ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1590792
This article is part of the Research TopicRapid and Efficient Analytical Technologies for Pathogen DetectionView all articles
Comparative and Clinical Impact of Targeted Next-Generation Sequencing in Pediatric Pneumonia Diagnosis and Treatment
Provisionally accepted
- Department of Pediatrics, Dongguan Maternal and Child Health Hospital, Dongguan, China
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Background: Community-acquired pneumonia (CAP) remains a significant cause of pediatric morbidity and mortality worldwide. Conventional microbial tests (CMTs) frequently fail to accurately identify pathogens, especially in cases involving co-infections or less common organisms. Targeted next-generation sequencing (tNGS) presents a promising alternative, offering comprehensive pathogen detection. Methods: A retrospective observational analysis was conducted on 206 pediatric CAP patients from July 2021 to January 2023. Bronchoalveolar lavage fluid (BALF) samples underwent simultaneous tNGS and CMTs. Clinical diagnoses based on comprehensive analysis served as the reference standard. Relative abundance thresholds were optimized to reduce false-positive detections.Results: tNGS detected pathogens in 97.0% (200/206) of cases, significantly higher than CMTs (52.9%, 109/206; P<0.001). tNGS identified a broader spectrum of pathogens, substantially improving overall detection compared to CMTs (84.6% vs. 40.7%). Specifically, detection rates of viral pathogens (P<0.05) and bacterial co-infections (P<0.001) were significantly enhanced. The sensitivity and specificity of tNGS were 96.4% and 66.7%, respectively. Additionally, tNGS demonstrated superior diagnostic concordance with clinical diagnoses in both single and co-infection cases. Optimizing relative abundance thresholds reduced the false-positive rate from 39.7% to 29.5% (P<0.0001). Clinical management was adjusted based on tNGS results in 41.7% of patients, significantly shortening hospital stays in severe CAP cases (P<0.01).Conclusion: tNGS provides significantly improved pathogen detection, especially for co-infections, compared to CMTs. Implementing standardized relative abundance thresholds enhances the diagnostic specificity of tNGS, supporting its integration into routine clinical diagnostics for pediatric CAP to facilitate precise, timely therapeutic interventions.
Keywords: Pediatric pneumonia, Targeted next-generation sequencing (TNGS), Bronchoalveolar lavage fluid (BALF), Pathogen Detection, Treatment
Received: 10 Mar 2025; Accepted: 29 May 2025.
Copyright: © 2025 Shang, Zou, Ma, Liang, Zhong, Li and Chen. 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:
Hui Shang, Department of Pediatrics, Dongguan Maternal and Child Health Hospital, Dongguan, China
Zhanying Ma, Department of Pediatrics, Dongguan Maternal and Child Health Hospital, Dongguan, China
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