Detection of potential pathogen in pancreatic fluid aspiration with metagenomic next-generation sequencing in patients with suspected infected pancreatic necrosis

Donghuang Hong; Peng Wang; Yingjie Chen; Jingzhu Zhang; Wendi Jiang; Bo Ye; Gang Li; Jing Zhou; Wenjian Mao; Zhihui Tong; Weiqin Li; Lu Ke

doi:10.1016/j.dld.2022.07.014

Detection of potential pathogen in pancreatic fluid aspiration with metagenomic next-generation sequencing in patients with suspected infected pancreatic necrosis

Dig Liver Dis. 2023 Feb;55(2):243-248. doi: 10.1016/j.dld.2022.07.014. Epub 2022 Aug 7.

Authors

Donghuang Hong¹, Peng Wang², Yingjie Chen³, Jingzhu Zhang², Wendi Jiang², Bo Ye², Gang Li², Jing Zhou², Wenjian Mao², Zhihui Tong², Weiqin Li⁴, Lu Ke⁵

Affiliations

¹ The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China.
² Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
³ Department of Critical Care Medicine, Jinjiang Hospital of Traditional Chinese Medicine, Jinjiang, China.
⁴ The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; National Institute of Healthcare Data Science, Nanjing University, Nanjing, China. Electronic address: liweiqindr@nju.edu.cn.
⁵ Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; National Institute of Healthcare Data Science, Nanjing University, Nanjing, China. Electronic address: ctgkelu@nju.edu.cn.

PMID: 35948458
DOI: 10.1016/j.dld.2022.07.014

Abstract

Background: Timely and accurate microbial diagnosis is important in managing patients with infected pancreatic necrosis (IPN).

Aims: To evaluate the diagnostic performance of Metagenomic next-generation sequencing (mNGS) in patients with suspected IPN.

Methods: The clinical data of 40 patients with suspected IPN who underwent CT-guided pancreatic fluid aspiration were retrospectively analyzed. Microbial culture and mNGS were simultaneously applied to identify the potential pathogens. The diagnostic performance of the mNGS was assessed by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results: The mNGS report can be obtained significantly earlier than culture methods (42 (36-62 h) vs. 60 (42-124 h), P = 0.032). Across all the study samples, seven species of bacteria and two species of fungi were reported accordingly to the culture results, while 22 species of bacteria and two species of fungi were detected by mNGS. The sensitivity, specificity, NPV, and PPV of mNGS were 88.0%, 100%, 83.33%, and 100%, respectively.

Conclusions: The diagnostic accuracy of mNGS in patients with suspected IPN is satisfactory. Moreover, mNGS may broaden the range of identifiable infectious pathogens and provide a more timely diagnosis.

Keywords: Acute necrotizing pancreatitis; Metagenomic next-generation sequencing (MNGS); Microbial culture; Pathogen.

MeSH terms

High-Throughput Nucleotide Sequencing
Humans
Pancreas
Pancreatitis, Acute Necrotizing* / diagnosis
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed