Clinical application of Metagenomic next-generation sequencing in peritoneal dialysis related peritonitis with antibiotic treatment

ZHANG Qing-Yan; LIU Ying; FENG Yuan; LIU Xu-Meng; JIANG Chun-Ming; TANG Ri-Ning

doi:10.3969/j.issn.1671-4091.2026.06.009

Chinese Journal of Blood Purification ›› 2026, Vol. 25 ›› Issue (06) : 484-489. DOI: 10.3969/j.issn.1671-4091.2026.06.009

Clinical application of Metagenomic next-generation sequencing in peritoneal dialysis related peritonitis with antibiotic treatment

ZHANG Qing-yan, LIU Ying, FENG Yuan, LIU Xu-meng, JIANG Chun-ming, TANG Ri-ning

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Abstract

Objective To investigate the diagnostic value of metagenomic next-generation sequencing (mNGS) for pathogens of peritoneal dialysis (PD)-associated peritonitis following antibiotic treatment. Methods We retrospectively analyzed clinical data of the patients with PD-associated peritonitis treated in Nanjing Drum Tower Hospital between June 2020 and May 2024. PD effluents were collected from the patients for mNGS and microbial culture. They were categorized into two groups based on antibiotic use within two weeks: antibiotic exposure group and no antibiotic exposure group. Pathogen detection rates of mNGS and microbial culture were compared between the two groups. Results A total of 69 patients were recruited in this study, including 25 patients in the antibiotic exposure group. The pathogen detection rate of microbial culture was significantly lower in the antibiotic exposure group than in the no antibiotic exposure group (χ2=20.707, P＜0.001), while the rate of mNGS remained unaffected (χ2=0.000, P=1.000). Based on the duration of antibiotic use prior to PD effluent collection, patients in the antibiotic exposure group were further divided into three groups: ≤1 day (n=5), 2～7 days (n=14), and ≥8 days (n=6) groups. There was no significant difference in pathogen detection rate of mNGS among the three groups (χ2=1.182, P=1.000), whereas the rate of microbial culture decreased along with the duration of antibiotic use (χ2=7.123, P=0.025). Both mNGS and microbial culture were found to be positive in 47 patients, of which 44 patients (93.6%) had the consistently positive results between the two detection methods, including identical results in 28 cases and partial identical results in 16 cases. Conclusion For patients with PD-associated peritonitis following antibiotic treatment, mNGS has the advantages of higher pathogen detection rate and stronger consistency with the pathogens identified by microbial culture.

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Peritoneal dialysis-associated peritonitis / Etiology / Metagenomics next-generation sequencing / Antibiotic exposure

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ZHANG Qing-yan, LIU Ying, FENG Yuan, LIU Xu-meng, JIANG Chun-ming, TANG Ri-ning. Clinical application of Metagenomic next-generation sequencing in peritoneal dialysis related peritonitis with antibiotic treatment[J]. Chinese Journal of Blood Purification. 2026, 25(06): 484-489 https://doi.org/10.3969/j.issn.1671-4091.2026.06.009

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