The application of metagenomic next-generation sequencing in patients with infection or colonization caused by Lichtheimia species

Lihua Chen; Weiting Peng; Gongbin Lan; Guo Long; Honghui Yang; Yajing Xu; Ai Fu; Huimin Yi; Qiquan Wan

doi:10.3389/fcimb.2023.1103626

The application of metagenomic next-generation sequencing in patients with infection or colonization caused by Lichtheimia species

Front Cell Infect Microbiol. 2023 Mar 28:13:1103626. doi: 10.3389/fcimb.2023.1103626. eCollection 2023.

Authors

Lihua Chen¹, Weiting Peng², Gongbin Lan³, Guo Long⁴, Honghui Yang⁴, Yajing Xu⁵, Ai Fu⁶, Huimin Yi⁷, Qiquan Wan^{8

9}

Affiliations

¹ Department of Laboratory Medicine, The Third Xiangya Hospital, Central South University, Changsha, China.
² Xiangya School of Medicine, Central South University, Changsha, China.
³ Department of Transplant Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
⁴ Department of Respiratory and Critical Care Medicine, The Third Xiangya Hospital, Central South University, Changsha, China.
⁵ Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.
⁶ Department of Tuberculosis, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
⁷ Department of Surgical Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
⁸ Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha, China.
⁹ Engineering and Technology Research Center for Transplantation Medicine of National Health Comission, the Third Xiangya Hospital, Central South University, Changsha, China.

Abstract

Background: Mucormycosis is considered the fourth most common invasive fungal disease after candidiasis, aspergillosis and cryptococcosis. Lichtheimia species accounted for 5%-29% of all mucormycosis. However, available data on species-specific analysis of Lichtheimia infections are limited.

Methods: This study included nine patients hospitalized in five hospitals in two cities in south China with mucormycosis or colonization caused by Lichtheimia species, diagnosed mainly by metagenomic next-generation sequencing (mNGS). The corresponding medical records were reviewed, and the clinical data analyzed included demographic characteristics, site of infection, host factors and type of underlying disease, diagnosis, clinical course, management, and prognosis.

Results: In this study, nine patients with Lichtheimia infections or colonization had a recent history of haematological malignancy (33.3%), solid organ transplants (33.3%), pulmonary disease (22.2%), and trauma (11.1%) and were categorized as 11.1% (one case) proven, 66.7% (six cases) probable mucormycosis and 22.2% (two cases) colonization. Pulmonary mucormycosis or colonization was the predominant presentation in 77.8% of cases and mucormycosis caused by Lichtheimia resulted in death in four out of seven patients (57.1%).

Conclusion: These cases highlight the importance of early diagnosis and combined therapy for these sporadic yet life-threatening infections. Further studies on the diagnosis and control of Lichtheimia infection in China are required.

Keywords: Lichtheimia species; colonization; infection; metagenomic next-generation sequencing; mucormycosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Early Diagnosis
High-Throughput Nucleotide Sequencing
Humans
Invasive Fungal Infections*
Mucorales* / genetics
Mucormycosis* / diagnosis
Mucormycosis* / drug therapy
Mucormycosis* / microbiology

Grants and funding

This work was supported by the Science and Technology Department of Hunan Province, China (grant 2021JJ30997).