Metagenomic Next-Generation Sequencing for Pathogenic Diagnosis and Antibiotic Management of Severe Community-Acquired Pneumonia in Immunocompromised Adults
单位：[1]Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China[2]Department of Pulmonaryand Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China–JapanFriendship Hospital, Beijing, China
Background Metagenomic next-generation sequencing (mNGS) is a promising technique for pathogens diagnosis. However, application of mNGS in immunocompromised adults with severe community-acquired pneumonia (SCAP) is relatively limited. Methods We retrospectively reviewed 23 immunocompromised and 21 immunocompetent SCAP patients with mNGS detection from April 2019 to December 2019. The performances of pathogenic diagnosis and subsequently antibiotic adjustment in immunocompromised SCAP patients were compared to immunocompetent SCAP patients. The defined by days of therapy (DOT) method was used for estimate daily antibiotic use. Results There was a significant difference in the diagnostic positivity rate between mNGS and conventional test in both groups (P<0.001). Compared to immunocompetent patients, more mixed pathogens in immunocompromised patients were found (P=0.023). Before the availability of mNGS, the DOTs in immunocompromise patients were higher than immunocompetent patients (3.0 [3.0, 4.0] vs. 3.0 [2.0, 3.0], P=0.013). Compared to immunocompetent patients, immunocompromised patients had fewer full pathogen covered empirical antibiotic therapy (14.7% vs. 57.1%, P=0.022), more adjustments of antibiotic treatment (87.0%) vs. 57.1%, P=0.027). More than a half (13 of 23) SCAP patients in immunosuppressed group had reduced or downgraded antibiotic adjustments based on the results. Conclusions mNGS may be a useful technique for detecting mixed pathogens and personalized antibiotic treatment in immunocompromised SCAP patients.
基金：
National Key Research and Development Program of China [2016YFC1304300]; Capital Clinical Features Applied Research and Achievement Promotion Project of Beijing, China [Z161100000516116]; CAMS Innovation Fund for Medical Sciences [2018-I2M-1-003]; Non-profit Central Research Institute Fund of CAMS [2019TX320006]
第一作者单位：[1]Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[1]Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China[2]Department of Pulmonaryand Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, China–JapanFriendship Hospital, Beijing, China
推荐引用方式(GB/T 7714)：
Sun Ting,Wu Xiaojing,Cai Ying,et al.Metagenomic Next-Generation Sequencing for Pathogenic Diagnosis and Antibiotic Management of Severe Community-Acquired Pneumonia in Immunocompromised Adults[J].FRONTIERS in CELLULAR and INFECTION MICROBIOLOGY.2021,11:doi:10.3389/fcimb.2021.661589.
APA：
Sun, Ting,Wu, Xiaojing,Cai, Ying,Zhai, Tianshu,Huang, Linna...&Zhan, Qingyuan.(2021).Metagenomic Next-Generation Sequencing for Pathogenic Diagnosis and Antibiotic Management of Severe Community-Acquired Pneumonia in Immunocompromised Adults.FRONTIERS in CELLULAR and INFECTION MICROBIOLOGY,11,
MLA：
Sun, Ting,et al."Metagenomic Next-Generation Sequencing for Pathogenic Diagnosis and Antibiotic Management of Severe Community-Acquired Pneumonia in Immunocompromised Adults".FRONTIERS in CELLULAR and INFECTION MICROBIOLOGY 11.(2021)
