Recently, Prof. Huang Gengwen's team from the Department of Pancreatic Surgery, General Surgery, Xiangya Hospital, Central South University (CSU) published its latest clinical research results in the top-notch journal,Journal of Infection(a top journal in CAS Q1, JCR Q1, IF=28.2) in the field of infectious diseases. The research entitled “Diagnostic performance of plasma metagenomic next-generation sequencing for infected pancreatic necrosis: A prospective multicenter study” was published online in the form of a research letter. Dr. Shen Dingcheng, a general pancreatic surgeon/newly recruited postdoctoral fellow at Xiangya Hospital, is the first author. Prof. Huang Gengwen is the corresponding author. Xiangya Hospital, CSU is the first affiliation and the corresponding affiliation.
Infected pancreatic necrosis (IPN) is one of the most serious complications of acute pancreatitis (AP), with the case fatality rate (CFR) up to 30%. Early pathogenic diagnosis of IPN and targeted intervention therapy are crucial for improving patient prognosis. However, the commonly used clinical methods based on symptomatic manifestations, serum inflammatory markers, blood cultures, and imaging characteristics have shown limited effectiveness in early IPN diagnosis. Metagenomic next-generation sequencing (mNGS) is an emerging high-throughput infection detection technique that has gradually been reported to have significant advantages in the clinical diagnosis of severe, rare, and complex infectious diseases. The preliminary single-center, small-sample study conducted by Prof. Huang Gengwen's team has preliminarily confirmed the promising application prospects of blood mNGS in the early pathogenetic diagnosis of IPN (published inPancreatology). In order to provide more detailed and high-quality evidence-based medicine to better guide clinical practice, the research team from Xiangya Hospital, as the leading unit, with the technical support from BGI Genomics, has initiated a multicenter, prospective, observational clinical study on the application of mNGS in the early diagnosis of IPN. The participating centers include the First People's Hospital of Changde City; Zhuzhou Central Hospital; Hunan Province Directly Affiliated TCM Hospital; the First People’s Hospital of Chenzhou City; the First Affiliated Hospital of University of South China; Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; and the People's Hospital of Liuyang, and other centers specialized in the diagnosis and treatment of pancreatitis, both within and outside the province.
The initial data analysis of this study has yielded encouraging results. The research team found that the sensitivity and accuracy of blood mNGS for the early pathogenetic diagnosis of IPN were significantly superior to all existing clinical diagnostic methods. Moreover, the concordance rate with the ultimate pathogen culture results around the pancreas in IPN patients reached as high as 82.1%. These research findings demonstrate that blood mNGS detection contributes to guiding the clinical use of antibiotics, preventing the misuse and overuse of antibiotics. It is expected to reduce the occurrence of antimicrobial drug resistance, thereby alleviating the economic burden on patients and improving their prognosis.
Prof. Huang Gengwen's team has been dedicated to clinical research on IPN and severe pancreatitis. Starting from real clinical issues, the team has established multiple high-quality prospective clinical study cohorts, led multicenter clinical studies, and set up a pancreatitis biobank. Utilizing comprehensive data from Xiangya Hospital, the team has aimed to address unsolved clinical questions in the field of severe pancreatitis and committed to revising clinical guidelines. The research team has successively published a series of clinical research results in top-notch and renowned journals in specialized fields such asJournal of Infection,British Journal of Surgery,International Journal of Surgery,Surgery,Infection, andDigestive and Liver Disease.Ithas wonthe 2022 Hunan Clinical Top Ten New Technology Award, the Hunan Provincial Medical Education Science and Technology Innovation Award, and multiple new medical technology achievementawards of Central South University.
Link to the Article:https://doi.org/10.1016/j.jinf.2023.10.014
Source: Xiangya Hospital of Central South University; Author: -
