Frontiers in microbiology · 2026
Application and evaluation of nanopore targeted sequencing in the detection of bacterial and fungal pathogens in leukemia bloodstream infections.
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Yao Qian, Tang Ling, Jiang Daozi, Wang Ming
Аннотация
OBJECTIVE: To evaluate the diagnostic performance and clinical impact of microbial nanopore-targeted sequencing (NTS) technology on pathogenic microorganisms in leukemia patients.
METHODS: In this retrospective observational study, we recruited 206 patients to study the effectiveness of NTS in the identification of infectious pathogens. The detection performance of NTS was compared with that of blood culture (BC).
RESULTS: The positive rate of NTS was significantly higher than that of BC [62.62% (129/206 cases) vs. 3.88% (8/206 cases)]. Compared with BC, the positive and negative percentage agreement of NTS were 87.50% (95%CI: 47.35-99.68%), (7 of 8 cases) and 38.38% (95%CI: 31.52-45.60%), (76 of 198 cases), respectively. The sensitivity of NTS for diagnosing bloodstream infections was 65.32% (95%CI: 56.21-73.69%), (81/124), which was significantly higher than BC [6.45% (95%CI: 2.84-12.13%), (8/124)], P < 0.001. The specificity of NTS was 41.46% (95%CI: 30.17-53.52%%), (34/82), and that of BC was [100%(95%CI: 95.56-100.00%) (82/82)]. The medication of 32 participants (24.81% [32/129]) was modified by NTS results. Among 206 participants, 29 cases who adjusted their medication based on NTS results showed improved clinical outcomes.
CONCLUSION: NTS increases pathogen-detection yield but has low specificity and can be used as an adjunctive diagnostic method for leukemia BSI.
METHODS: In this retrospective observational study, we recruited 206 patients to study the effectiveness of NTS in the identification of infectious pathogens. The detection performance of NTS was compared with that of blood culture (BC).
RESULTS: The positive rate of NTS was significantly higher than that of BC [62.62% (129/206 cases) vs. 3.88% (8/206 cases)]. Compared with BC, the positive and negative percentage agreement of NTS were 87.50% (95%CI: 47.35-99.68%), (7 of 8 cases) and 38.38% (95%CI: 31.52-45.60%), (76 of 198 cases), respectively. The sensitivity of NTS for diagnosing bloodstream infections was 65.32% (95%CI: 56.21-73.69%), (81/124), which was significantly higher than BC [6.45% (95%CI: 2.84-12.13%), (8/124)], P < 0.001. The specificity of NTS was 41.46% (95%CI: 30.17-53.52%%), (34/82), and that of BC was [100%(95%CI: 95.56-100.00%) (82/82)]. The medication of 32 participants (24.81% [32/129]) was modified by NTS results. Among 206 participants, 29 cases who adjusted their medication based on NTS results showed improved clinical outcomes.
CONCLUSION: NTS increases pathogen-detection yield but has low specificity and can be used as an adjunctive diagnostic method for leukemia BSI.