{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:44:01Z","timestamp":1772844241450,"version":"3.50.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"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>Introduction<\/jats:title><jats:p>Metagenomic next-generation sequencing (mNGS) is a novel technique for detecting pathogens. This retrospective study evaluated the diagnostic value of mNGS using plasma for infections in hematology patients and its impact on clinical treatment and prognosis in different subgroups of hematology patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 153 hematology patients with suspected infection who underwent mNGS using plasma were enrolled in the study. Their clinical histories, conventional microbiological test (CMT) results, mNGS results, treatment and prognosis were retrospectively analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 153 plasma samples, mNGS yielded a higher positivity rate than CMT (total: 88.24% vs. 40.52%, P&amp;lt;0.001; bacteria: 35.95% vs. 21.57%, P &amp;lt; 0.01; virus: 69.93% vs. 21.57%, P&amp;lt;0.001; fungi: 20.26% vs. 7.84%, P&amp;lt;0.01). mNGS had a higher positivity rate for bacteria and fungi in the neutropenia group than in the non-neutropenia group (bacteria: 48.61% vs. 24.69%, P&amp;lt;0.01; fungi: 27.78% vs. 13.58%, P&amp;lt;0.05). mNGS demonstrated a greater advantage in the group of patients with hematopoietic stem cell transplantation (HSCT). Both the 3-day and 7-day efficacy rates in the HSCT group were higher than those in the non-HSCT group (3-day: 82.22% vs. 58.65%, P &amp;lt; 0.01; 7-day: 88.89% vs. 67.31%, P &amp;lt; 0.01), and the 28-day mortality rate was lower in the HSCT group than in the non-HSCT group (6.67% vs. 38.89%, P &amp;lt; 0.000). The neutropenia group achieved similar efficacy and mortality rates to the non-neutropenia group (7-day efficiency rate: 76.39% vs. 71.43%, P &amp;gt; 0.05; mortality rate: 29.17% vs. 29.63%, P &amp;gt; 0.05) with more aggressive antibiotic adjustments (45.83% vs. 22.22%, P &amp;lt; 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>mNGS can detect more microorganisms with higher positive rates, especially in patients with neutropenia. mNGS had better clinical value in patients with hematopoietic stem cell transplantation (HSCT) or neutropenia, which had a positive effect on treatment and prognosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2024.1338307","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T04:29:30Z","timestamp":1706848170000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Application of plasma metagenomic next-generation sequencing improves prognosis in hematology patients with neutropenia or hematopoietic stem cell transplantation for infection"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuhui","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinjin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinai","family":"Gan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongzhao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Niu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"969","DOI":"10.3760\/cma.j.issn.0253-2727.2020.12.001","article-title":"Chinese guidelines for the clinical application of antibacterial drugs for agranulocytosis with fever (2020)","volume":"41","author":"Chinese Society of Hematology","year":"2020","journal-title":"Zhonghua xue ye xue za zhi= Zhonghua xueyexue zazhi"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27734","article-title":"Cell-free DNA next-generation sequencing successfully detects infectious pathogens in pediatric oncology and hematopoietic stem cell transplant patients at risk for invasive fungal disease","volume":"66","author":"Armstrong","year":"2019","journal-title":"Pediatr. Blood Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.3324\/haematol.2013.091025","article-title":"European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia","volume":"98","author":"Averbuch","year":"2013","journal-title":"Haematologica"},{"key":"B4","doi-asserted-by":"publisher","first-page":"479","DOI":"10.3760\/cma.j.issn.0253-2727.2023.06.006","article-title":"[A single-center study on the distribution and antibiotic resistance of pathogens causing bloodstream infection in patients with hematological Malignancies]","volume":"44","author":"Cai","year":"2023","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"B5","doi-asserted-by":"publisher","first-page":"4171","DOI":"10.1007\/s00520-019-04701-8","article-title":"Impact of time to antibiotic on hospital stay, intensive care unit admission, and mortality in febrile neutropenia","volume":"27","author":"Daniels","year":"2019","journal-title":"Support Care Cancer"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/microbiolspec.DMIH2-0026-2016","article-title":"Overview of infections in the immunocompromised host","volume":"4","author":"Dropulic","year":"2016","journal-title":"Microbiol. Spectr."},{"key":"B7","doi-asserted-by":"publisher","first-page":"29","DOI":"10.5847\/wjem.j.1920-8642.2021.01.005","article-title":"Effects of viral infection and microbial diversity on patients with sepsis: A retrospective study based on metagenomic next-generation sequencing","volume":"12","author":"Duan","year":"2021","journal-title":"World J. Emerg. Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.cmi.2023.05.034","article-title":"Clinical metagenomic sequencing of plasma microbial cell-free DNA for febrile neutropenia in patients with acute leukaemia","volume":"30","author":"Feng","year":"2024","journal-title":"Clin. Microbiol. Infect."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e56","DOI":"10.1093\/cid\/cir073","article-title":"Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america","volume":"52","author":"Freifeld","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"5425","DOI":"10.2147\/idr.S379582","article-title":"Metagenomic next-generation sequencing in the diagnosis of infectious fever during myelosuppression among pediatric patients with hematological and neoplastic diseases","volume":"15","author":"Fu","year":"2022","journal-title":"Infect. Drug Resist."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.02916-20","article-title":"Metagenomic sequencing as a pathogen-agnostic clinical diagnostic tool for infectious diseases: a systematic review and meta-analysis of diagnostic test accuracy studies","volume":"59","author":"Govender","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1038\/s41591-020-1105-z","article-title":"Rapid pathogen detection by metagenomic next-generation sequencing of infected body fluids","volume":"27","author":"Gu","year":"2021","journal-title":"Nat. Med."},{"key":"B13","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":"B14","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.ijid.2021.12.335","article-title":"mNGS for identifying pathogens in febrile neutropenic children with hematological diseases","volume":"116","author":"Guo","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1080\/21505594.2016.1156821","article-title":"Bloodstream infections in neutropenic cancer patients: A practical update","volume":"7","author":"Gustinetti","year":"2016","journal-title":"Virulence"},{"key":"B16","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1080\/1040841x.2019.1681933","article-title":"mNGS in clinical microbiology laboratories: on the road to maturity","volume":"45","author":"Han","year":"2019","journal-title":"Crit. Rev. Microbiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"766","DOI":"10.3760\/cma.j.issn.0253-2727.2022.09.009","article-title":"[Clinical application value of peripheral blood metagenomic next-generation sequencing test for patients with hematological diseases accompanied by fever]","volume":"43","author":"Hao","year":"2022","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e3876","DOI":"10.1093\/cid\/ciaa1639","article-title":"Liquid biopsy for invasive mold infections in hematopoietic cell transplant recipients with pneumonia through next-generation sequencing of microbial cell-free DNA in plasma","volume":"73","author":"Hill","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"B19","doi-asserted-by":"publisher","first-page":"567","DOI":"10.2147\/idr.S235182","article-title":"Metagenomic next-generation sequencing versus traditional pathogen detection in the diagnosis of peripheral pulmonary infectious lesions","volume":"13","author":"Huang","year":"2020","journal-title":"Infect. Drug Resist."},{"key":"B20","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1101\/cshperspect.a019638","article-title":"Mendelian genetics of human susceptibility to fungal infection","volume":"4","author":"Lionakis","year":"2014","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1978","DOI":"10.1038\/s41409-021-01243-8","article-title":"Metagenomic next-generation sequencing for identifying pathogens in central nervous system complications after allogeneic hematopoietic stem cell transplantation","volume":"56","author":"Liu","year":"2021","journal-title":"Bone Marrow Transplant."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.3390\/microorganisms9112309","article-title":"Clinical application of metagenomic next-generation sequencing in patients with hematologic Malignancies suffering from sepsis","volume":"9","author":"Liu","year":"2021","journal-title":"Microorganisms"},{"key":"B23","doi-asserted-by":"publisher","first-page":"S231","DOI":"10.1093\/cid\/ciy693","article-title":"Microbiological diagnostic performance of metagenomic next-generation sequencing when applied to clinical practice","volume":"67","author":"Miao","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"B24","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1469-0691.2009.02977.x","article-title":"The role of neutrophils in the development and outcome of zygomycosis in haematological patients","volume":"15","author":"Pagano","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"B25","doi-asserted-by":"publisher","first-page":"574.e571","DOI":"10.1016\/j.cmi.2017.02.006","article-title":"Untargeted next-generation sequencing-based first-line diagnosis of infection in immunocompromised adults: a multicentre, blinded, prospective study","volume":"23","author":"Parize","year":"2017","journal-title":"Clin. Microbiol. Infect."},{"key":"B26","doi-asserted-by":"publisher","first-page":"875","DOI":"10.3760\/cma.j.cn112138-20201228-01056","article-title":"[Pathogen distribution and antimicrobial resistance among lower respiratory tract infections in patients with hematological Malignancies]","volume":"60","author":"Ren","year":"2021","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"B27","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1086\/518873","article-title":"Polymicrobial infection in patients with cancer: an underappreciated and underreported entity","volume":"45","author":"Rolston","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1093\/bib\/bbac004","article-title":"Toward accurate diagnosis and surveillance of bacterial infections using enhanced strain-level metagenomic next-generation sequencing of infected body fluids","volume":"23","author":"Ruan","year":"2022","journal-title":"Brief Bioinform."