Abstract：
OBJECTIVE: Metagenomic next-generation sequencing (mNGS) has been widely used in the diagnosis of infectious diseases. However, studies on Talaromyces marneffei detection using mNGS remain scarce. Therefore, this study aimed to explore the diagnostic performance of mNGS in T. marneffei.
METHODS: Between March 2021 and June 2023, patients who were discharged with a final diagnosis of talaromycosis, or confirmed T. marneffei infection by mNGS, culture or pathological examination were included in the study. Culture and mNGS were performed simultaneously for all patients. Clinical data were retrieved for analysis.
RESULTS: A total of 78 patients were enrolled, with 40 in the talaromycosis group and 38 in the suspected-talaromycosis group. In the talaromycosis group, mNGS showed a higher positivity rate(40/40, 100.0%) compared to culture(34/40, 85.0%)(P = 0.111). All patients in the suspected-talaromycosis group tested negative via culture, while mNGS yielded positive results. The T. marneffei reads in the talaromycosis group were significantly higher than in the suspected-talaromycosis group (4399 vs. 28, P < 0.001). In the suspected-talaromycosis group, of the four patients with low reads who did not receive antifungal therapy, one died and one lung lesion progressed; most patients(31/34, 91.2%) recovered after receiving appropriate antifungal therapy.
CONCLUSIONS: mNGS proves to be a rapid and highly sensitive method for detecting T. marneffei. Higher reads of T. marneffei correspond to a higher likelihood of infection. However, cases with low reads necessitate a comprehensive approach, integrating clinical manifestations, laboratory tests, and imaging examinations to confirm T. marneffei infection.
METHODS: Between March 2021 and June 2023, patients who were discharged with a final diagnosis of talaromycosis, or confirmed T. marneffei infection by mNGS, culture or pathological examination were included in the study. Culture and mNGS were performed simultaneously for all patients. Clinical data were retrieved for analysis.
RESULTS: A total of 78 patients were enrolled, with 40 in the talaromycosis group and 38 in the suspected-talaromycosis group. In the talaromycosis group, mNGS showed a higher positivity rate(40/40, 100.0%) compared to culture(34/40, 85.0%)(P = 0.111). All patients in the suspected-talaromycosis group tested negative via culture, while mNGS yielded positive results. The T. marneffei reads in the talaromycosis group were significantly higher than in the suspected-talaromycosis group (4399 vs. 28, P < 0.001). In the suspected-talaromycosis group, of the four patients with low reads who did not receive antifungal therapy, one died and one lung lesion progressed; most patients(31/34, 91.2%) recovered after receiving appropriate antifungal therapy.
CONCLUSIONS: mNGS proves to be a rapid and highly sensitive method for detecting T. marneffei. Higher reads of T. marneffei correspond to a higher likelihood of infection. However, cases with low reads necessitate a comprehensive approach, integrating clinical manifestations, laboratory tests, and imaging examinations to confirm T. marneffei infection.
摘要：
目的：宏基因组下一代测序（mNGS）已广泛应用于感染性疾病的诊断。然而,使用mNGS检测马尔尼菲塔拉酵母的研究仍然很少。因此,本研究旨在探讨mNGS在马尔尼菲氏杆菌中的诊断性能。
方法：在2021年3月至2023年6月之间，最终诊断为塔拉真菌病的出院患者，或者被mNGS证实了马尔尼菲T.本研究包括培养或病理检查.对所有患者同时进行培养和mNGS。检索临床数据用于分析。
结果：共纳入78例患者，塔拉真菌病组40例，疑似塔拉真菌病组38例。在塔拉真菌病组中，mNGS的阳性率(40/40,100.0%)高于培养(34/40,85.0%)(P=0.111)。所有的患者在可疑的距骨真菌病组通过培养检测阴性，而mNGS产生了积极的结果。距骨真菌病组的马内菲菌读数显着高于可疑的距骨真菌病组（4399vs.28,P<0.001)。在疑似塔拉真菌病组中，在四名没有接受抗真菌治疗的低读数患者中，1例死亡,1例肺部病变进展;大多数患者(31/34,91.2%)在接受适当的抗真菌治疗后康复.
结论：mNGS被证明是一种快速和高度灵敏的检测马尔尼菲的方法。较高的马内菲木霉读段对应于较高的感染可能性。然而,低读数的情况需要一个全面的方法，整合临床表现，实验室测试,和影像学检查以确认马尔尼菲氏杆菌感染。
方法：在2021年3月至2023年6月之间，最终诊断为塔拉真菌病的出院患者，或者被mNGS证实了马尔尼菲T.本研究包括培养或病理检查.对所有患者同时进行培养和mNGS。检索临床数据用于分析。
结果：共纳入78例患者，塔拉真菌病组40例，疑似塔拉真菌病组38例。在塔拉真菌病组中，mNGS的阳性率(40/40,100.0%)高于培养(34/40,85.0%)(P=0.111)。所有的患者在可疑的距骨真菌病组通过培养检测阴性，而mNGS产生了积极的结果。距骨真菌病组的马内菲菌读数显着高于可疑的距骨真菌病组（4399vs.28,P<0.001)。在疑似塔拉真菌病组中，在四名没有接受抗真菌治疗的低读数患者中，1例死亡,1例肺部病变进展;大多数患者(31/34,91.2%)在接受适当的抗真菌治疗后康复.
结论：mNGS被证明是一种快速和高度灵敏的检测马尔尼菲的方法。较高的马内菲木霉读段对应于较高的感染可能性。然而,低读数的情况需要一个全面的方法，整合临床表现，实验室测试,和影像学检查以确认马尔尼菲氏杆菌感染。
