ArticleBMC infectious diseases2025
Application of metagenomic next-generation sequencing technology in hematologic malignancy patients with sepsis following antibiotic use.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMetagenomic next-generation sequencing (mNGS) has been widely applied in clinical pathogen detection; however, its utility in patients with hematologic malignancies complicated by sepsis after antibiotic therapy requires further investigation.
methodsA total of 119 patients with hematologic malignancies complicated by sepsis, who had received antibiotic treatment for ≥ 3 days without clinical improvement, were enrolled in the study. All patients underwent simultaneous blood culture and mNGS analysis. The diagnostic value of mNGS and its impact on optimizing anti-infective therapy were evaluated.
resultsFor the detection of bacterial and fungal pathogens, mNGS demonstrated a significantly higher positive rate compared to blood culture (89.36% vs. 25.53%). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of mNGS were 58.33%, 0.00%, 16.67%, and 0.00%, respectively. The overall agreement rate between the two methods was 13.21% (kappa = -0.202). Based on mNGS results, anti-infective treatment regimens were modified in 47 patients (39.49%). Granulocytopenia related to antitumor therapy was identified as a high-risk factor for polymicrobial infections (P < 0.05)
conclusionsPatients with hematologic malignancies and sepsis, particularly those with antitumor therapy-induced granulocytopenia, are at increased risk for polymicrobial infections. Blood mNGS offers a rapid and comprehensive approach to pathogen identification, showing significant potential for guiding anti-infective therapy in this patient population. CLINICAL TRIAL NUMBER: Not applicable.
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