{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:55:13Z","timestamp":1789750513342,"version":"4.0.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"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:p>Mucormycosis is a lethal fungal infection disease with high mortality rate. However, investigations assessing the value of metagenomic next-generation sequencing (mNGS) for distinguishing <jats:italic>Mucorales<\/jats:italic> infection from colonization are currently insufficient. A retrospective analysis of clinical date from 71 patients at Sichuan Provincial People\u2019s Hospital from September 2021 to September 2024 was conducted. The performance of mNGS in distinguishing <jats:italic>Mucorales<\/jats:italic> infection from colonization, along with the differences in patients\u2019 characteristics, imaging characteristics, antimicrobial adjustment, and microbiota, were examined. Among the 71 patients, 51 were identified as <jats:italic>Mucorales<\/jats:italic> infection group (3 proven and 48 probable cases), and 20 were colonization group (possible cases). Receiver operating characteristic (ROC) curve for mNGS indicated an area under the curve of 0.7662 (95%CI: 0.6564-0.8759), with an optimal threshold value of 51 for discriminating <jats:italic>Mucorales<\/jats:italic> infection from colonization. The infection group exhibited a higher proportion of antimicrobial adjustments compared to the colonization group (64.71% <jats:italic>vs<\/jats:italic>. 35.00%, <jats:italic>P<\/jats:italic> &amp;lt; 0.05), with antifungal agent changed being more dominant (43.14% <jats:italic>vs<\/jats:italic>. 10.00%, <jats:italic>P<\/jats:italic> &amp;lt; 0.01). <jats:italic>Mucorales<\/jats:italic> RPTM value, length of hospital stays, hsCRP, immunocompromised, malignant blood tumor, and antifungal changed were significantly positively correlated with <jats:italic>Mucorales<\/jats:italic> infection. <jats:italic>Rhizomucor pusillus<\/jats:italic> showed significant differences between the two groups. The abundance of <jats:italic>Torque teno virus<\/jats:italic> significantly increased in the infection group, whereas the colonization group exhibited higher abundance of <jats:italic>Rhizomucor delemar<\/jats:italic>. mNGS is a valuable tool for differentiating colonization from infection of <jats:italic>Mucorales<\/jats:italic>. Malignant blood tumor, immunocompromised, length of hospital stays and hsCRP were significant different indicators between patients with <jats:italic>Mucorales<\/jats:italic> infection from colonization.<\/jats:p>","DOI":"10.3389\/fcimb.2025.1631960","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:32:50Z","timestamp":1758173570000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical performance of metagenomic next-generation sequencing for distinction and diagnosis of Mucorales infection and colonization"],"prefix":"10.3389","volume":"15","author":[{"given":"Xiaoli","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingai","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengkun","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiren","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1038\/s41564-018-0349-6","article-title":"Analytical and clinical validation of a microbial cell-free DNA sequencing test for infectious disease","volume":"4","author":"Blauwkamp","year":"2019","journal-title":"Nat. Microbiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1186\/s13059-014-0487-y","article-title":"Improved characterization of medically relevant fungi in the human respiratory tract using next-generation sequencing","volume":"15","author":"Bittinger","year":"2019","journal-title":"Genome Biol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1086\/430710","article-title":"Predictors of pulmonary zygomycosis versus invasive pulmonary aspergillosis in patients with cancer","volume":"41","author":"Chamilos","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1038\/s41576-019-0113-7","article-title":"Clinical metagenomics","volume":"20","author":"Chiu","year":"2019","journal-title":"Nat. Rev. Genet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e405","DOI":"10.1016\/S1473-3099(19)30312-3","article-title":"Global guideline for the diagnosis and management of mucormycosis: an initiative of the European confederation of medical mycology in cooperation with the mycoses study group education and research consortium","volume":"19","author":"Cornely","year":"2019","journal-title":"Lancet Infect. Diseases."},{"key":"B6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/1469-0691.12371","article-title":"ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013","volume":"20","author":"Cornely","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/1469-0691.12569","article-title":"European society of clinical microbiology and infectious diseases (ESCMID) fungal infection study group (EFISG) and European confederation of medical mycology (ECMM) 2013 joint guidelines on diagnosis and management of rare and emerging fungal diseases","volume":"20","author":"Cornely","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and update of the consensus definitions of invasive fungal disease from the European organization for research and treatment of cancer and the mycoses study group education and research consortium","volume":"71","author":"Donnelly","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1016\/S2213-2600(22)00259-4","article-title":"Lung epithelial and myeloid innate immunity in influenza-associated or COVID-19-associated pulmonary aspergillosis: an observational study","volume":"10","author":"Feys","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"B10","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":"B11","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":"B12","doi-asserted-by":"publisher","first-page":"742","DOI":"10.2214\/AJR.17.18792","article-title":"Pulmonary mucormycosis: radiologic features at presentation and over time","volume":"210","author":"Hammer","year":"2018","journal-title":"Am. J. Roentgenol."