Table_1_The value of next-generation metagenomic sequencing in pathogen detection of pleural effusions and ascites from children with sepsis.xlsx

ObjectiveTo investigate the diagnostic value of metagenomic next-generation sequencing (mNGS) using pleural effusion and ascites from children with sepsis.
MethodsIn this study, children with sepsis or severe sepsis and appeared pleural or peritoneal effusions were enrolled, of whom the pleural effusions or ascites and blood samples were conducted pathogen detection using both conventional and mNGS methods. The samples were divided into pathogen-consistent and pathogen-inconsistent groups based on the consistency of mNGS results from different sample types, and into exudate and transudate groups based on their pleural effusion and ascites properties. The pathogen positive rates, pathogen spectrum, consistency between different sample types, and clinical diagnosis consistency were compared between mNGS and conventional pathogen tests.
ResultsA total of 42 pleural effusions or ascites and 50 other type samples were collected from 32 children. The pathogen positive rate of the mNGS test was significantly higher than that of traditional methods (78.57% vs. 14.29%, P < 0.001) in pleural effusion and ascites samples, with a consistent rate of 66.67% between the two methods. Nearly 78.79% (26/33) of mNGS positive results of the pleural effusions and ascites samples were consistent with clinical evaluation, and 81.82% (27/33) of these positive samples reported 1-3 pathogens. The pathogen-consistent group outperformed the pathogen-inconsistent group in terms of consistency with respect to clinical evaluation (88.46% vs. 57.14%, P = 0.093), while there was no significant difference between the exudate and transudate groups (66.67% vs. 50.00%, P = 0.483).
ConclusionCompared to conventional methods, mNGS has great advantages in pathogen detection of pleural effusion and ascites samples. Moreover, consistent results of mNGS tests with different sample types provide more reference values in clinical diagnosis.

研究目的：本研究旨在探讨宏基因组二代测序（metagenomic next-generation sequencing，mNGS）应用于脓毒症患儿胸腔积液与腹腔积液的病原学诊断价值。

研究方法：本研究纳入确诊脓毒症或严重脓毒症且合并胸腔或腹腔积液的患儿，采集其胸腔积液、腹腔积液及血液样本，分别采用传统病原学检测方法与宏基因组二代测序（mNGS）进行病原体检测。根据不同样本类型的mNGS结果一致性，将样本分为病原体一致组与病原体不一致组；同时依据胸腔积液及腹腔积液的理化性质，分为渗出液组与漏出液组。比较mNGS与传统病原检测的病原体阳性率、病原体谱、不同样本间结果一致性及临床诊断契合度。

研究结果：本研究共纳入32例患儿，采集胸腔积液或腹腔积液样本42份、其他类型样本50份。在胸腔积液及腹腔积液样本中，mNGS检测的病原体阳性率显著高于传统检测方法（78.57% vs. 14.29%，P < 0.001），两种方法结果一致率为66.67%。胸腔积液及腹腔积液样本的mNGS阳性结果中，近78.79%（26/33）与临床评估结果相符，且81.82%（27/33）的阳性样本检出1~3种病原体。病原体一致组的临床评估契合度优于病原体不一致组（88.46% vs. 57.14%，P = 0.093）；而渗出液组与漏出液组间的临床契合度无显著统计学差异（66.67% vs. 50.00%，P = 0.483）。

研究结论：相较于传统病原检测方法，mNGS在胸腔积液及腹腔积液样本的病原体检测中具有显著优势。此外，基于不同样本类型的mNGS检测结果一致性可为临床诊断提供更具参考价值的依据。