Case Report: Metagenomic next-generation sequencing assists in dynamic pathogen monitoring: powerful tool for progressing severe pneumonia

Frontiers in Cellular and Infection Microbiology

Cellular and Infection Microbiology

Zhigang Ren¹  Xiaoxu Ma²  Yaoguang Li³  Jun Lei³ 

[1] Department of Infectious Disease, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;Department of Respiration, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;Department of Infectious Disease, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;

关键词: metagenomic next-generation sequencing;    pathogen detection;    influenza;    community-acquired pneumonia;    extracorporeal membrane oxygenation;    case report;   

DOI  :  10.3389/fcimb.2023.1230813

 received in 2023-05-29, accepted in 2023-08-16,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundSevere community-acquired pneumonia (sCAP) is life-threatening and characterized by intensive care unit (ICU) admission and high mortality. And they are vulnerable to hospital-acquired infection. In such a severe condition, metagenomic next-generation sequencing (mNGS) outperforms for short turnaround time and broad detection spectrum.Case presentationA 15-year-old male with severe influenza and methicillin-resistant Staphylococcus aureus (MRSA) pneumonia progressed rapidly, initially misdiagnosed as influenza co-infected with Aspergillus for misleading bronchoscopy manifestations. The turnaround time of mNGS is 13 h, which has the potential to expedite the clinical medication process. With the powerful support of mNGS and extracorporeal membrane oxygenation (ECMO), anti-infective therapy was adjusted accordingly, and vital signs gradually stabilized. After tortuous treatment and unremitting efforts, the patient recovered well.ConclusionsRapid mNGS applications, timely medication adjustments, strong ECMO support and active family compliance contribute to this miracle of life. False-negative or false-positive results are alarming, anti-infective medications should be adjusted after a comprehensive review of physical status and other indicators.

【 授权许可】

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Copyright © 2023 Li, Lei, Ren and Ma