Clinical Utility and Outcomes of Targeted Next-Generation Sequencing in Pediatric Respiratory Tract Infections: A Nine-Month Retrospective Study at a North Chinese Hospital

Abstract

Background/ObjectivesChildren are at increased risk for respiratory tract infections (RTIs) due to their developing pulmonary functions and immune systems, highlighting the necessity of accurate and rapid pathogen diagnostic methods. MethodsIn this study, 940 pediatric hospitalized patients with RTIs were included to evaluate the clinical utility and outcomes of 107-pathogen targeted next-generation sequencing (tNGS) panel by comparing it with CMTs. ResultsOur study demonstrated that tNGS exhibited significantly higher sensitivity in pathogen detection compared to CMTs, with a detection rate of 91.38%. tNGS was capable of identifying a broader range of pathogens, including low-abundance and RNA viruses frequently missed by CMTs, and it was able to detect mixed infections, whereas CMTs typically identified only a single pathogen. Treatment adjustments based on tNGS results led to clinical improvements in the majority of patients, with 35.32% experiencing escalated treatment plans and 29.04% experiencing de-escalated treatment plans. Additionally, the analysis revealed significant variations in pathogen prevalence across different age groups and seasons, highlighting the need for tailored diagnostic, treatment, and prevention strategies. ConclusionsThe findings highlight the potential of tNGS to improve clinical outcomes in pediatric RTIs by providing more accurate and comprehensive pathogen detection.