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1177\/20499361211005600","article-title":"Infectious disease in hematopoietic stem cell transplantation","volume":"8","author":"Sahu","year":"2021","journal-title":"Ther. Adv. Infect. Dis."},{"key":"B30","doi-asserted-by":"publisher","first-page":"2103","DOI":"10.1007\/s40121-023-00850-w","article-title":"Metagenomic next-generation sequencing for pathogens in bronchoalveolar lavage fluid improves the survival of patients with pulmonary complications after allogeneic hematopoietic stem cell transplantation","volume":"12","author":"Shen","year":"2023","journal-title":"Infect. Dis. Ther."},{"key":"B31","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1093\/cid\/cix881","article-title":"Understanding the promises and hurdles of metagenomic next-generation sequencing as a diagnostic tool for infectious diseases","volume":"66","author":"Simner","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"B32","doi-asserted-by":"publisher","first-page":"928","DOI":"10.3760\/cma.j.cn112138-20220212-00104","article-title":"Application value of metagenomic next-generation sequencing for infectious pathogens in patients receiving allogeneic hematopoietic stem cell transplantation","volume":"61","author":"Sun","year":"2022","journal-title":"Zhonghua nei ke za zhi"},{"key":"B33","doi-asserted-by":"publisher","first-page":"4984","DOI":"10.1182\/blood-2022-165036","article-title":"The role of metagenomics next-generation sequencing (mNGS) in early diagnosis of bloodstream infection in hematologic patients with febrile neutropenia: A multicenter prospective study","volume":"140","author":"Sun","year":"2022","journal-title":"Blood"},{"key":"B34","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1093\/cid\/ciq245","article-title":"Decreased infection-related mortality and improved survival in severe aplastic anemia in the past two decades","volume":"52","author":"Valdez","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"B35","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.jinf.2022.11.020","article-title":"Utility of plasma cell-free DNA next-generation sequencing for diagnosis of infectious diseases in patients with hematological disorders","volume":"86","author":"Xu","year":"2022","journal-title":"J. Infection"},{"key":"B36","doi-asserted-by":"publisher","first-page":"4333","DOI":"10.2147\/idr.S333818","article-title":"Metagenomic next-generation sequencing for pulmonary fungal infection diagnosis: lung biopsy versus bronchoalveolar lavage fluid","volume":"14","author":"Yang","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.969126","article-title":"Comparing the application of mNGS after combined pneumonia in hematologic patients receiving hematopoietic stem cell transplantation and chemotherapy: A retrospective analysis","volume":"12","author":"Zhang","year":"2022","journal-title":"Front. Cell. Infection Microbiol."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.888398","article-title":"Application of next-generation sequencing in infections after allogeneic haematopoietic stem cell transplantation: A retrospective study","volume":"12","author":"Zhang","year":"2022","journal-title":"Front. Cell. Infection Microbiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"3549","DOI":"10.2147\/idr.S364525","article-title":"The value of metagenomic next-generation sequencing in hematological Malignancy patients with febrile neutropenia after empiric antibiotic treatment failure","volume":"15","author":"Zhang","year":"2022","journal-title":"Infection Drug Resistance"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1135460","article-title":"Clinical application value of metagenomic second-generation sequencing technology in hematologic diseases with and without transplantation","volume":"13","author":"Zhang","year":"2023","journal-title":"Front. Cell. Infection Microbiol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.cca.2022.10.008","article-title":"Metagenomic next-generation sequencing for the diagnosis of fever of unknown origin in pediatric patients with hematological Malignancy","volume":"537","author":"Zhang","year":"2022","journal-title":"Clinica Chimica Acta"},{"key":"B42","doi-asserted-by":"publisher","first-page":"718","DOI":"10.7499\/j.issn.1008-8830.2212059","article-title":"Value of metagenomic next-generation sequencing in children with hematological Malignancies complicated with infections","volume":"25","author":"Zhong","year":"2023","journal-title":"Zhongguo dang dai er ke za zhi = Chin. J. Contemp. Pediatr."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2024.1338307\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T04:29:41Z","timestamp":1706848181000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2024.1338307\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,2]]},"references-count":42,"alternative-id":["10.3389\/fcimb.2024.1338307"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2024.1338307","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,2]]},"article-number":"1338307"}}