Early detection of gram‑negative bacteria using metagenomic next‑generation sequencing in acute respiratory distress syndrome: A case report

Abstract

Metagenomic next-generation sequencing (mNGS) is an effective method that can be used for the identification of early pathogens in patients with suspected severe pneumonia. However, the potential of mNGS for evaluating the prognosis of acute respiratory distress syndrome (ARDS) in patients with severe pneumonia remains unclear. In the present report, hospital-acquired gram-negative bacteria infections were detected in a case using metagenomic next-generation sequencing (mNGS) in a sample of bronchoalveolar fluid. This was obtained from a 58-year-old male patient with traumatic wet lung after a neurosurgery. According to the results, of which the profiles of the resistance genes were detected by mNGS, drugs designed to control infection were adjusted, namely to polymyxin B (500,000 U/12 h), azithromycin (0.5 g/24 h) and ganciclovir (0.25 g/12 h). Following adjusting treatment for 8 days, the symptoms of lung infection and hypoxemia were markedly improved, resulting in the patient being transferred out of the intensive care unit 15 days after treatment. To conclude, observations from the present report suggest that mNGS is a useful method for the early identification of pathogens in patients with pneumonia caused by ARDS. However, further studies are required to identify the complementary role of mNGS in supporting conventional microbiological methods in routine clinical practice.

Higher diagnostic value of metagenomic next-generation sequencing in acute infection than chronic infection: a multicenter retrospective study

“…Various studies have proved the clinical value of mNGS for acute infectious patients. Some studies discussed the application of mNGS in acute viral encephalitis (Cao and Zhu, 2020 ), acute respiratory distress syndrome (Zhang et al, 2021 ; Wang et al, 2022 ), acute respiratory distress syndrome (Zhang et al, 2023 ) and other acute infectious diseases, demonstrating that mNGS is a promising tool for the diagnosis of acute disease caused by multiple infectious agents. mNGS represents a valuable supplementary tool to CM in order to rapidly determine etiological factors of various infections and guide treatment decision- making for patients (Xu et al, 2023 ).…”