Diagnostic and Clinical Value of Targeted Next-Generation Sequencing for Pediatric Respiratory Infections in Northern China

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal Pub Date : 2026-04-12 DOI:10.1111/crj.70185

Lixiang Wang, Xue Yang, Lexia Yang, Ke Yin, Hui Zhong

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引用次数: 0

Abstract

Background

Pediatric patients are particularly susceptible to respiratory tract infections (RTIs) due to ongoing maturation of pulmonary and immune function, highlighting the need for rapid and accurate pathogen identification. Although targeted next-generation sequencing (tNGS) is increasingly applied in infectious disease diagnostics, its real-world clinical utility in pediatric RTIs remains underexplored.

Methods

We conducted a retrospective study of 940 hospitalized children with RTIs in northern China between April and December 2023. All patients underwent tNGS alongside conventional microbiological tests (CMTs), including PCR, culture, and serology. Diagnostic performance metrics—including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)—were calculated. The clinical impact of tNGS was assessed by examining treatment adjustments, turnaround time (TAT), and patient outcomes.

Results

tNGS demonstrated superior diagnostic performance compared with CMTs: sensitivity 91.38% versus 29.68%, specificity 91.03% versus 90.17%, PPV 97.68% versus 77.78%, and NPV 73.39% versus 54.60%. tNGS identified a broader spectrum of pathogens, including RNA viruses and low-abundance organisms frequently missed by CMTs, and detected polymicrobial infections in 17.77% of cases versus 1.17% by CMTs. Based on tNGS, treatment was escalated in 35.32% and de-escalated in 29.04% of patients, with over 90% of adjustments made within 48 h, facilitated by a mean TAT of 28.5 h. Clinical improvement was observed in most adjusted cases. Pathogen distribution showed age- and season-specific patterns, underscoring the need for context-informed diagnostics and therapy.

Conclusion

tNGS enhances pathogen detection accuracy in pediatric RTIs, enables timely and appropriate treatment modifications, and supports antimicrobial stewardship. Its high sensitivity, rapid TAT, and capacity to identify co-infections reinforce its clinical utility in guiding optimized management of pediatric respiratory infections.

Abstract Image

查看原文本刊更多论文

靶向新一代测序在中国北方儿童呼吸道感染中的诊断和临床价值。

背景：由于肺和免疫功能的持续成熟，儿科患者特别容易发生呼吸道感染（RTIs），这突出了快速准确识别病原体的必要性。尽管靶向下一代测序（tNGS）在传染病诊断中的应用越来越多，但其在儿童RTIs中的实际临床应用仍未得到充分探索。方法：我们对2023年4月至12月在中国北方住院的940例RTIs患儿进行了回顾性研究。所有患者均接受tNGS和常规微生物试验（cmt），包括PCR、培养和血清学。计算诊断性能指标，包括敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。通过检查治疗调整、周转时间（TAT）和患者预后来评估tNGS的临床影响。结果：与CMTs相比，tNGS表现出更优越的诊断性能：敏感性91.38%比29.68%，特异性91.03%比90.17%,PPV 97.68%比77.78%,NPV 73.39%比54.60%。tNGS鉴定出更广泛的病原体，包括RNA病毒和经常被cmt遗漏的低丰度生物体，并且在17.77%的病例中检测到多微生物感染，而cmt检测到的多微生物感染为1.17%。根据tNGS， 35.32%的患者治疗升级，29.04%的患者治疗降级，超过90%的患者在48小时内进行调整，平均TAT为28.5小时。大多数调整后的病例均有临床改善。病原体分布表现出年龄和季节特异性模式，强调需要根据具体情况进行诊断和治疗。结论：tNGS提高了儿科呼吸道感染的病原体检测准确性，实现了及时和适当的治疗修改，并支持抗菌药物管理。其高灵敏度、快速TAT和识别合并感染的能力增强了其在指导儿科呼吸道感染优化管理方面的临床应用。

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

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)