ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical and Diagnostic Microbiology and Immunology
Value of Plasma Metagenomic Next-Generation Sequencing for the Diagnosis of Invasive Aspergillosis: A Multicenter-Center Retrospective Study
Provisionally accepted
- 1The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- 2Shaoxing University Affiliated Hospital, Shaoxing, China
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【Abstract】 Invasive aspergillosis (IA) is a severe fungal infection. Metagenomic Next Generation Sequencing (mNGS) is a broad and highly sensitive pathogen detection method that can accurately differentiate fungi to the species, and even subspecies level. To explore the value of plasma mNGS in the diagnosis of invasive aspergillosis, a retrospective analysis was conducted on the clinical data of 334 patients with findings of Aspergillus spp. from mNGS from plasma at 4 hospitals, Zhejiang, from February 2021 to December 2022. The study analyzed risk factors, clinical manifestations, imaging features, microbiological results, and treatment outcomes of patients with Aspergillus infection. According to the diagnostic criteria for IA, among the 334 patients, there were 4 confirmed cases, 62 probable cases, 134 possible cases, and 134 false-positive cases. All 196 probable and possible cases exhibited risk factors, clinical manifestations, imaging features, and treatment outcomes consistent with Aspergillus infection. In 18 out of the 62 probable cases, the same Aspergillus nucleic acid was found in 2-4 peripheral blood mNGS samples collected at intervals of 17 days. The remaining 134 patients had detectable Aspergillus in plasma mNGS but lacked high-risk factors and clinical characteristics of Aspergillus infection, and there was a lack of other microbiological evidence, determined as false positives. Among the cases included in this study, the positive predictive value of plasma mNGS for diagnosing invasive aspergillosis was 59.9%. Plasma mNGS detection has significant reference value for diagnosing IA. However, comprehensive judgment should still be made in conjunction with clinical features.
Keywords: Plasma, MNGs, Aspergillus, invasive aspergillosis, microbial cell free-DNA
Received: 29 Jun 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 XIAOMAI, Zhou, Xu, Wang, Zhou and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hua Zhou, zhouhua8101@126.com
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