Utility of targeted next-generation sequencing for the etiological diagnosis of Orientia tsutsugamushi infection

Background: Scrub typhus is a vector-borne disease caused by the Orientia tsutsugamushi (O. tsutsugamushi)which in a proportion of patients causes multiorgan involvement and death. Traditional technologies were limited to rapidly and successfully detecting O.tsutsugamushi due to poor specificity, especially in the condition of atypical symptoms. The technology of Targeted next-generation sequencing (tNGS) is a platform that can select and enrich specific regions before data enter the NGS pipeline amenable to finding the real pathogen.