Deng QM, Zhang J, Zhang YY, Jia M, Ding DS, Fang YQ, Wang HZ, Gu HC. Diagnosis and treatment of refractory infectious diseases using nanopore sequencing technology: Three case reports. World J Clin Cases 2024; 12(22): 5208-5216 [DOI: 10.12998/wjcc.v12.i22.5208]
Corresponding Author of This Article
Hong-Zhi Wang, Doctor, Professor, Science Island Branch, Graduate School of University of Science and Technology of China, Yangqiao Road, Shushan District, Hefei 230031, Anhui Province, China. wanghz@hfcas.ac.cn
Research Domain of This Article
Nanoscience & Nanotechnology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Qing-Mei Deng, Hong-Zhi Wang, Science Island Branch, Graduate School of University of Science and Technology of China, Hefei 230031, Anhui Province, China
Qing-Mei Deng, Min Jia, Hong-Cang Gu, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Science, Hefei 230031, Anhui Province, China
Qing-Mei Deng, Jian Zhang, Yi-Yong Zhang, Min Jia, Du-Shan Ding, Yu-Qin Fang, Hong-Cang Gu, Medical Pathology Center, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei 230031, Anhui Province, China
Co-corresponding authors: Hong-Zhi Wang and Hong-Cang Gu.
Author contributions: Deng QM, Zhang J and Jia M contributed to manuscript writing and editing; Ding DS and Fang YQ contributed to data collection; Zhang YY contributed to data analysis; Wang HZ and Gu HC contributed to conceptualization and supervision for co-corresponding authors; all authors have read and approved the final manuscript.
Supported byResearch and Development Funding for Medical and Health Institutions, No. 2021YL007.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Zhi Wang, Doctor, Professor, Science Island Branch, Graduate School of University of Science and Technology of China, Yangqiao Road, Shushan District, Hefei 230031, Anhui Province, China. wanghz@hfcas.ac.cn
Received: April 10, 2024 Revised: May 29, 2024 Accepted: June 17, 2024 Published online: August 6, 2024 Processing time: 82 Days and 23.3 Hours
Abstract
BACKGROUND
Infectious diseases are still one of the greatest threats to human health, and the etiology of 20% of cases of clinical fever is unknown; therefore, rapid identification of pathogens is highly important. Traditional culture methods are only able to detect a limited number of pathogens and are time-consuming; serologic detection has window periods, false-positive and false-negative problems; and nucleic acid molecular detection methods can detect several known pathogens only once. Three-generation nanopore sequencing technology provides new options for identifying pathogens.
CASE SUMMARY
Case 1: The patient was admitted to the hospital with abdominal pain for three days and cessation of defecation for five days, accompanied by cough and sputum. Nanopore sequencing of the drainage fluid revealed the presence of oral-like bacteria, leading to a clinical diagnosis of bronchopleural fistula. Cefoperazone sodium sulbactam treatment was effective. Case 2: The patient was admitted to the hospital with fever and headache, and CT revealed lung inflammation. Antibiotic treatment for Streptococcus pneumoniae, identified through nanopore sequencing of cerebrospinal fluid, was effective. Case 3: The patient was admitted to our hospital with intermittent fever and an enlarged neck mass that had persisted for more than six months. Despite antibacterial treatment, her symptoms worsened. The nanopore sequencing results indicate that voriconazole treatment is effective for Aspergillus brookii. The patient was diagnosed with mixed cell type classical Hodgkin's lymphoma with infection.
CONCLUSION
Three-generation nanopore sequencing technology allows for rapid and accurate detection of pathogens in human infectious diseases.
Core Tip: Routine culture methods have traditionally been the primary clinical approach for detecting pathogenic microorganisms. However, this article reports on three cases of refractory infectious diseases caused by pathogens that are not easily detected through routine culture methods or are susceptible to inhibition by the growth of other normal flora during the culture process. Nanopore sequencing technology offers a novel approach to identifying the source of infection, achieving precise and prompt pathogen detection, and guiding the use of clinical antimicrobial drugs.
