Comparison of targeted next-generation sequencing and metagenomic next-generation sequencing in the identification of pathogens in pneumonia after congenital heart surgery: a comparative diagnostic accuracy study

Ital J Pediatr. 2024 Sep 12;50(1):174. doi: 10.1186/s13052-024-01749-z.

Abstract

Background: This study aimed to compare targeted next-generation sequencing (tNGS) with metagenomic next-generation sequencing (mNGS) for pathogen detection in infants with severe postoperative pneumonia after congenital heart surgery.

Methods: We conducted a retrospective observational study using data from the electronic medical record system of infants who developed severe pneumonia after surgery for congenital heart disease from August 2021 to August 2022. Infants were divided into tNGS and mNGS groups based on the pathogen detection methods. The primary outcome was the efficiency of pathogen detection, and the secondary outcomes were the timeliness and cost of each method.

Results: In the study, 91 infants were included, with tNGS detecting pathogens in 84.6% (77/91) and mNGS in 81.3% (74/91) of cases (P = 0.55). No significant differences were found in sensitivity, specificity, PPA, and NPA between the two methods (P > 0.05). tNGS identified five strains with resistance genes, while mNGS detected one strain. Furthermore, tNGS had a faster detection time (12 vs. 24 h) and lower cost ($150 vs. $500) compared to mNGS.

Conclusion: tNGS offers similar sensitivity to mNGS but with greater efficiency and cost-effectiveness, making it a promising approach for respiratory pathogen detection.

Keywords: Congenital heart disease; Infection; Metagenomic next-generation sequencing; Pneumonia; Targeted next-generation sequencing.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Female
  • Heart Defects, Congenital* / surgery
  • High-Throughput Nucleotide Sequencing*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Metagenomics* / methods
  • Pneumonia / diagnosis
  • Pneumonia / microbiology
  • Postoperative Complications / diagnosis
  • Retrospective Studies
  • Sensitivity and Specificity