the diagnostic accuracy of mNGS in plasma versus blood cell samples for immunocompromised children with febrile diseases.
Methods: The results of conventional microbiological test (CMT) and mNGS using plasma and blood cells in 106 patients with 128 episodes of febrile diseases from the Department of Hematology/Oncology were analyzed and described.
Results: The positivity rates for CMT and mNGS of plasma and blood cells were 35.9 %, 84.4 % and 46.9 %, respectively (P < 0.001). Notably, mNGS identified multiple pathogens in a single specimen in 68.5 % of plasma samples and 38.3 % of blood cell samples (P < 0.001). Furthermore, plasma and blood cell mNGS identified causative pathogens in 58 and 46 cases, accounting for 53.7 % and 76.7 % of the mNGS-positive cases for each sample type, respectively (P = 0.002). By integrating results from both plasma and blood cell samples, causative pathogens were identified in 77 cases (60.2 %), enhancing sensitivity to 87.5 % but reducing specificity to 15.0 %, compared to plasma (65.9 % sensitivity and 20.0 % specificity) and blood cell samples (52.3 % sensitivity and 80.0 % specificity).
Conclusions: mNGS of plasma is sensitive but has a high false-positive rate, while mNGS of blood cells has low sensitivity but higher specificity.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152940 | PMC |
| http://dx.doi.org/10.1016/j.heliyon.2024.e31677 | DOI Listing |
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