Clinical Evaluation of a Metagenomics-Based Assay for Pneumonia Management
Clinical value of metagenomic next-generation sequencing (mNGS) in pneumonia management is still controversial. A prospective study was conducted to evaluate the clinical impact of PneumoSeq in 57 immunocompetent (ICO) and 75 immunocompromised (ICH) pneumonia patients. The value of PneumoSeq for bot...
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| Published in | Frontiers in microbiology Vol. 12; p. 751073 |
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| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Frontiers Media S.A
16.09.2021
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| Abstract | Clinical value of metagenomic next-generation sequencing (mNGS) in pneumonia management is still controversial. A prospective study was conducted to evaluate the clinical impact of PneumoSeq in 57 immunocompetent (ICO) and 75 immunocompromised (ICH) pneumonia patients. The value of PneumoSeq for both etiological and clinical impact investigation in pneumonia was assessed. Among the 276 potential pathogens detected with PneumoSeq in our cohort, 251 (90.9%) were cross-validated. Clinical diagnoses of the causative pathogens were obtained for 97 patients, 90.7% of which were supported by PneumoSeq. Compared to conventional testing, PneumoSeq suggested potentially missed diagnoses in 16.7% of cases (22/132), involving 48 additional pathogenic microorganisms. In 58 (43.9%) cases, PneumoSeq data led to antimicrobial treatment de-escalation (
n
= 12 in ICO,
n
= 18 in ICH) and targeted treatment initiation (
n
= 7 in ICO,
n
= 21 in ICH). The PneumoSeq assay benefited the diagnosis and clinical management of both ICH and ICO pneumonia patients in real-world settings. |
|---|---|
| AbstractList | Clinical value of metagenomic next-generation sequencing (mNGS) in pneumonia management is still controversial. A prospective study was conducted to evaluate the clinical impact of PneumoSeq in 57 immunocompetent (ICO) and 75 immunocompromised (ICH) pneumonia patients. The value of PneumoSeq for both etiological and clinical impact investigation in pneumonia was assessed. Among the 276 potential pathogens detected with PneumoSeq in our cohort, 251 (90.9%) were cross-validated. Clinical diagnoses of the causative pathogens were obtained for 97 patients, 90.7% of which were supported by PneumoSeq. Compared to conventional testing, PneumoSeq suggested potentially missed diagnoses in 16.7% of cases (22/132), involving 48 additional pathogenic microorganisms. In 58 (43.9%) cases, PneumoSeq data led to antimicrobial treatment de-escalation (n = 12 in ICO, n = 18 in ICH) and targeted treatment initiation (n = 7 in ICO, n = 21 in ICH). The PneumoSeq assay benefited the diagnosis and clinical management of both ICH and ICO pneumonia patients in real-world settings. Clinical value of metagenomic next-generation sequencing (mNGS) in pneumonia management is still controversial. A prospective study was conducted to evaluate the clinical impact of PneumoSeq in 57 immunocompetent (ICO) and 75 immunocompromised (ICH) pneumonia patients. The value of PneumoSeq for both etiological and clinical impact investigation in pneumonia was assessed. Among the 276 potential pathogens detected with PneumoSeq in our cohort, 251 (90.9%) were cross-validated. Clinical diagnoses of the causative pathogens were obtained for 97 patients, 90.7% of which were supported by PneumoSeq. Compared to conventional testing, PneumoSeq suggested potentially missed diagnoses in 16.7% of cases (22/132), involving 48 additional pathogenic microorganisms. In 58 (43.9%) cases, PneumoSeq data led to antimicrobial treatment de-escalation ( n = 12 in ICO, n = 18 in ICH) and targeted treatment initiation ( n = 7 in ICO, n = 21 in ICH). The PneumoSeq assay benefited the diagnosis and clinical management of both ICH and ICO pneumonia patients in real-world settings. Clinical value of metagenomic next-generation sequencing (mNGS) in pneumonia management is still controversial. A prospective study was conducted to evaluate the clinical impact of PneumoSeq in 57 immunocompetent (ICO) and 75 immunocompromised (ICH) pneumonia patients. The value of PneumoSeq for both etiological and clinical impact investigation in pneumonia was assessed. Among the 276 potential pathogens detected with PneumoSeq in our cohort, 251 (90.9%) were cross-validated. Clinical diagnoses of the causative pathogens were obtained for 97 patients, 90.7% of which were supported by PneumoSeq. Compared to conventional