AUTHOR=Zhao Xi , Bai Lin-Peng , Li Bo-Yan , Yue Zhen-Zhen , Zhao Yang-Chao , Zhao Xiao-Yan 

TITLE=Comparison of mNGS and conventional culture in non-organ transplant critically ill patients supported by ECMO: a single-center study

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1146088

DOI=10.3389/fcimb.2023.1146088

ISSN=2235-2988

ABSTRACT=Objectives: Infection is one of the important causes of death in intensive care unit (ICU) patients. At present, there are few articles focused on the detailed analysis of pathogenic microorganisms detected in different therapy periods of critically ill patients who supported by extracorporeal membrane oxygenation (ECMO).
Methods: From Oct 2020 to Oct 2022, the ECMO assisted patients who underwent multiple times of both metagenomic next-generation sequencing (mNGS) test and conventional culture were enrolled continuously in the First Affiliated Hospital of Zhengzhou University. The baseline data, laboratory test results, and pathogenic microorganisms detected by mNGS and traditional culture in different time periods were recorded and analyzed.
Results: In the present study, 62 patients were included finally. According to whether the patients survived at discharge, they were divided into survival group (N=24) and death group (N=38). Then, according to the different types of ECMO support, they were divided into VV ECMO group (N=43) and VA ECMO group (N=19). The summit period of specimens of traditional culture and mNGS detection of ECMO patients was 7 days after admission, and the largest number of specimens of surviving patients was appeared after ECMO withdrawal. The total number of traditional culture specimens was 1249, the positive rate was 30.4% (380/1249), and the positive rate of mNGS was 79.6% (82/103). A total of 28 kinds of pathogenic microorganisms were cultured from conventional culture, and 58 kinds of pathogenic microorganisms were detected by mNGS, including myco- bacterium, rickettsia and Chlamydia psittaci. In conventional culture, the most frequent Gram negative bacteria, Gram positive bacteria and fungi were Klebsiella pneumoniae, Corynebacterium striatum, and Candida glabrata, and the highest frequency of them occurrence in  mNGS detection were Acinetobacter baumannii, Enterococcus faecium, Aspergillus flavus.
Conclusions: Throughout the whole treatment process, different kinds of suspicious biological specimens of high infection risk ICU patients supported by ECMO should be send to both mNGS detection and traditional culture early and repeatedly.