• Peng Zhang, Baoyi Liu, Shuang Zhang, Xuefei Chang, Lihe Zhang, Dejian Gu, Xin Zheng, Jiaqing Chen, Saiyin Xiao, Zhentao Wu, Xuemin Cai, Mingfa Long, Wenjie Lu, Mingzhu Zheng, Rongrong Chen, Rui Gao, Yan Zheng, Jinhua Wu, Qiujuan Feng, Gang He, Yantang Chen, Weihao Zheng, Wanli Zuo, Yanming Huang, and Xin Zhang.
• Department of Critical Care Medicine, Jiangmen Central Hospital, Jiangmen, 529030, China.
• Crit Care. 2024 Jul 8; 28 (1): 225225.

BackgroundThe precise identification of the underlying causes of infectious diseases, such as severe pneumonia, is essential, and the development of next-generation sequencing (NGS) has enhanced the effectiveness of pathogen detection. However, there is limited information on the systematic assessment of the clinical use of targeted next-generation sequencing (tNGS) in cases of severe pneumonia.MethodsA retrospective analysis was conducted on 130 patients with severe pneumonia treated in the ICU from June 2022 to June 2023. The consistency of the results of tNGS, metagenomics next-generation sequencing (mNGS), and culture with the clinical diagnosis was evaluated. Additionally, the results for pathogens detected by tNGS were compared with those of culture, mNGS, and quantitative reverse transcription PCR (RT-qPCR). To evaluate the efficacy of monitoring severe pneumonia, five patients with complicated infections were selected for tNGS microbiological surveillance. The tNGS and culture drug sensitisation results were then compared.ResultsThe tNGS results for the analysis of the 130 patients showed a concordance rate of over 70% with clinical diagnostic results. The detection of pathogenic microorganisms using tNGS was in agreement with the results of culture, mNGS, and RT-qPCR. Furthermore, the tNGS results for pathogens in the five patients monitored for complicated infections of severe pneumonia were consistent with the culture and imaging test results during treatment. The tNGS drug resistance results were in line with the drug sensitivity results in approximately 65% of the cases.ConclusionsThe application of tNGS highlights its promise and significance in assessing the effectiveness of clinical interventions and providing guidance for anti-infection therapies for severe pneumonia.© 2024. The Author(s).

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