Next-generation sequencing guides the treatment of severe community-acquired pneumonia with empiric antimicrobial therapy failure: A propensity-score-matched study

Yuhao Zhao; Yajuan Wang; Yi Li; Chao Song; Pinhua Pan

doi:10.1371/journal.pntd.0012701

Next-generation sequencing guides the treatment of severe community-acquired pneumonia with empiric antimicrobial therapy failure: A propensity-score-matched study

PLoS Negl Trop Dis. 2024 Dec 2;18(12):e0012701. doi: 10.1371/journal.pntd.0012701. Online ahead of print.

Authors

Yuhao Zhao^{1

2

3

4

5}, Yajuan Wang^{1

2

3

4

5}, Yi Li^{1

2

3

4

5}, Chao Song^{1

2

3

4

5

6}, Pinhua Pan^{1

2

3

4

5}

Affiliations

¹ Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.
² Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China.
³ Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China.
⁴ National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China.
⁵ Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China.
⁶ Nosocomial Infection Control Center, Xiangya Hospital, Central South University, Changsha, Hunan, China.

PMID: 39621807
DOI: 10.1371/journal.pntd.0012701

Abstract

Background: Next-generation sequencing (NGS) is a promising diagnostic tool for pathogens diagnosis. The aim of this study is to evaluate the application of NGS-based antimicrobial therapy on clinical outcomes in severe community-acquired pneumonia (SCAP) patients with empiric antimicrobial therapy failure.

Methodology: We performed a multi-center, retrospective cohort of SCAP patients with initial empiric therapy failure. Propensity score (PS) matching was used to obtain balance among the baseline variables in NGS group (n = 82) and conventional group (n = 82). We compared the diagnostic performance of NGS with conventional microbial culture. We also compared the impact of NGS-based antimicrobial therapy on the prognosis of patients with empirical antimicrobial therapy failure.

Results: The positive rate of NGS was higher than that of conventional pathogen detection methods (92.6% vs. 74.7%, P = 0.001). Compared to the conventional group, the NGS group has a considerably higher modifications rate of antibiotic treatment (73.2% vs. 54.9%, P = 0.015). The mortality of NGS group was significantly lower than that of conventional group (28.0% vs. 43.9%, P = 0.034). Moreover, the detection of NGS can significantly shorten the ventilation time (P = 0.046), and reduce the antibiotic cost (P = 0.026).

Conclusions: NGS is a valuable tool for microbial identification of SCAP patient with initial empiric therapy failure.

Copyright: © 2024 Zhao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.