(488) The Clinical Application Value of Next-Generation Sequencing Technology in Early Infection Diagnosis

Introduction: Objection：To evaluate the clinical value of next generation sequencing (NGS) in the diagnosis of infection among hospitalized patients in intensive care unit (ICU).

Methods: Methods：An observational and retrospective study of patients admitted to ICU in Zhongnan Hospital of Wuhan University from April 2021 to March 2023 was conducted. The basic information (name, sex, age) and clinical data (reason of admission, whether infection, underlying disease, treatment measures, SOFA score, APACHEII score, NGS results, pathogen culture results and inflammatory index score) of the patients were collected to evaluate the clinical application value of NGS, and the results of NGS were compared with the results of pathogenic microorganism culture. The effects of the above factors on the 28-day and 90-day survival rate of patients were explored.

Results: Results：Broncho alveolar lavage fluid (BALF) (56.41%) and blood (48.25%) were the main sources of sample in the 601 included samples. The detection rate of NGS was 83.86% (viruses, 33.44%; bacteria, 73.7%; fungi, 43.59%; parasites etc., 8%), while the culture rate was only 45.09% (bacteria, 20.63%; fungi, 9.98%). The turnaround time for NGS was 48.00 hour (41.88, 48.00), whereas the turnaround time for culture was 48.00 hour (48.00, 120.00), which was statistically different (Z=-16.79, P=0.000), with the significant difference in turnaround time in blood samples (48.00 hour (48.00, 48.00) vs. 120.00 hour (120.00, 120.00)). Comparison of the concordance between NGS and culture results revealed the highest positive concordance for samples of BALF (55.2%) and the highest negative concordance for samples of blood origin (45.9%). Multifactorial logistic regression showed that age and coronary heart disease were independent influences of 28-day survival and 90-day survival rate (P < 0.05).

Conclusions: Conclusion：Compared with pathogen culture, NGS has higher positive rate and accuracy, providing clinicians with faster and more comprehensive pathogen information of infection, but pathogen culture is convenient and helps to directly identify antibiotic resistance. Meanwhile, early NGS detection and reexamination of inflammatory indexes in patients with suspected infection, and active intervention on this basis can greatly improve the prognosis of patients.