Early diagnosis by mNGS could improve the prognosis for severe leptospirosis patients

Abstract

PurposesTo evaluate the diagnostic efficiency of metagenomics next generation sequencing (mNGS) assay in severe leptospirosis and its role on prognosis. Methods We retrospectively reviewed the medical records of patients with confirmed leptospirosis from Jan. 1, 2019 to Dec. 31, 2021 from three hospitals. Detailed data including socio-demographic data, clinical manifestations, laboratory examination results, CT images etc. were collected and analyzed. Results Six severe cases were included in this study. All were diagnosed by positive mNGS results. Three of the patients were also polymerase chain reaction examined and presented negative results. Five patients were diagnosed by mNGS assay within two or three days and antibiotics were down-graded to ceftriaxone in them. All of them were cured finally. One case, who was diagnosed by mNGS late on day 5, died. Conclusions mNGS is highly efficient in diagnosing leptospirosis and could possibly reduce the mortality rate if used at an early stage.