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World Journal of Emergency Medicine ›› 2021, Vol. 12 ›› Issue (1): 29-35.doi: 10.5847/wjem.j.1920-8642.2021.01.005

• Original Articles • Previous Articles     Next Articles

Effects of viral infection and microbial diversity on patients with sepsis: A retrospective study based on metagenomic next-generation sequencing

Li-wei Duan1, Jin-long Qu1, Jian Wan2, Yong-hua Xu1, Yi Shan1, Li-xue Wu1, Jin-hao Zheng1, Wei-wei Jiang1, Qi-tong Chen1, Yan Zhu1, Jian Zhou1, Wen-bo Yu1, Lei Pei1, Xi Song2, Wen-fang Li1(), Zhao-fen Lin1()   

  1. 1 Department of Emergency and Critical Care Medicine, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
    2 Department of Emergency and Critical Care Medicine, Pudong New Area People’s Hospital, Shanghai 201299, China
  • Received:2020-01-15 Accepted:2020-07-20 Online:2021-01-01 Published:2021-01-01
  • Contact: Wen-fang Li,Zhao-fen Lin E-mail:chzhedlwf@163.com;linzhaofen@smmu.edu.cn

Abstract:

BACKGROUND: The study aims to investigate the performance of a metagenomic next-generation sequencing (NGS)-based diagnostic technique for the identification of potential bacterial and viral infections and effects of concomitant viral infection on the survival rate of intensive care unit (ICU) sepsis patients.

METHODS: A total of 74 ICU patients with sepsis who were admitted to our institution from February 1, 2018 to June 30, 2019 were enrolled. Separate blood samples were collected from patients for blood cultures and metagenomic NGS when the patients’ body temperature was higher than 38 °C. Patients’ demographic data, including gender, age, ICU duration, ICU scores, and laboratory results, were recorded. The correlations between pathogen types and sepsis severity and survival rate were evaluated.

RESULTS: NGS produced higher positive results (105 of 118; 88.98%) than blood cultures (18 of 118; 15.25%) over the whole study period. Concomitant viral infection correlated closely with sepsis severity and had the negative effect on the survival of patients with sepsis. However, correlation analysis indicated that the bacterial variety did not correlate with the severity of sepsis.

CONCLUSIONS: Concurrent viral load correlates closely with the severity of sepsis and the survival rate of the ICU sepsis patients. This suggests that prophylactic administration of antiviral drugs combined with antibiotics may be beneficial to ICU sepsis patients.

Key words: Sepsis, Metagenomic next-generation sequencing, Viral infections, Bacterial infections, Microbial diversity