Comprehensive evaluation of plasma microbial cell-free DNA sequencing for predicting bloodstream and local infections in clinical practice: a multicenter retrospective study

• Published in: Frontiers in cellular and infection microbiology 2024-01, Vol.13, p.1256099-1256099
• Main Authors: Pang, Feng, Xu, Wenbin, Zhao, Hui, Chen, Shuai, Tian, Yaxian, Fu, Juanjuan, You, Zhiqing, Song, Pingping, Xian, Qingjie, Zhao, Qigang, Wang, Chengtan, Jia, Xiuqin
• Format: Article
• Language: English
• Subjects: bloodstream infections; Cellular and Infection Microbiology; local infections; metagenomic next-generation sequencing (mNGS); plasma cell-free DNA (cfDNA); ROC curves
• ISSN: 2235-2988; 2235-2988
• DOI: 10.3389/fcimb.2023.1256099

Metagenomic next-generation sequencing (mNGS) of plasma cell-free DNA (cfDNA) shows promising application for complicated infections that cannot be resolved by conventional microbiological tests (CMTs). The criteria for cfDNA sequencing are currently in need of agreement and standardization. We performed a retrospective cohort observation of 653 patients who underwent plasma cfDNA mNGS, including 431 with suspected bloodstream infections (BSI) and 222 with other suspected systemic infections. Plasma mNGS and CMTs were performed simultaneously in clinical practice. The diagnostic efficacy of plasma mNGS and CMTs in the diagnosis of blood-borne and other systemic infections was evaluated using receiver operating characteristic (ROC) curves. The sensitivity and specificity of the two methods were analyzed based on the final clinical outcome as the gold standard. The mNGS test showed an overall positive rate of 72.3% (472/653) for detecting microorganisms in plasma cfDNA, with a range of 2 to 6 different microorganisms detected in 171 patient specimens. Patients with positive mNGS results were more immunocompromised and had a higher incidence of severe disease (P