The Clinical Value of Metagenomic Next-Generation Sequencing in Pneumocystis jirovecii Pneumonia

被引:3
|
作者
Huang, Meng-Qi [1 ]
Zheng, Ting -Ting [1 ]
Wang, Xiao-Rong [1 ]
Xiang, Fei [1 ,2 ]
机构
[1] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Resp & Crit Care Med, Wuhan, Hubei, Peoples R China
[2] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Resp & Crit Care Med, 1277 Jiefang Ave, Wuhan 430022, Hubei, Peoples R China
来源
INFECTION AND DRUG RESISTANCE | 2024年 / 17卷
关键词
Pneumocystis jirovecii pneumonia; Pneumocystis jirovecii; clinical value; metagenomic next-generation sequencing; non-HIV; HEMATOLOGICAL MALIGNANCIES; ECIL GUIDELINES; DIAGNOSIS; INFECTION;
D O I
10.2147/IDR.S444571
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: The incidence of Pneumocystis jirovecii pneumonia (PJP) is increasing.Methods: 108 patients were analysed retrospectively at the Wuhan Union Hospital. The patients were classified into the PJP group or the P. jirovecii colonisation (PJC) group based on clinical diagnosis. Clinical data included demographics, laboratory examinations, treatment, and outcomes.Results: A notable difference in the fungal load was seen between two groups, with median reads of 3215.79 vs. 5.61 in two groups, respectively (P<0.001). The optimal threshold value for discriminating P. jirovecii infection between colonisation for mNGS was six, and serum (1,3)-beta-D-glucan (BDG) was 47.6 pg/mL. Besides, the positive detection rate of mNGS for co-pathogens in PJP patients was significantly higher than that of culture (88.16% vs. 22.37%, P<0.0001). Epstein-Barr virus and cytomegalovirus were the most common pathogens of co-infection in PJP patients. The antibiotic therapy in PJP patients was adjusted according to the mNGS results, of which seventeen (22.37%) were downgraded, 38 (50.0%) patients were upgraded, and 21 (27.63%) were unchanged. And almost all patients showed significant improvement in C-reactive protein. Conclusion: mNGS is a promising and valuable technique with good performance for differentiating P. jirovecii infection and colonisation, the detection of pathogens, and antibiotic treatment.
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页码:69 / 80
页数:12
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