Metagenomic Next-Generation Sequencing Assists in the Diagnosis of Mediastinal Aspergillus fumigatus Abscess in an Immunocompetent Patient: A Case Report and Literature Review

Deng, Wusheng; Jiang, Yun; Qin, Jiaoxia; Chen, Gang; Lv, Yongjie; Lei, Yanmei; Luo, Jing; Hong, Kangkang; Bi-rong, Huang; Qin, Luhai; Tang, Xiujia; Ye, Liumei; Dang, Yuhai; Wang, Chao; Long, Feiyang; Wang, Ke; Kong, Jinliang

doi:10.2147/idr.s399484

Cited by 9 publications

(7 citation statements)

References 38 publications

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“…In patients with normal immune function, Aspergillus fumigatus was identified through endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) tissue with mNGS. Histological analysis of mediastinal biopsy and tissue fungal culture also indicated Aspergillus fumigatus infection, confirming the detection of mNGS [29]. In an infant patient initially suspected of having a lung tumor, mNGS identified Aspergillus fumigatus in BALF as the causative agent.…”

Section: The Clinical Application Of Mngs In Pulmonary Aspergillosismentioning

confidence: 55%

Metagenomic Next-Generation Sequencing (mNGS) for the Diagnosis of Pulmonary Aspergillosis

Tang¹,

Bao²,

Zhong³

2023

Infectious Diseases

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The diagnosis of pulmonary aspergillosis is a critical step in initiating prompt treatment and improving patients’ prognosis. Currently, microbiological analysis of pulmonary aspergillosis involves fungal smear and culture, serum (1,3)-β-D-glucan (G) or galactomannan (GM) tests, and polymerase chain reaction (PCR). However, these methods have limitations. Recent studies have demonstrated that polymorphisms in pentraxin3 (PTX3), a soluble pattern recognition receptor, are associated with increased susceptibility to invasive aspergillosis. mNGS, a new microbial diagnostic method, has emerged as a promising alternative. It has high sensitivity in identifying pulmonary aspergillosis and can accurately distinguish species. Additionally, it outperforms other methods in detecting mixed infections and instructing the adjustment of antimicrobial treatments. As a result, mNGS has the potential to be adopted as the gold standard for the diagnosis of pulmonary aspergillosis.

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Section: The Clinical Application Of Mngs In Pulmonary Aspergillosismentioning

confidence: 55%

Metagenomic Next-Generation Sequencing (mNGS) for the Diagnosis of Pulmonary Aspergillosis

Tang¹,

Bao²,

Zhong³

2023

Infectious Diseases

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“…Peripheral blood mNGS assay has recently been adopted as a supplementary approach to detect infectious microorganisms (Deng et al, 2023). Yet no large sample size studies have comprehensively apprised the clinical values of this approach.…”

Section: Discussionmentioning

confidence: 99%

Blood metagenomics next-generation sequencing has advantages in detecting difficult-to-cultivate pathogens, and mixed infections: results from a real-world cohort

Qian,

Li,

Zhang

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundBlood is a common sample source for metagenomics next-generation sequencing (mNGS) in clinical practice. In this study, we aimed to detect the diagnostic value of blood mNGS in a large real-world cohorts.MethodsBlood mNGS results of 1,046 cases were collected and analyzed along with other laboratory tests. The capabilities and accuracy of blood mNGS were compared with other conventional approaches.ResultsBoth the surgical department and the intensive care unit had a positive rate of over 80% in blood mNGS. The positive rate of mNGS was consistent with clinical manifestations. Among the 739 positive samples, 532 were detected as mixed infections. Compared to pathogen cultures, the negative predictive value of blood mNGS for bacteria and fungi detection was 98.9% [95%CI, 96.9%-100%], with an accuracy rate of 89.39%. When compared with polymer chain reaction, the consistency rates of blood mNGS for virus identification were remarkably high.ConclusionsBlood mNGS have significant advantages in detecting difficult-to-cultivate bacteria or fungi, viruses, and mixed infections, which benefits patients of surgery department the most. Samples other than blood are recommended for mNGS test if a specific infection is suspected. The reporting threshold and reporting criteria of blood mNGS need to be optimized.

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“…mcfDNA has the potential to identify concurrent infections and unexpected etiological agents in undiagnosed patients, as was noted in a study by Hoenigl et al, wherein reports showed R. microsporus in patients suspected to have CAPA [ 83 ]. In one of the case reports, authors reached the diagnosis of mediastinal aspergillosis merely within a day of sample collection, which was two weeks before culture and five days before histopathological results [ 84 ]. Another study showed A. lentulus as the implicated pathogen, which is difficult to differentiate from A. fumigatus using conventional modalities but requires different antifungal therapy [ 85 ].…”

Section: Other Emerging Modalities Of Nucleic-acid-based Molecular Di...mentioning

confidence: 99%

Nucleic-Acid-Based Molecular Fungal Diagnostics: A Way to a Better Future

Gudisa,

Harchand,

Rudramurthy

2024

Diagnostics

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The world has seen a tremendous increase in the number of fungal infections during the past two decades. Recently, the World Health Organisation released the pathogen priority list for fungal infections, signifying the importance of these infections in the fields of research and public health. Microbiology laboratories demand an upgrade in the diagnostic system to keep up with the increased burden of these infections. Diagnosis of fungal infections using conventional techniques has always faced limitations in terms of specificity, sensitivity, and turnaround time. Although these methods are the core pillars of the diagnosis, there is an increased need for molecular approaches. Molecular techniques have revolutionised the field of fungal diagnostics. The diverse array of molecular techniques, including techniques like Polymerase Chain Reaction (PCR), have emerged as a cornerstone in fungal diagnostics. Molecular techniques have transformed fungal diagnostics, providing powerful tools for the rapid and accurate identification of pathogens. As these technologies continue to evolve, their integration into routine clinical practice holds the promise of improving patient outcomes through timely and targeted antifungal interventions. This review will cover the molecular approaches involved in fungal diagnostics, moving from the basic techniques to the advanced-level nucleic-acid-based molecular approaches providing a high throughput and decreased turnaround time for the diagnosis of serious fungal infections.

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Metagenomic Next-Generation Sequencing Assists in the Diagnosis of Mediastinal Aspergillus fumigatus Abscess in an Immunocompetent Patient: A Case Report and Literature Review

Cited by 9 publications

References 38 publications

Metagenomic Next-Generation Sequencing (mNGS) for the Diagnosis of Pulmonary Aspergillosis

Metagenomic Next-Generation Sequencing (mNGS) for the Diagnosis of Pulmonary Aspergillosis

Blood metagenomics next-generation sequencing has advantages in detecting difficult-to-cultivate pathogens, and mixed infections: results from a real-world cohort

Nucleic-Acid-Based Molecular Fungal Diagnostics: A Way to a Better Future

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