Application of Pathogen Targeted Second-Generation Sequencing(t-NGS)in Pathogen Diagnosis of Critically ill Patients
Objective:To evaluate the diagnostic utility of pathogen-targeted next-generation sequencing(t-NGS)for pathogen detection in critically ill patients.Methods:Seventy critically ill patients with suspected infections underwent metagenomic next-generation sequencing(m-NGS),pathogen-targeted next-generation sequencing(t-NGS),and traditional microbiological culture.The diagnostic performance of these methods was assessed against a composite clinical diagnosis.Results:In pathogen detection,m-NGS showed the highest detection rate(55.71%),followed by t-NGS(52.86%)and traditional culture(21.43%)(P<0.001).For diagnostic efficacy,t-NGS achieved a sensitivity of 81.82%,specificity of 89.19%,negative predictive value(NPV)of 84.62%,positive predictive value(PPV)of 87.10%,and an area under the curve(AUC)of 0.855(95%CI:0.785-0.952).m-NGS demonstrated a sensitivity of 90.91%,specificity of 89.19%,NPV of 91.67%,PPV of 88.24%,and an AUC of 0.900(95%CI:0.819-0.982).There was no statistically significant difference in diagnostic efficacy between t-NGS and m-NGS(P>0.05).Traditional culture,by comparison,had a sensitivity of 42.42%,specificity of 97.30%,NPV of 65.45%,PPV of 93.33%,and an AUC of 0.699(95%CI:0.572-0.826).The diagnostic efficacy of t-NGS was significantly superior to traditional culture(P<0.001),though the detection cycle of t-NGS was longer than that of m-NGS.Conclusion:Pathogen-targeted next-generation sequencing offers significant advantages over traditional culture in diagnosing infections in ICU patients.Its diagnostic performance is comparable to metagenomic next-generation sequencing,making it a valuable tool for pathogen identification in critically ill populations.
intensive care unitinfectious diseasesmetagenomic next-generation sequencingpathogen targeted next-generation sequencing
万方数据
维普