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1223576","article-title":"Diagnostic efficacy of metagenomic next generation sequencing in bronchoalveolar lavage fluid for proven invasive pulmonary aspergillosis","volume":"13","author":"Jia","year":"2023","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1345706","article-title":"Clinical performance of metagenomic next-generation sequencing for diagnosis of pulmonary aspergillus infection and colonization","volume":"14","author":"Jiang","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1016\/j.cmi.2021.02.005","article-title":"Serology anno 2021-fungal infections: from invasive to chronic","volume":"27","author":"Lass-Fl\u00f6rl","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"B16","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1093\/cid\/cit929","article-title":"The reversed halo sign: pathognomonic pattern of pulmonary mucormycosis in leukemic patients with neutropenia","volume":"58","author":"Legouge","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1375058","article-title":"Rhino-orbital-cerebral mucormycosis caused by Rhizopus arrhizus diagnosis via metagenomics next-generation sequencing: a case report","volume":"14","author":"Li","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2396570","DOI":"10.1080\/07853890.2024.2396570","article-title":"Epidemiology, pathogenesis, clinical characteristics, and treatment of mucormycosis: a review","volume":"56","author":"Liang","year":"2024","journal-title":"Ann. Med."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1322700","article-title":"Invasive Fusarium solani infection diagnosed by traditional microbial detection methods and metagenomic next-generation sequencing in a pediatric patient: a case report and literature review","volume":"11","author":"Ling","year":"2024","journal-title":"Front. Med."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.784236","article-title":"Clinical performance of BAL metagenomic next-generation sequence and serum (1,3)-\u03b2-d-glucan for differential diagnosis of Pneumocystis jirovecii pneumonia and Pneumocystis jirovecii colonisation","volume":"11","author":"Liu","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"S102","DOI":"10.1093\/cid\/ciaa1943","article-title":"Assessment of the role of 1,3-\u03b2-d-glucan testing for the diagnosis of invasive fungal infections in adults","volume":"72","author":"Lmoth","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1002\/rmv.668","article-title":"Human anelloviruses and the central nervous system","volume":"20","author":"Maggi","year":"2010","journal-title":"Rev. Med. Virol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1006\/bbrc.1997.7765","article-title":"A novel DNA virus (TTV) associated with elevated transaminase levels in posttransfusion hepatitis of unknown etiology","volume":"241","author":"Nishizawa","year":"1997","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1007\/s42770-024-01315-z","article-title":"Mucormycosis: a rare disease to notifiable disease","volume":"55","author":"Panda","year":"2024","journal-title":"Braz. J. Microbiol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"S77","DOI":"10.1093\/cid\/ciaa1765","article-title":"The evidence supporting the revised EORTC\/MSGERC definitions for invasive fungal infections","volume":"72","author":"Pappas","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"B26","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1086\/432579","article-title":"Epidemiology and outcome of zygomycosis: a review of 929 reported cases","volume":"41","author":"Roden","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3390\/jof4030090","article-title":"Therapy of mucormycosis","volume":"4","author":"Sipsas","year":"2018","journal-title":"J. Fungi."},{"key":"B28","doi-asserted-by":"publisher","first-page":"S93","DOI":"10.1093\/mmy\/myx101","article-title":"Challenges in the diagnosis and treatment of mucormycosis","volume":"56","author":"Skiada","year":"2018","journal-title":"Med. Mycol."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1398714","article-title":"A case report: comorbidity of rhinocerebral mucormycosis and pulmonary aspergillosis with challenging diagnosis","volume":"11","author":"Wang","year":"2024","journal-title":"Front. Med."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.03553-23","article-title":"Clinical impact of metagenomic next-generation sequencing of peripheral blood for the diagnosis of invasive mucormycosis: a single-center retrospective study","volume":"12","author":"Wang","year":"2024","journal-title":"Microbiol. Spectr."},{"key":"B31","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.ijid.2023.03.037","article-title":"Pulmonary scedosporiosis caused by Lomentospora prolificans in a patient who is immunocompetent: a rare case report","volume":"130","author":"Xing","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1210857","article-title":"Clinical performance of metagenomic next-generation sequencing for diagnosis of invasive fungal disease after hematopoietic cell transplant","volume":"14","author":"Zhang","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1368165","article-title":"Clinical features of pediatric mucormycosis: role of metagenomic next generation sequencing in diagnosis","volume":"14","author":"Zhang","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.985373","article-title":"Neurosyphilis with ocular involvement and normal magnetic resonance imaging results affirmed by metagenomic next-generation sequencing","volume":"12","author":"Zhou","year":"2022","journal-title":"Front. Cell. Infect. Microbiol."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1631960\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T05:32:51Z","timestamp":1758173571000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1631960\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":34,"alternative-id":["10.3389\/fcimb.2025.1631960"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2025.1631960","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]},"article-number":"1631960"}}