Clinical analysis of metagenomic next-generation sequencing assay in the peripheral blood in patients with hematological condition and fever
Objective:To investigate the clinical application value of metagenomic next-generation sequencing(mNGS)test in patients of hematological diseases concomitant with fever.Methods:The clinical and laboratory data were reviewed in 48 hospitalized patients of hematological condition complicated with fever treated in the Hematology Department of our hospital between January 2022 and March 2023,and the factors affecting mNGS findings were analyzed.Results:The days of hospital stay were 7.50(2.00-25.25)before development of fever symptom in the 48 patients.The common sites of infection were lungs in 39 cases(81.25%).Multiple infections were seen in 6 cases(12.5%)and another 4 cases were involved in upper respiratory tract infection(8.3%).The median detection time by mNGS test was 2.00(2.00-3.00)days.Bacteria,fungi,viruses and rare pathogens were detected in 7(14.58%),10(20.83%),21(43.75%)and 1 case(2.08%),respectively.Eleven cases(22.92%)were mixed infections with 2 or more species of pathogens.The detection rate of common pathogens in the peripheral blood in mNGS test group was significantly higher than that in the blood culture group(P<0.001),and the median detection time by mNGS assay was significantly shorter compared to both blood and secretion cultures(P<0.05).CRP expression level was higher in the mNGS-positive group than in the negative group(P<0.05).Conclusion:The detection rate for virus and fungi is high by mNGS test in the peripheral blood of patients with hematological diseases complicated with fever,and the proportion of mixed infections appears higher in this group of patients as well.Compared with conventional culturing methods,mNGS is more efficient and sensitive,suggesting that this assay can be recommended for clinical application in patients of hematological condition concomitant with fever.