Etiological diagnostic performance of probe capture-based targeted next-generation sequencing in bloodstream infection

Sishi Cai; Jianying Yuan; Yingzhen Li; Fengming Guo; Zengshun Lin; Hongyi Li; Qing Miao; Tingting Fang; Yuan Wu; Xiaodong Gao; Pei Li; Jun Liu; Chaohui Hu; Bijie Hu

doi:10.21037/jtd-24-400

Etiological diagnostic performance of probe capture-based targeted next-generation sequencing in bloodstream infection

J Thorac Dis. 2024 Apr 30;16(4):2539-2549. doi: 10.21037/jtd-24-400. Epub 2024 Apr 18.

Authors

Sishi Cai^#¹, Jianying Yuan^#², Yingzhen Li^#², Fengming Guo², Zengshun Lin², Hongyi Li², Qing Miao¹, Tingting Fang¹, Yuan Wu¹, Xiaodong Gao³, Pei Li⁴, Jun Liu², Chaohui Hu², Bijie Hu^{1

3}

Affiliations

¹ Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
² Guangzhou KingCreate Biotechnology Company Limited, Guangzhou, China.
³ Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai, China.
⁴ Guangzhou KingMed Diagnostics Group Company Limited, Guangzhou, China.

^# Contributed equally.

Abstract

Background: A rapid and precise etiological diagnosis is crucial for the effective treatment of bloodstream infection (BSI). In this study, the performance of probe capture-based targeted next-generation sequencing (tNGS) was compared to that of blood culture and metagenomic next-generation sequencing (mNGS) in detecting potential pathogens in patients with BSI.

Methods: A total of 80 patients with suspected BSI were prospectively enrolled from 24 November 2023 to 30 December 2023 at Zhongshan Hospital, Shanghai, China. All 80 participants underwent simultaneous blood culture, blood mNGS, and blood tNGS after admission when febrile, and the results were compared.

Results: Among the 80 participants, 11 were clinically diagnosed with noninfectious fever, and 69 were diagnosed with BSI. Blood tNGS had a higher sensitivity for the diagnosis of BSI than blood culture (91.3% vs. 23.2%, P<0.001) and blood mNGS (91.3% vs. 69.6%, P=0.001). There was no significant difference in specificity between blood mNGS and tNGS (81.8% vs. 100.0%, P=0.13). Blood tNGS demonstrated a faster turnaround time than blood culture and blood mNGS. In 22 (31.9%) patients with BSI, targeted adjustment of the anti-infectious therapy according to the blood tNGS results resulted in clinical improvement.

Conclusions: Blood tNGS may be a promising tool for detecting potential pathogens in patients with BSI. The application of blood tNGS for BSI could guide anti-infectious treatment strategies and might improve clinical outcomes.

Keywords: Probe capture-based targeted next-generation sequencing (probe capture-based tNGS); blood culture; bloodstream infection (BSI); diagnostic; metagenomic next-generation sequencing (mNGS).