EP19.01: The diagnostic performance of nanopore sequencing method in the detection of intra‐amniotic infection in preterm labour
Year: 2023
Type: conference-abstract
Abstract: To determine the diagnostic performance of 16S rDNA nanopore sequencing method for the identification of intra-amniotic infection. We performed a prospective cohort study including 56 singleton pregnancies presenting with preterm labour. Amniotic fluid (AF) samples were obtained for the evaluation of bacteria in the amniotic cavity using cultivation and 16S rDNA Sanger sequencing methods. Participants were classified according to the results of AF culture, 16S Sanger sequencing and AF interleukin (IL)-6 concentration into four groups: 1) no intra-amniotic inflammation (AF IL-6 <2.6 ng/mL); 2) microbial invasion of the amniotic cavity (MIAC); 3) sterile intra-amniotic inflammation (AF IL-6 ≥2.6 ng/mL without MIAC); 4) intra-amniotic infection (AF IL-6 ≥2.6 ng/mL with MIAC). Nanopore sequencing was performed. 1) A positive 16S nanopore sequencing had a sensitivity of 88.89%, specificity of 80.9%, positive predictive value of 47.1%, negative predictive value of 97.4%, positive likelihood ratio 4.6 (95% CI 2.5-8.7), and negative likelihood ratio 0.14 (95% CI 0.02-0.88) for the identification of intra-amniotic infection; 2) About 10 of 56 samples showed discordant results, of these 1 was false negative and 9 were false positive; 3) Among nine cases with false-positive nanopore sequencing results, two cases were classified as MIAC by positive 16S Sanger sequencing results, 3 cases were categorised in sterile intra-amniotic inflammation group. The remaining 4 cases had no intra-amniotic inflammation; and 4) Nanopore sequencing additionally detect bacteria in 21.4% of patients with sterile intra-amniotic inflammation. Nanopore sequencing is advantageous in detection speed with high sensitivity and negative predictive value for the identification of intra-amniotic infection. False-positive nanopore cases without intra-amniotic inflammation represent contamination. We confirmed that a subset of women with preterm/preterm PROM has sterile intra-amniotic inflammation despite deep a long read sequencing technique.
DOI: 10.1002/uog.26968
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4387259948