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Preprint VersionCC BY-NC V4.0, Open Access
Preprint
Performance of next-generation molecular methods in the diagnosis of pleural space infections and their aetiology
medRxiv, Vol.23 October 2023
Cold Spring Harbor Laboratory Press
2023
Abstract
Pleural space infections (PSIs) are common and associated with substantial healthcare cost, morbidity, and mortality. Accurate PSI diagnosis remains challenging due to low culture positivity rates, frequent polymicrobial involvement, and non-specific diagnostic biomarkers. To better understand the comparative diagnostic yield of culture-independent technologies for PSI diagnosis, we prospectively characterised 26 clinically suspected PSIs and 10 control patients with non-infective pleural effusions using shotgun metagenomics, bacterial metataxonomics, quantitative PCR, and conventional culture. We demonstrate that culture-independent molecular techniques have superior sensitivity and negative predictive values for PSI diagnosis compared with conventional culture. Bacterial metataxonomics and metagenomics were both sensitive to the detection of polymicrobial infections, and unveiled microbial heterogeneity. Metagenomics also detected fungi and DNA viruses within pleural fluid. Dominant pathogens in the PSI cohort according to the highest resolution method, metagenomics, included streptococci (S. intermedius, S. pyogenes, S. mitis), Prevotella spp. (P. oris, P. pleuritidis), staphylococci (S. aureus, S. saprophyticus), and Klebsiella pneumoniae. Taken together, these results demonstrate the potential utility of molecular methods in the accurate diagnosis of PSI, which represents an important step towards improving personalised treatment decision-making and antimicrobial stewardship in suspected PSI.
Details
- Title
- Performance of next-generation molecular methods in the diagnosis of pleural space infections and their aetiology
- Authors
- Peter Bell - Sunshine Coast University HospitalTimothy Baird - University of the Sunshine Coast, Queensland, Centre for BioinnovationJohn Goddard - Griffith UniversityOlusola Olagoke - University of the Sunshine Coast, Queensland, Centre for BioinnovationAndrew Burke - The University of QueenslandShradha Subedi - Sunshine Coast University HospitalTiana Davey - University of the Sunshine Coast, Queensland, School of Health - BiomedicineJames Anderson - Sunshine Coast University HospitalDerek Sarovich - University of the Sunshine Coast, Queensland, Centre for BioinnovationErin Price - University of the Sunshine Coast, Queensland, Centre for Bioinnovation
- Publication details
- medRxiv, Vol.23 October 2023
- Publisher
- Cold Spring Harbor Laboratory Press
- Date published
- 2023
- DOI
- 10.1101/2023.10.22.23297281
- Copyright note
- The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC 4.0 International license.
- Organisation Unit
- School of Health - Biomedicine; School of Science, Technology and Engineering; Centre for Bioinnovation; School of Health and Behavioural Sciences - Legacy
- Language
- English
- Record Identifier
- 991014496802621
- Output Type
- Preprint
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