Emergence and Rapid Diagnosis of Talaromyces marneffei Infections in Renal Transplant Recipients by Next-Generation Sequencing.

IF 3.6 3区 生物学 Q2 MYCOLOGY Mycopathologia Pub Date : 2024-10-10 DOI:10.1007/s11046-024-00898-3
Fanfan Xing, Chaowen Deng, Shan Zou, Chi-Ching Tsang, Simon K F Lo, Susanna K P Lau, Patrick C Y Woo
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Abstract

In the last few years, next-generation sequencing (NGS) has emerged as a technology for laboratory diagnosis of many culture-negative infections and slow-growing microorganisms. In this study, we describe the use of metagenomic NGS (mNGS) for rapid diagnosis of T. marneffei infection in a 37-year-old renal transplant recipient who presented with chronic pneumonia syndrome. Bronchoalveolar lavage for mNGS was positive for T. marneffei sequence reads. Prolonged incubation of the bronchoalveolar lavage revealed T. marneffei colonies after 6 days of incubation. Analysis of 23 cases of T. marneffei infections in renal transplant recipients from the literature revealed that the number of cases ranged from 1 to 4 cases per five years from 1990 to 2020; but increased rapidly to 9 cases from 2021 to 2023, with 7 of them diagnosed by NGS. Twenty of the 23 cases were from T. marneffei-endemic areas [southern part of mainland China (n = 9); Hong Kong (n = 4); northeastern India (n = 2); Indonesia (n = 1) and Taiwan (n = 4)]. For the 3 patients from non-T. marneffei-endemic areas [United Kingdom (n = 2) and Australia (n = 1)], they had travel histories to China and Vietnam respectively. The time taken for diagnosis by mNGS [median 1 (range 1 to 2) day] was significantly shorter than that for fungal culture [median 6 (range 3 to 15) days] (P = 0.002). mNGS is useful for picking up more cases of T. marneffei infections in renal transplant recipients as well as providing a rapid diagnosis. Talaromycosis is an emerging fungal infection in renal transplant recipients.

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利用新一代测序技术快速诊断肾移植受者中的马氏塔拉罗米菌感染。
在过去几年中,下一代测序(NGS)已成为实验室诊断许多培养阴性感染和生长缓慢微生物的一种技术。在本研究中,我们描述了使用元基因组 NGS(mNGS)快速诊断一名 37 岁肾移植受者的 T. marneffei 感染的情况,该受者出现了慢性肺炎综合征。对 mNGS 进行支气管肺泡灌洗后,发现 T. marneffei 序列读数呈阳性。对支气管肺泡灌洗液进行长时间培养,6 天后发现了 T. marneffei 菌落。对文献中 23 例肾移植受者感染 T. marneffei 的病例进行分析后发现,从 1990 年到 2020 年,每五年的病例数在 1 到 4 例之间;但从 2021 年到 2023 年,病例数迅速增加到 9 例,其中 7 例是通过 NGS 诊断的。23 例病例中有 20 例来自马氏梭菌流行地区 [中国大陆南部(9 例);香港(4 例);印度东北部(2 例);印度尼西亚(1 例)和台湾(4 例)]。3名来自非马氏蟠尾丝菌流行地区的患者[英国(n = 2)和澳大利亚(n = 1)]分别有前往中国和越南的旅行史。mNGS 的诊断时间[中位数为 1(1 到 2)天]明显短于真菌培养[中位数为 6(3 到 15)天](P = 0.002)。他拉菌病是肾移植受者中新出现的真菌感染。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Mycopathologia
Mycopathologia 生物-真菌学
CiteScore
6.80
自引率
3.60%
发文量
76
审稿时长
3 months
期刊介绍: Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
期刊最新文献
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