{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:26:19Z","timestamp":1783664779974,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Talaromycosis is an invasive endemic mycosis caused by the dimorphic fungus <jats:italic>Talaromyces marneffei<\/jats:italic> (<jats:italic>T. marneffei<\/jats:italic>, TM). It mainly affects immunodeficient patients, especially HIV-infected individuals, which causes significant morbidity and mortality. Culture-based diagnosis takes a long turnaround time with low sensitivity, leading to treatment delay. In this study, we aimed to evaluate the performance of Metagenomic Next-Generation Sequencing (mNGS) for the rapid diagnosis of talaromycosis in HIV-infected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospectively analysis was conducted in HIV-infected cases at Changsha First Hospital (China) from January 2021 to March 2022. Patients who underwent routine microbiological examination and mNGS testing in parallel were enrolled. The clinical final diagnosis was used as a reference standard, and cases were classified into the TM group (60 cases) and the non-TM group (148 cases). The clinical performances of mNGS were compared with culture and serum Galactomannan (GM). The mixed infections detected by mNGS were analyzed. The impact of mNGS detection on treatment was also investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sensitivity of mNGS test reached 98.3% (95% CI, 89.8-99.9), which was significantly higher than culture (66.7% [95% CI, 53.2-77.9], <jats:italic>P<\/jats:italic> &amp;lt; 0.001) and serum GM (83.3% [95% CI, 71.0-91.2], <jats:italic>P<\/jats:italic> &amp;lt; 0.05). The specificity of 98.6% (95% CI, 94.7-99.7) was similar to culture (100.0% [95% CI, 96.8-100.0], <jats:italic>P<\/jats:italic> = 0.156), and superior to serum GM (91.9% [95% CI, 85.9-95.5], <jats:italic>P<\/jats:italic> &amp;lt; 0.05). In bronchoalveolar lavage fluid (BALF) samples, the positive rate of mNGS was 97.6%, which was significantly higher than culture (28.6%, <jats:italic>P &amp;lt;<\/jats:italic>0.001). mNGS has excellent performance in the identification of mixed infection in TM group patients. <jats:italic>Cytomegalovirus<\/jats:italic>, <jats:italic>Epstein-Barr virus<\/jats:italic> and <jats:italic>Pneumocystis jirovecii<\/jats:italic> were the most common concurrent pathogens. In summary, 60.0% (36\/60) patients were added or adjusted to antimicrobial therapy after mNGS test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>mNGS is a powerful technique with high specificity and sensitivity for the rapid diagnosis of talaromycosis. mNGS of BALF samples may be a good option for early identification of <jats:italic>T. marneffei<\/jats:italic> in HIV-infected individuals with manifestations of infection. Moreover, mNGS shows excellent performance in mixed infection, which benefits timely treatment and potential mortality reduction.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2022.962441","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T07:39:30Z","timestamp":1666337970000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":26,"title":["Clinical performance of metagenomic next-generation sequencing for the rapid diagnosis of talaromycosis in HIV-infected patients"],"prefix":"10.3389","volume":"12","author":[{"given":"Yuhuan","family":"Mao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caili","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunying","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinwei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiliang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.3760\/cma.j.cn112138-20211006-00676","article-title":"Chinese Guidelines for diagnosis and treatment of HIV\/AIDS, (2021 edition)","volume":"60","year":"2021","journal-title":"Zhonghua. Nei. Ke. Za. Zhi."},{"key":"B2","doi-asserted-by":"publisher","first-page":"61","DOI":"10.13718\/j.cnki.xdzk.2020.07.005","article-title":"Expert consensus on the diagnosis and treatment of talaromycosis in AIDS patients in China","volume":"42","year":"2020","journal-title":"J. Southwest. University(Natural. Science)."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e97","DOI":"10.1186\/s12879-020-05526-1","article-title":"Laboratory maintenance and growth of talaromyces marneffei","volume":"56","author":"Andrianopoulos","year":"2020","journal-title":"Curr. Protoc. Microbiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1186\/s12879-020-05526-1","article-title":"Unusual disseminated talaromyces marneffei infection mimicking lymphoma in a non-immunosuppressed patient in East China: a case report and review of the literature","volume":"20","author":"Chen","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-022-00618-9","article-title":"Talaromyces marneffei Mp1p antigen detection may play an important role in the early diagnosis of talaromycosis in patients with acquired immunodeficiency syndrome","volume":"187","author":"Chen","year":"2022","journal-title":"Mycopathologia"},{"key":"B6","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1186\/s12879-021-06551-4","article-title":"Metagenomic next-generation sequencing for the early diagnosis of talaromycosis in HIV-uninfected patients: five cases report","volume":"21","author":"Chen","year":"2021","journal-title":"BMC Infect. Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s12879-020-05746-5","article-title":"The diagnostic value of metagenomic next rectanglegeneration sequencing in infectious diseases","volume":"21","author":"Duan","year":"2021","journal-title":"BMC Infect. Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1146\/annurev-pathmechdis-012418-012751","article-title":"Clinical metagenomic next-generation sequencing for pathogen detection","volume":"14","author":"Gu","year":"2019","journal-title":"Annu. Rev. Pathol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1111\/myc.12530","article-title":"Development and evaluation of a real-time polymerase chain reaction assay for the rapid detection of talaromyces marneffei MP1 gene in human plasma","volume":"59","author":"Hien","year":"2016","journal-title":"Mycoses"},{"key":"B10","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11046-012-9577-0","article-title":"Penicillium marneffei infection: an emerging disease in mainland China","volume":"175","author":"Hu","year":"2013","journal-title":"Mycopathologia"},{"key":"B11","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.cmi.2018.04.018","article-title":"Effects of talaromyces marneffei infection on mortality of HIV\/AIDS patients in southern China: a retrospective cohort study","volume":"25","author":"Jiang","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.21037\/atm-20-2274","article-title":"Diagnostic accuracy of metagenomic next-generation sequencing for active tuberculosis in clinical practice at a tertiary general hospital","volume":"8","author":"Jin","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.841674","article-title":"Clinical characteristics, laboratory findings, and prognosis in patients with talaromyces marneffei infection across various immune statuses","volume":"9","author":"Li","year":"2022","journal-title":"Front. Med. (Lausanne)."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e334","DOI":"10.1016\/s1473-3099(17)30303-1","article-title":"Fungal infections in HIV\/AIDS","volume":"17","author":"Limper","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1093\/mmy\/myz052","article-title":"Evaluation of quantitative real-time PCR and platelia galactomannan assays for the diagnosis of disseminated talaromyces marneffei infection","volume":"58","author":"Li","year":"2020","journal-title":"Med. Mycol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1093\/mmy\/myv068","article-title":"Whole blood nested PCR and real-time PCR amplification of talaromyces marneffei specific DNA for diagnosis","volume":"54","author":"Lu","year":"2016","journal-title":"Med. Mycol."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa502","article-title":"Occult talaromyces marneffei infection unveiled by the novel Mp1p antigen detection assay","volume":"7","author":"Ly","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"B18","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/s11046-021-00570-0","article-title":"Pulmonary talaromycosis: A window into the immunopathogenesis of an endemic mycosis","volume":"186","author":"Narayanasamy","year":"2021","journal-title":"Mycopathologia"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195569","article-title":"Accuracy of rapid diagnosis of talaromyces marneffei: A systematic review and meta-analysis","volume":"13","author":"Ning","year":"2018","journal-title":"PloS One"},{"key":"B20","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jinf.2021.01.029","article-title":"Metagenomic next-generation sequencing for the diagnosis of suspected pneumonia in immunocompromised patients","volume":"82","author":"Peng","year":"2021","journal-title":"J. Infect."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195596","article-title":"Development and characterization of an immunochromatographic test for the rapid diagnosis of talaromyces (Penicillium) marneffei","volume":"13","author":"Pruksaphon","year":"2018","journal-title":"PloS One"},{"key":"B22","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1186\/s12879-020-05260-8","article-title":"Burden of talaromyces marneffei infection in people living with HIV\/AIDS in Asia during ART era: a systematic review and meta-analysis","volume":"20","author":"Qin","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1909","DOI":"10.1097\/CM9.0000000000000345","article-title":"Determinants of prognosis in talaromyces marneffei infections with respiratory system lesions","volume":"132","author":"Qiu","year":"2019","journal-title":"Chin. Med. J. (Engl)."},{"key":"B24","doi-asserted-by":"publisher","first-page":"159","DOI":"10.3114\/sim.2011.70.04","article-title":"Phylogeny and nomenclature of the genus talaromyces and taxa accommodated in penicillium subgenus biverticillium","volume":"70","author":"Samson","year":"2011","journal-title":"Stud. Mycol."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.656194","article-title":"Case report: Metagenomic next-generation sequencing in diagnosis of talaromycosis of an immunocompetent patient","volume":"8","author":"Shi","year":"2021","journal-title":"Front. Med. (Lausanne)."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e330","DOI":"10.1093\/cid\/ciaa826","article-title":"Superiority of a novel Mp1p antigen detection enzyme immunoassay compared to standard BACTEC blood culture in the diagnosis of talaromycosis","volume":"73","author":"Thu","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"B27","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1128\/CMR.19.1.95-110.2006","article-title":"Penicillium marneffei infection and recent advances in the epidemiology and molecular biology aspects","volume":"19","author":"Vanittanakom","year":"2006","journal-title":"Clin. Microbiol. Rev."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028796","article-title":"Immunoassays based on penicillium marneffei Mp1p derived from pichia pastoris expression system for diagnosis of penicilliosis","volume":"6","author":"Wang","year":"2011","journal-title":"PloS One"},{"key":"B29","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1111\/hiv.13024","article-title":"Clinical epidemiology and outcome of HIV-associated talaromycosis in guangdong, China, during 2011-2017","volume":"21","author":"Ying","year":"2020","journal-title":"HIV Med."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0130376","article-title":"A clinical study of acquired immunodeficiency syndrome associated penicillium marneffei infection from a non-endemic area in China","volume":"10","author":"Zheng","year":"2015","journal-title":"PloS One"},{"key":"B31","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1186\/s12879-021-06063-1","article-title":"Gastrointestinal manifestations of talaromyces marneffei infection in an HIV-infected patient rapidly verified by metagenomic next-generation sequencing: a case report","volume":"21","author":"Zhou","year":"2021","journal-title":"BMC Infect. Dis."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.962441\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T07:39:34Z","timestamp":1666337974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.962441\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":31,"alternative-id":["10.3389\/fcimb.2022.962441"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2022.962441","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,21]]},"article-number":"962441"}}