Metagenomic Next-Generation Sequencing for the Diagnosis of Pneumocystis jirovecii Pneumonia in Non-HIV-Infected Patients: A Retrospective Study
| العنوان: | Metagenomic Next-Generation Sequencing for the Diagnosis of Pneumocystis jirovecii Pneumonia in Non-HIV-Infected Patients: A Retrospective Study |
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| المؤلفون: | Jian An, Wenzhong Peng, Lu Bai, Yuanyuan Li, Juan Jiang, Pinhua Pan, Wei Yang, Yanhao Wu |
| المصدر: | Infectious Diseases and Therapy |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Microbiology (medical), medicine.medical_specialty, Concordance, Grocott's methenamine silver stain, Gastroenterology, Internal medicine, Diagnosis, medicine, Pneumocystis jirovecii, Immunodeficiency, Original Research, medicine.diagnostic_test, biology, business.industry, Retrospective cohort study, medicine.disease, biology.organism_classification, Pneumocystis jirovecii pneumonia, Staining, Pneumonia, Infectious Diseases, Bronchoalveolar lavage, Next-generation sequencing, Metagenomics, business |
| الوصف: | Introduction This study aimed to evaluate the utility of metagenomic next-generation sequencing (mNGS) for the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in non-human immunodeficiency virus-infected patients. Methods We conducted a retrospective study. A total of 60 non-human immunodeficiency virus-infected PJP patients and 134 patients diagnosed with non-PJP pneumonia were included. P. jirovecii and other co-pathogens identified by mNGS in bronchoalveolar lavage fluid and/or blood samples were analyzed. Using clinical composite diagnosis as the reference standard, we compared the diagnostic performance of mNGS in PJP with conventional methods, including Gomori methenamine silver staining and serum (1,3)-β-d-glucan. Modifications of antimicrobial treatment for PJP patients after the report of mNGS results were also reviewed. Results mNGS reached a sensitivity of 100% in diagnosing PJP, which was remarkably higher than Gomori methenamine silver staining (25.0%) and serum (1,3)-β-d-glucan (67.4%). The specificity of mNGS (96.3%) significantly surpassed serum (1,3)-β-d-glucan (81.4%). Simultaneous mNGS of bronchoalveolar lavage fluid and blood samples was performed in 21 out of 60 PJP patients, and it showed a concordance rate of 100% in detecting P. jirovecii. Besides, mNGS showed good performance in identifying co-pathogens of PJP patients, among which cytomegalovirus and Epstein-Barr virus were most commonly seen. Initial antimicrobial treatment was modified in 71.7% of PJP patients after the report of mNGS results. Conclusion mNGS is a useful diagnostic tool with good performance for the diagnosis of PJP and the detection of co-pathogens. mNGS of bronchoalveolar lavage fluid and/or blood samples is suggested in patients with presumptive diagnosis of PJP. Blood samples may be a good alternative to bronchoalveolar lavage fluid for mNGS when bronchoscopic examination is not feasible. |
| تدمد: | 2193-6382 2193-8229 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8a74d3f479a22dc9ff9797e864a9d60bTest https://doi.org/10.1007/s40121-021-00482-yTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8a74d3f479a22dc9ff9797e864a9d60b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21936382 21938229 |
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