AMC in Blood - Advanced Metagenomic Analysis

Description

What is AMC in Blood?

AMC in blood (AMCS) is an advanced clinical analysis performed using metagenomic nanopore sequencing, designed to detect viral, bacterial and other microorganism infections present in venous blood.

It uses third-generation sequencing (NGS) techniques to comprehensively identify all microorganisms and resistance and virulence plasmids present in the sample.

Technical specifications

Parameter	Value
Sensitivity	> 99.55%
Specificity	> 99.55%
Minimum depth	30X
PCR amplification	Not required
Technology	3rd-generation NGS
Read length	> 4 Mb

Key features

• High quality and precision in genomic sequencing
• Read length greater than 4 Mb
• Easy reassembly of microbial genomes
• Lower error rate

Technology

Nanopore sequencing

We use third-generation nanopore technology that enables long reads (> 4 Mb) for a comprehensive analysis of all microorganisms present in the blood sample.

• Reads longer than 4 megabases
• Complete reassembly of microbial genomes
• Identification of resistance plasmids
• Detection of virulence genes

No PCR amplification

Our protocol does not require PCR amplification, eliminating biases and artifacts that can interfere with the accurate detection of microorganisms.

• Elimination of amplification biases
• Reduction of technical artifacts
• Higher sequencing fidelity
• Detection of minority variants

High precision and sensitivity

We achieve a sensitivity and specificity greater than 99.55% with a minimum depth of 30X, guaranteeing the reliable detection of pathogenic microorganisms.

• Sensitivity > 99.55%
• Specificity > 99.55%
• Coverage depth 30X
• Lower error rate

Workflow

1. DNA extraction — Direct extraction of microbial DNA from the blood sample.
2. Library preparation — Preparation without PCR amplification to avoid biases.
3. NGS sequencing — Third-generation nanopore sequencing.
4. Bioinformatic analysis — Identification of microorganisms and resistances.
5. Clinical report — Detailed report with therapeutic recommendations.

Sample

Sample collection protocol

Requirement	Detail
Sample type	Venous blood (primary sample)
Volume	5-10 ml
Anticoagulant	EDTA (purple tube)

Transport conditions

Condition	Requirement
Temperature	2-8 °C (refrigerated)
Maximum time	48 hours
Container	Specific packaging for transport
Labeling	Clear patient identification

Important considerations

• Draw before starting antibiotic therapy (if possible)
• Aseptic technique to avoid contamination
• Correct patient identification
• Cold storage until processing
• Avoid freezing the sample

Required clinical information

• Patient demographic data
• Current clinical symptoms
• Prior antimicrobial treatments
• Diagnostic suspicion
• Clinical context (ICU, transplant, etc.)

Results

Microorganism detection

Group	Detection scope
Bacteria	Pathogenic and commensal species
Viruses	Detection of viral DNA and RNA
Fungi	Yeasts and filamentous fungi
Parasites	Protozoa and other pathogens
Mycobacteria	M. tuberculosis and atypical mycobacteria

Antimicrobial resistance

Element	Description
Resistance plasmids	Mobile genetic elements
Resistance genes	Specific mechanisms
Virulence factors	Pathogenicity genes
Phenotypic prediction	Antimicrobial susceptibility

Results turnaround time

Phase	Timing
Receipt	Day 0 — Arrival of the sample at the laboratory
Processing	Days 1-10 — Sequencing and analysis
Report	Day 12 — Delivery of the clinical report

Clinical recommendations

• Correlation with the patient’s clinical presentation is essential
• Consider possible contamination in cases of gram-positive cocci
• Absence of detection does not rule out infection
• Results should be interpreted in clinical context
• Consult a clinical microbiology specialist if necessary

Clinical indications

Priority indications

• Sepsis and septic shock — Rapid diagnosis in critically ill patients.
• Bacteremia in immunocompromised patients — Transplant, oncology, HIV.
• Nosocomial infections — Suspected multidrug resistance.
• Fever of unknown origin — When conventional methods fail.

Secondary indications

• Infective endocarditis
• Vascular prosthesis infections
• Meningitis of unknown etiology
• Chronic osteomyelitis
• Intravascular catheter infections

Specialties that request it

Critical Care Medicine · Cardiology · Clinical Infectious Diseases · Oncology · Pulmonology · Nephrology · Surgery · Pediatrics

Advantages of AMC in Blood

• Broad detection of microorganisms
• Identification of resistances
• Does not require prior culture
• Higher sensitivity than cultures
• Results in 15 days