mNGS在感染高危儿童肿瘤患者中应用的研究相当有限。2020年3月至2022年6月，本研究共纳入195例疑似血流感染的儿童肿瘤患者的224份血液样本。回顾性审查他们的临床和实验室数据，评估 mNGS 的诊断性能。与参考测试相比，mNGS 显示出显着更高的敏感性（89.8% vs 32.5%，P<0.001）和临床一致性（76.3% vs 51.3%， P < 0.001）在检测潜在病原体和区分 BSI 与非 BSI 方面。尤其是，mNGS在病毒检测方面表现出色，实现了100%的临床诊断病毒。中性粒细胞减少症患者的样本显示细菌感染的发生率较高（P = 0.035）。最常见的细菌是大肠杆菌，革兰氏阴性菌的总体感染率明显高于革兰氏阳性菌（90% vs 10%，P<0.001）。总体而言，mNGS 对本研究中 54.3% 的样本的抗菌治疗方案的使用产生了影响。mNGS 的优势在于可以对疑似 BSI 的儿科肿瘤患者进行快速有效的病原体诊断，尤其是病毒诊断。与参考测试相比，mNGS在检测潜在病原体以及区分血流感染 (BSI) 和非 BSI 方面表现出显着更高的灵敏度和临床一致性。 mNGS在临床诊断病毒检测方面尤为突出。中性粒细胞减少症患者细菌感染发生率较高，革兰阴性菌总体感染率明显高于革兰阳性菌。 mNGS 影响超过一半患者的抗菌治疗方案的使用。© 2023。作者。

Studies on mNGS application in pediatric oncology patients, who are at high risk of infection, are quite limited.From March 2020 to June 2022, a total of 224 blood samples from 195 pediatric oncology patients who were suspected as bloodstream infections were enrolled in this study. Their clinical and laboratory data were retrospectively reviewed, and the diagnostic performance of mNGS was assessed.Compared to the reference tests, mNGS showed significantly higher sensitivity (89.8% vs 32.5%, P < 0.001) and clinical agreement (76.3% vs 51.3%, P < 0.001) in detecting potential pathogens and distinguishing BSI from non-BSI. Especially, mNGS had an outstanding performance for virus detection, contributing to 100% clinical diagnosed virus. Samples from patients with neutropenia showed higher incidence of bacterial infections (P = 0.035). The most identified bacteria were Escherichia coli, and the overall infections by gram-negative bacteria were significantly more prevalent than those by gram-positive ones (90% vs 10%, P < 0.001). Overall, mNGS had an impact on the antimicrobial regimens' usage in 54.3% of the samples in this study.mNGS has the advantage of rapid and effective pathogen diagnosis in pediatric oncology patients with suspected BSI, especially for virus.Compared with reference tests, mNGS showed significantly higher sensitivity and clinical agreement in detecting potential pathogens and distinguishing bloodstream infections (BSI) from non-BSI. mNGS is particularly prominent in clinical diagnosed virus detection. The incidence of bacterial infection was higher in patients with neutropenia, and the overall infection rate of Gram-negative bacteria was significantly higher than that of Gram-positive bacteria. mNGS affects the antimicrobial regimens' usage in more than half of patients.© 2023. The Author(s).