testing, PneumoSeq suggested potentially missed diagnoses in 16.7% of cases (22/132), involving 48 additional pathogenic microorganisms. In 58 (43.9%) cases, PneumoSeq data led to antimicrobial treatment de-escalation (n = 12 in ICO, n = 18 in ICH) and targeted treatment initiation (n = 7 in ICO, n = 21 in ICH). The PneumoSeq assay benefited the diagnosis and clinical management of both ICH and ICO pneumonia patients in real-world settings.Clinical value of metagenomic next-generation sequencing (mNGS) in pneumonia management is still controversial. A prospective study was conducted to evaluate the clinical impact of PneumoSeq in 57 immunocompetent (ICO) and 75 immunocompromised (ICH) pneumonia patients. The value of PneumoSeq for both etiological and clinical impact investigation in pneumonia was assessed. Among the 276 potential pathogens detected with PneumoSeq in our cohort, 251 (90.9%) were cross-validated. Clinical diagnoses of the causative pathogens were obtained for 97 patients, 90.7% of which were supported by PneumoSeq. Compared to conventional testing, PneumoSeq suggested potentially missed diagnoses in 16.7% of cases (22/132), involving 48 additional pathogenic microorganisms. In 58 (43.9%) cases, PneumoSeq data led to antimicrobial treatment de-escalation (n = 12 in ICO, n = 18 in ICH) and targeted treatment initiation (n = 7 in ICO, n = 21 in ICH). The PneumoSeq assay benefited the diagnosis and clinical management of both ICH and ICO pneumonia patients in real-world settings. |
| Author | Xie, Mingzhou Chen, Rongchang Li, Shaoqiang Cheng, Linling Li, Zhengtu Li, Xiaolei Xu, Teng Zhong, Nanshan He, Fusheng Zhan, Yangqing Guan, Wei-jie Ye, Feng |
| AuthorAffiliation | 3 Key Laboratory of Animal Gene Editing and Animal Cloning in Yunnan Province and College of Veterinary Medicine, Yunnan Agricultural University , Kunming , China 5 Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen Institute of Respiratory Diseases , Shenzhen , China 2 Vision Medicals Co., Ltd. , Guangzhou , China 4 Department of Thoracic Surgery, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou , China 1 State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease , Guangzhou , China |
| AuthorAffiliation_xml | – name: 2 Vision Medicals Co., Ltd. , Guangzhou , China – name: 1 State Key Laboratory of Respiratory Disease, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease , Guangzhou , China – name: 4 Department of Thoracic Surgery, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou , China – name: 3 Key Laboratory of Animal Gene Editing and Animal Cloning in Yunnan Province and College of Veterinary Medicine, Yunnan Agricultural University , Kunming , China – name: 5 Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen Institute of Respiratory Diseases , Shenzhen , China |
| Author_xml | – sequence: 1 givenname: Yangqing surname: Zhan fullname: Zhan, Yangqing – sequence: 2 givenname: Teng surname: Xu fullname: Xu, Teng – sequence: 3 givenname: Fusheng surname: He fullname: He, Fusheng – sequence: 4 givenname: Wei-jie surname: Guan fullname: Guan, Wei-jie – sequence: 5 givenname: Zhengtu surname: Li fullname: Li, Zhengtu – sequence: 6 givenname: Shaoqiang surname: Li fullname: Li, Shaoqiang – sequence: 7 givenname: Mingzhou surname: Xie fullname: Xie, Mingzhou – sequence: 8 givenname: Xiaolei surname: Li fullname: Li, Xiaolei – sequence: 9 givenname: Rongchang surname: Chen fullname: Chen, Rongchang – sequence: 10 givenname: Linling surname: Cheng fullname: Cheng, Linling – sequence: 11 givenname: Nanshan surname: Zhong fullname: Zhong, Nanshan – sequence: 12 givenname: Feng surname: Ye fullname: Ye, Feng |
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| Copyright | Copyright © 2021 Zhan, Xu, He, Guan, Li, Li, Xie, Li, Chen, Cheng, Zhong and Ye. Copyright © 2021 Zhan, Xu, He, Guan, Li, Li, Xie, Li, Chen, Cheng, Zhong and Ye. 2021 Zhan, Xu, He, Guan, Li, Li, Xie, Li, Chen, Cheng, Zhong and Ye |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Reviewed by: Bernard Joseph Hudson, New South Wales Health Pathology, Australia; Nicolas Leveque, University of Poitiers, France This article was submitted to Infectious Diseases, a section of the journal Frontiers in Microbiology These authors have contributed equally to this work Edited by: David Andes, University of Wisconsin-Madison, United States |
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| Title | Clinical Evaluation of a Metagenomics-Based Assay for Pneumonia Management |
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