The Trans-Kingdom Spectrum of Mpox-like Lesion Pustules of Suspect Patients in the Mpox Clade Ib Outbreak in Eastern Democratic Republic of the Congo

During infectious disease outbreaks, acquiring genetic data across various kingdoms offers essential information to tailor precise treatment methodologies and bolster clinical, epidemiological, and public health awareness. Metagenomics sequencing has paved the way for personalized treatment approaches and streamlined the monitoring process for both co-infections and opportunistic infections. In this study, we conducted long-read metagenomic DNA sequencing on mpox-like lesion pustules from six suspected patients who were positive and confirmed to be infected with MPXV during the MPXV subclade Ib outbreak in the Eastern Democratic Republic of the Congo. The sequenced data were taxonomically classified as bacterial, fungal, and viral in composition. Our results show a wide spectrum of microorganisms present in the lesions. Bacteria such as <i>Corynebacterium amycolatum</i>, <i>Gardnerella vaginalis</i>, <i>Enterococcus faecium</i>, <i>Enterobacter clocae</i>, <i>Staphylococcus epidermidis</i>, and <i>Stenotrophomonas maltophilia</i> were found in the lesions. The viral classification of the reads pointed out the absolute predominance of the monkeypox virus. Taken together, the outcomes of this investigation underscore the potential involvement of microorganisms in mpox lesions and the possible role that co-infections played in exacerbating disease severity and transmission during the MPXV subclade Ib outbreak.