Metagenomic next-generation sequencing (mNGS) for diagnostically challenging infectious diseases in patients with acute leukemia

Garnica, Márcia; Pierrotti, Lı́gia Camera; Oliveira, Paula Vanessa de; Mazzi, Mariana; Chebabo, Alberto

doi:10.1016/j.bjid.2021.101548

Cited by 12 publications

(3 citation statements)

References 12 publications

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“…While mNGS is a high-throughput, has short turnaround time, and has the accurate sequencing method that directly extracts all microbial DNA from clinical samples rather than cultures from the samples [ 8 ]. The mNGS test revealed Candida tropicalis in liver biopsy while the culture remained negative [ 14 ]. In case 2, the mNGS test revealed the presence of K. pneumoniae after 16 hours while blood culture showed CrKP after 4 days.…”

Section: Discussionmentioning

confidence: 99%

Metagenomic Next-Generation Sequencing (mNGS) for the Timely Diagnosis of Carbapenem-Resistant Klebsiella pneumoniae in Leukemia Patients

Tao

Hua

Chen

et al. 2022

Case Reports in Infectious Diseases

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This report shows the contribution of metagenomic next-generation sequencing (mNGS) as an alternative to challenging diagnostic infection in immunosuppressed individuals. Herein, we report two leukemia patients who developed severe infections due to carbapenem-resistant Klebsiella pneumoniae (CrKP). The mNGS can be strongly recommended as an alternative investigation for patients who are at high risk of infection without positivity on body fluid culture. This can provide the opportunity for adequate therapy.

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Section: Discussionmentioning

confidence: 99%

Metagenomic Next-Generation Sequencing (mNGS) for the Timely Diagnosis of Carbapenem-Resistant Klebsiella pneumoniae in Leukemia Patients

Tao

Hua

Chen

et al. 2022

Case Reports in Infectious Diseases

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“…Furthermore, unrecorded pathogens can be initially detected by mNGS, along with the identification of non-culturable pathogens (Ren et al, 2021;Tang et al, 2021;Bohl et al, 2022). In the future, mNGS technology could become the primary method of identifying, predicting, and preventing infectious diseases (Han et al, 2019;Garnica et al, 2021;Yu et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Application of metagenomic next-generation sequencing in cutaneous tuberculosis

Kang

Kong

et al. 2022

Front. Cell. Infect. Microbiol.

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Tuberculous infection in a skin wound is a rare but well-known condition. This study describes a child infected with tuberculosis after being wounded. Because of swelling and pain in his wrist tissue, he was admitted to the Affiliated Hospital of Jining Medical University of Shandong Province on 16 October 2021. His medical history only included a wound. He was discharged after debridement. The laboratory data were normal. Two months after surgery, his wound was still swollen and painful. Secretions from the wound were sent for metagenomic next-generation sequencing (mNGS), which revealed three reads related to the Mycobacterium tuberculosis complex group (MTBC). A diagnosis of cutaneous tuberculosis (TB) was made. The wound disappeared after anti-TB drugs were administered. This case demonstrates that, while TB presenting as a severe cutaneous wound is rare, it should be considered in the clinical diagnosis. Clinicians should also pay attention to extrapulmonary infection with MTBC in patients, particularly in some long-suffering patients, and identify the specific pathogen as soon as possible. mNGS could help to identify pathogens and facilitate early treatment, thereby improving the prognosis.

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“…Plasma metagenomic next-generation sequencing (mNGS) is a new, noninvasive blood test that can identify the cell-free DNA of over 1000 pathogens within 72 hours. 12 Prior reports have described the utility of plasma mNGS in diagnosing life-threatening, deep-seeded infections, particularly in immunocompromised children who have been treated with or remain on antimicrobial treatment [13][14][15][16] ; however, the diagnostic value and clinical utility of plasma mNGS compared to conventional testing are debated. 17 Additionally, the role of plasma mNGS in screening immunocompromised infants born in countries where BCG vaccination is offered at birth for disseminated BCG disease before SCT is unknown.…”

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confidence: 99%

Plasma Metagenomic Sequencing Expedites Diagnosis of Disseminated BCG in an Infant With IKBKB Mutation

Taylor

Nicholas

Satter

et al. 2022

Pediatric Infectious Disease Journal

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Background: Infants with inborn errors of immunity (IEI), born in countries where Bacillus-Calmette-Guerin (BCG) vaccination is recommended at birth, are at risk of developing infectious complications following vaccination. A prompt diagnosis of disseminated BCG infection in these infants is essential, as many will require stem cell transplantation (SCT) for the immunologic cure. In patients with IEI, the mortality risk from disseminated mycobacterial infection is high, both before and following SCT. Methods: A 7-month-old Qatari infant with an IEI, homozygous IKBKB gene mutation, was evaluated at our institution for SCT. He had a history of recurrent pneumonias, but pretransplant evaluation revealed negative cultures from bronchoalveolar fluid, blood and urine. At 8 months of age, the infant developed skin nodules of unclear etiology, prompting additional evaluation. Results: Given his profound immunosuppression and receipt of broadspectrum antimicrobials, plasma metagenomic next-generation sequencing (mNGS) was obtained and identified Mycobacterium tuberculosis complex within 72 hours. A skin biopsy was performed, and antimycobacterial therapy was initiated. Mycobacterium bovis-BCG was confirmed from cultures 3 weeks later. Treatment was complicated by elevated serum liver transaminases and aminoglycoside-associated high-frequency hearing loss. The infant completed 14 months of treatment from engraftment. Evaluation for active BCG infection after SCT was negative. Conclusion:In an infant with a unique IEI, plasma mNGS provided the first diagnosis of disseminated BCG infection. We believe that early initiation of antimycobacterial treatment improved the infant's clinical outcome. Plasma mNGS testing should be considered as a noninvasive screen for infectious pathogens in children with IEIs before SCT.

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Metagenomic next-generation sequencing (mNGS) for diagnostically challenging infectious diseases in patients with acute leukemia

Cited by 12 publications

References 12 publications

Metagenomic Next-Generation Sequencing (mNGS) for the Timely Diagnosis of Carbapenem-Resistant Klebsiella pneumoniae in Leukemia Patients

Metagenomic Next-Generation Sequencing (mNGS) for the Timely Diagnosis of Carbapenem-Resistant Klebsiella pneumoniae in Leukemia Patients

Application of metagenomic next-generation sequencing in cutaneous tuberculosis

Plasma Metagenomic Sequencing Expedites Diagnosis of Disseminated BCG in an Infant With IKBKB Mutation

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