DOI: 10.4103/mjbl.mjbl_850_24 ISSN: 1812-156X

Differences in Pathogenic Bacteria Identification in Hemodialysis Patients with Urinary Tract Infections: A Traditional Culture Methods Versus Metagenomic Next-Generation Sequencing

Noor A. Al-Ogaili, Wathiq A. Al-Draghi
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Abstract

Background:

The development of a promising metagenomic next-generation sequencing (mNGS) technology that objectively enables the detection of pathogens is gaining popularity for application in clinical diagnosis.

Objective:

We aimed to reanalyze cases where traditional culture identified Escherichia coli as the pathogenic agent by mNGS and compare the results of two methods.

Materials and Methods:

A total of 150 male and female samples (10 mL midstream urine) under more than 1 year of hemodialysis therapy were collected from hospitals and private labs in Baghdad, Iraq. They were tested for urinary tract infection (UTI) by microscopic and culture methods. Four samples, which were detected with E.coli were re-tested by the molecular method (mNGs).

Results:

From 150 samples, 71 (47.3%) patients were positive for UTI by microscopic examination, and 59 (83.1%) were positive for UTI by urine culture, whereas 12 (16.9%) samples produced negative urine culture. Of the positive urine culture and Vitek-2 system, the results found that the following bacterial species were isolated: 12 (19.7%) Gram-positive bacteria, Staphylococcus spp. (14.75%), Enterococcus faecalis (3.27%), and Aerococcus viridans (1.64%). The majority of pathogenic isolates (80.3%) were Gram-negative bacteria ( E. coli , 45.9%; Klebsiella pneumoniae , 18%; Enterobacter aerogenes , 6.55%; Acinetobacter baumannii , 3.27%; Pseudomonas aeruginosa , 3.27%; Serratia spp., 1.64%; and Pantoea spp., 1.64%). However, mNGS revealed the dominance of Escherichia albertii instead of E. coli in the four tested urine samples. The implications of these differences, including the potential impact on patient management and treatment outcomes, were explored.

Conclusion:

This study reviews the sensitivity and limitations of culture methods compared with next-generation sequencing, highlighting the importance of integrating advanced molecular techniques in diagnostic workflows and showing that the vast majority of UTI bacteria were Gram-negative.

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