P1603: CLINICAL OBSERVATION OF PATHOGEN MICROBIAL NEXT-GENERATION SEQUENCING ASSISTED IN INFECTION DIAGNOSIS AND TREATMENT OF PATIENTS WITH HEMATOLOGICAL TUMORS

Background: Infection is still the most important complication in patients with blood tumors and one of the most common causes of death. Timely finding of the pathogenic microorganisms is the key to control the infection. Aims: Rapid identification of pathogenic microorganisms by pathogen microbial next-generation sequencing (NGS), analysis of their accuracy and effectiveness, as well as the impact on disease treatment. Methods: Retrospective analysis of hematological tumor patients hospitalized from September 2019 to February 2021 in the Hematology Department of the Second Affiliated Hospital of the Army Military Medical University,70 patients developed recurrent fever after chemotherapy for a week, with empirical anti-infection symptoms uncontrolled. The pathogen basis could not be found through blood culture and humoral culture, and the pathogenic microorganisms were submitted for NGS examination to analyze the pathogenic microorganisms. Of these, 40 had acute leukemia, 8 lymphoma, 8 myelodysplastic syndrome, 5 multiple myeloma, and 9 patients with other diseases who received chemotherapy. 13 patients had used immunosuppressive agents such as glucocorticoids. The infection site was mainly respiratory tract and blood flow, and 2 cases had a cutaneous soft-tissue infection. The NGS test was mainly blood, 9 were bronchoalveolar lavage fluid, 3 with puncture tissue fluid, 1 sputum, 1 cerebrospinal fluid and 1 paraffin tissue section. Results: In this study, 63 (90%) patients confirmed the pathogenic microorganisms based on NGS test. 18 bacterial infections, the most was Klebsiella pneumoniae (n=5). 19 fungal infections, at most Aspergillus (n=9), and 4 patients were infected with Candida; 24 viral infections were detected, followed at most by herpesvirus (n=19), followed by CMV infection (n=8). There were 2 cases of pulmonary tuberculosis. 11 of these patients had a carbapenem exposure.The mean time from initial infection symptoms to NGS delivery was 8.2 days.The median time for temperature control for the adjusted anti-infection regimen was 5.2 days. 61 patients (87.1%) were controlled by treatment, 2 patients died, and 7 patients delayed tumor treatment due to severe infection. Summary/Conclusion: Pathogenic microorganism NGS has high sensitivity to the detection of pathogenic microorganisms, which can be used as an auxiliary means of infection diagnosis and treatment, and has a positive role in timely control of infection.