宏基因组下一代测序（mNGS）彻底改变了病原体的检测，特别是在免疫功能低下的个体中，例如接受强化化疗和造血干细胞移植的儿科患者。本研究旨在探讨中性粒细胞计数对mNGS诊断发热性疾病儿童感染的诊断效能的影响。我们对2019年1月至2022年9月血液科/肿瘤科发热性疾病儿科患者进行了回顾性分析。该研究纳入了387名患者，共出现516次发热发作。通过分析 516 例儿科病例的数据，我们的研究发现，70.7% 的儿童患有发热性中性粒细胞减少症 (FN)，29.3% 的儿童患有发热性中性粒细胞减少症 (FWN)。 mNGS 的阳性检出率为 84.9%，而传统微生物检测 (CMT) 的阳性检出率为 29.7%。虽然 FN 和 FWN 组的 mNGS 阳性检出率相似，但 FN 患者中细菌病原体的检出率更高。此外，与 FWN 组 (65.6%，p＜0.001) 相比，FN 组 (46.8%) 识别出“可能的”微生物病因的比率较低。在分析生物体和标本类型时，mNGS 以及血液和鼻咽拭子样本中检测到的病毒和真菌的“可能”识别率特别低。这些发现强调了中性粒细胞计数对儿科发热患者 mNGS 结果的显着影响，并强调了针对该人群采取定制诊断方法的必要性。© 2024 作者。

Metagenomic next-generation sequencing (mNGS) has revolutionized the detection of pathogens, particularly in immunocompromised individuals such as pediatric patients undergoing intensive chemotherapy and hematopoietic stem cell transplantation. This study aims to explore the impact of neutrophil count on the diagnostic efficacy of mNGS in diagnosing infections in pediatric patients with febrile diseases. We conducted a retrospective analysis of pediatric patients with febrile diseases in the hematology/oncology department from January 2019 to September 2022. The study included 387 patients with 516 febrile episodes. Analyzing data from 516 pediatric cases, our study found that 70.7 % had febrile neutropenia (FN) and 29.3 % had febrile without neutropenia (FWN). mNGS demonstrated a high positive detection rate of 84.9 %, compared to 29.7 % for conventional microbiological tests (CMT). While the positive detection rates of mNGS were similar in both FN and FWN groups, bacterial pathogens were more frequently detected in FN patients. Furthermore, the rate of identifying a "probable" microbial etiology was lower in the FN group (46.8 %) compared to the FWN group (65.6 %, p＜0.001). When analyzing the types of organisms and specimens, the "probable" identification rates were particularly lower for viruses and fungi detected by mNGS, as well as in blood and nasopharyngeal swab samples. These findings underscore the significant influence of neutrophil counts on mNGS results in pediatric febrile patients and highlight the necessity for tailored diagnostic approaches in this population.© 2024 The Authors.