Use of metagenomic next-generation sequencing for diagnosis of peritonitis in end-stage liver disease

作者全名："He, Taiyu; Luo, Ning; Kang, Juan; Ling, Ning; Zhang, Dazhi"

作者地址："[He, Taiyu; Luo, Ning; Kang, Juan; Ling, Ning; Zhang, Dazhi] Chongqing Med Univ, Affiliated Hosp 2, Inst Viral Hepatitis, Minist Educ,Dept Infect Dis,Key Lab Mol Biol Infec, Chongqing, Peoples R China; [Zhang, Dazhi] Chongqing Med Univ, Affiliated Hosp 2, Inst Viral Hepatitis, Minist Educ,Dept Infect Dis,Key Lab Mol Biol Infec, 288 Tianwen Ave, Chongqing 401336, Peoples R China"

通信作者："Zhang, DZ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Inst Viral Hepatitis, Minist Educ,Dept Infect Dis,Key Lab Mol Biol Infec, 288 Tianwen Ave, Chongqing 401336, Peoples R China."

来源：INTERNATIONAL JOURNAL OF MEDICAL SCIENCES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001108635600012

JCR分区：Q1

影响因子：3.2

年份：2023

卷号：20

期号：13

开始页：1698

结束页：1704

文献类型：Article

关键词：Metagenomic next-generation sequencing; conventional methods; peritonitis; end-stage liver disease; diagnosis

摘要："Background: Conventional methods are low in positive rates and time-consuming for ascites pathogen detection in patients with end-stage liver disease (ESLD). With many advantages, metagenomic next-generation sequencing (mNGS) may be a good alternative method. However, the related studies are still lacking. Methods: Ascites from 50 ESLD patients were sampled for pathogen detection using mNGS and conventional methods (culture and polymorphonuclear neutrophils detection) in this prospective observational study. Results: Forty-two samples were detected positive using mNGS. 29 strains of bacteria, 11 strains of fungi, and 9 strains of viruses were detected. 46% of patients were detected to be co-infected with 2 or more pathogens by mNGS. Moreover, mNGS showed similar and high positive rates in ESLD patients with different clinical characteristics. Compared to conventional methods, mNGS had higher positivity rates (84% vs. 20%, P<0.001), sensitivity (45.2% vs. 23.8%, P=0.039), broader pathogen spectrum, shorter detection time (24 hours vs. 3-7 days), but lower specificity (25% vs 100%, P = 0.010). Furthermore, compared to conventional methods, mNGS showed similar consistence with final diagnosis (42% vs. 36%, P=0.539). Conclusions: mNGS may be a good supplement for conventional methods and helpful to early etiological diagnosis of peritonitis, and thus improve ESLD patients' survival."

基金机构：National Major Science and Technology Project of China [2017ZX10203202]

基金资助正文：<B>Funding</B> This work is supported by the National Major Science and Technology Project of China (2017ZX10203202) .