The clinical application of metagenomic next-generation sequencing in neonatal sepsis / 中国新生儿科杂志

ABSTRACT

Objective:To study the clinical application of metagenomic next-generation sequencing (mNGS) on pathogen diagnosis and clinical management in neonatal sepsis.Methods:From January 2019 to February 2021, neonates suspected of sepsis receiving both mNGS and blood culture in our hospital were retrospectively reviewed. The effects of mNGS on pathogen detection, antibiotic choice and clinical management were analyzed.Results:A total of 35 neonates were included. Sepsis was confirmed in 24 neonates. 12 neonates had positive microbiology results (both mNGS and blood culture were positive in 3 cases, only mNGS positive in 8 cases and only blood culture positive in 1 case). mNGS showed higher positive rate than blood culture in patients with neonatal sepsis (45.8% vs. 16.7%, P=0.049). The concordance of mNGS and blood culture was 74.3%. 21 cases (60.0%) had antibiotics before testing and the positive rate showed no significant difference between mNGS and blood culture [19.0% (4/21) vs. 4.8% (1/21), P=0.343] in these patients. 14 cases didn't receive antibiotics before testing and the positive rate also showed no significant difference between mNGS and blood culture [28.6%(4/14) vs.21.4% (3/14), P=1.000]. 8.6% patients changed clinical treatment based on the mNGS results. Conclusions:mNGS increases pathogen detection in neonatal sepsis and is well consistent with blood culture. mNGS is useful in clinical practice.