Application of nanopore adaptive sequencing in pathogen detection of a patient with infection.

Introduction: Nanopore sequencing has been widely used in clinical metagenomic sequencing for pathogen detection with high portability and real-time sequencing. Oxford Nanopore Technologies has recently launched an adaptive sequencing function, which can enrich on-target reads through real-time alignment and eject uninteresting reads by reversing the voltage across the nanopore. Here we evaluated the utility of adaptive sequencing in clinical pathogen detection.

Methods: Nanopore adaptive sequencing and standard sequencing was performed on a same flow cell with a bronchoalveolar lavage fluid sample from a patient with psittacosis infection, and was compared with the previous mNGS results.

Results: Nanopore adaptive sequencing identified 648 on-target stop receiving reads with the longest median read length(688bp), which account for 72.4% of all psittaci reads and 0.03% of total reads in enriched group. The read proportion matched to in the stop receiving group was 99.85%, which was much higher than that of the unblock (<0.01%) and fail to adapt (0.02%) groups. Nanopore adaptive sequencing generated similar data yield of compared with standard nanopore sequencing. The proportion of reads in adaptive sequencing is close to that of standard nanopore sequencing and mNGS, but generated lower genome coverage than mNGS.

Discussion: Nanopore adaptive sequencing can effectively identify target reads in real-time, but how to increase the targeted data of pathogens still needs to be further evaluated.