Introduction: The aim of this study was to compare the detection performance of mNGS against that of conventional tests (CT) in patients suffering from infection after kidney transplantation.
Methods: A total of 138 samples from 85 kidney transplant patients with acute or chronic infections were simultaneously analyzed using mNGS and CT from July 2021 to August 2023.
Results: Compared with CT, mNGS demonstrated a higher sensitivity (95.96% vs. 27.27%) but lower specificity (48.72% vs. 84.62%) in pathogen detection. Moreover, mNGS exhibited significant advantages in detecting mixed and rare infections. The pathogens commonly identified in kidney transplant patients were severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), followed by Pneumocystis jirovecii and Cytomegalovirus (CMV). mNGS guided the precise clinical diagnosis in 89.13% of cases and assisted in altering therapeutics from empirical antibiotic approaches to personalized plans in 56.10% of cases, including treatment escalation (40.65%), initiation (11.38%), drug adjustment (3.25%), and de-escalation (0.81%).
Discussion: Our study demonstrated the superior detection performance of mNGS and its significant clinical value. This reflected the great potential of mNGS as a complementary clinical detection technology for kidney transplant patients.
Keywords: clinical decision-making; infection; kidney transplantation; metagenomic next-generation sequencing; pathogen detection.
Copyright © 2024 Ye, Lin, Yang, Qi, Wei, Huang and Wang.