{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T23:58:17Z","timestamp":1774396697690,"version":"3.50.1"},"reference-count":56,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006478","name":"German\u2013French cooperation project between the German Armed Forces Hospital Hamburg and the Military Hospital Laveran, Marseille","doi-asserted-by":"publisher","award":["36K2-S-45 1922"],"award-info":[{"award-number":["36K2-S-45 1922"]}],"id":[{"id":"10.13039\/501100006478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Molecular diagnostic approaches are increasingly included in the diagnostic workup and even in the primary diagnosis of malaria in non-endemic settings, where it is difficult to maintain skillful microscopic malaria detection due to the rarity of the disease. Pathogen-specific nucleic acid amplification, however, bears the risk of overlooking other pathogens associated with febrile illness in returnees from the tropics. Here, we assessed the discriminatory potential of metagenomic sequencing for the identification of different Plasmodium species with various parasitemia in EDTA blood of malaria patients. Overall, the proportion of Plasmodium spp.-specific sequence reads in the assessed samples showed a robust positive correlation with parasitemia (Spearman r = 0.7307, p = 0.0001) and a robust negative correlation with cycle threshold (Ct) values of genus-specific real-time PCR (Spearman r = \u22120.8626, p \u2264 0.0001). Depending on the applied bioinformatic algorithm, discrimination on species level was successful in 50% (11\/22) to 63.6% (14\/22) instances. Limiting factors for the discrimination on species level were very low parasitemia, species-depending lacking availability of reliable reference genomes, and mixed infections with high variance of the proportion of the infecting species. In summary, metagenomic sequencing as performed in this study is suitable for the detection of malaria in human blood samples, but the diagnostic detection limit for a reliable discrimination on species level remains higher than for competing diagnostic approaches like microscopy and PCR.<\/jats:p>","DOI":"10.3390\/ijms231911150","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T21:10:05Z","timestamp":1663881005000},"page":"11150","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Metagenomic Sequencing for the Diagnosis of Plasmodium spp. with Different Levels of Parasitemia in EDTA Blood of Malaria Patients\u2014A Proof-of-Principle Assessment"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8967-9528","authenticated-orcid":false,"given":"Hagen","family":"Frickmann","sequence":"first","affiliation":[{"name":"Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany"},{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9173-7072","authenticated-orcid":false,"given":"Felix","family":"Weinreich","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Loderst\u00e4dt","sequence":"additional","affiliation":[{"name":"Department of Hospital Hygiene & Infectious Diseases, University Medicine G\u00f6ttingen, 37075 Goettingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4873-249X","authenticated-orcid":false,"given":"Sven","family":"Poppert","sequence":"additional","affiliation":[{"name":"Bernhard Nocht Institute for Tropical Medicine Hamburg, 20359 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Egbert","family":"Tannich","sequence":"additional","affiliation":[{"name":"Bernhard Nocht Institute for Tropical Medicine Hamburg, 20359 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Bull","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9527-5098","authenticated-orcid":false,"given":"Bernd","family":"Kreikemeyer","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5252-4485","authenticated-orcid":false,"given":"Israel","family":"Barrantes","sequence":"additional","affiliation":[{"name":"Research Group Translational Bioinformatics, Institute for Biostatistics and Informatics in Medicine und Aging Research, University Medicine Rostock, 18057 Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.3201\/eid1907.121573","article-title":"GeoSentinel Surveillance Network. 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