School of Medicine, Ningbo University, Ningbo, Zhejiang, China.
Department of Infectious Diseases, Ningbo First Hospital, Ningbo University, Ningbo, Zhejiang, China.
Front Cell Infect Microbiol. 2022 Dec 19;12:957073. doi: 10.3389/fcimb.2022.957073. eCollection 2022.
Compared with traditional diagnostic methods (TDMs), rapid diagnostic methods for infectious diseases (IDs) are urgently needed. Metagenomic next-generation sequencing (mNGS) has emerged as a promising diagnostic technology for clinical infections.
This retrospective observational study was performed at a tertiary hospital in China between May 2019 and August 2022. The chi-square test was used to compare the sensitivity and specificity of mNGS and TDMs. We also performed a subgroup analysis of the different pathogens and samples.
A total of 435 patients with clinical suspicion of infection were enrolled and 372 (85.5%) patients were finally categorized as the ID group. The overall sensitivity of mNGS was significantly higher than that of the TDMs (59.7% vs. 30.1%, < 0.05). However, there was no significant difference in the overall specificity between the two methods (83.3% vs. 89.6%, = 0.37). In patients with identified pathogens, the positive rates of mNGS for detecting bacteria (88.7%), fungi (87.9%), viruses (96.9%), and (NTM; 100%) were significantly higher than those of TDMs ( < 0.05). The positive rate of mNGS for detecting was not superior to that of TDMs (77.3% vs. 54.5%, = 0.11). The sensitivity rates of mNGS for pathogen identification in bronchoalveolar lavage fluid, blood, cerebrospinal fluid, pleural fluid, and tissue were 72.6%, 39.3%, 37.5%, 35.0% and 80.0%, respectively.
With the potential for screening multiple clinical samples, mNGS has an overall advantage over TDMs. It can effectively identify pathogens, especially those that are difficult to identify using TDMs, such as NTM, chlamydia, and parasites.
与传统诊断方法（TDMs）相比，急需用于传染病的快速诊断方法。宏基因组下一代测序（mNGS）已成为临床感染的一种很有前途的诊断技术。
这是一项在中国一家三级医院进行的回顾性观察性研究，时间为 2019 年 5 月至 2022 年 8 月。采用卡方检验比较 mNGS 和 TDMs 的灵敏度和特异性。我们还对不同病原体和样本进行了亚组分析。
共纳入 435 例临床疑似感染患者，最终有 372 例（85.5%）患者被归类为感染组。mNGS 的总体灵敏度明显高于 TDMs（59.7%比 30.1%，<0.05）。然而，两种方法的总体特异性无显著差异（83.3%比 89.6%，=0.37）。在确定病原体的患者中，mNGS 检测细菌（88.7%）、真菌（87.9%）、病毒（96.9%）和分枝杆菌（NTM；100%）的阳性率明显高于 TDMs（<0.05）。mNGS 检测的阳性率并不优于 TDMs（77.3%比 54.5%，=0.11）。mNGS 对支气管肺泡灌洗液、血液、脑脊液、胸腔积液和组织中病原体鉴定的灵敏度分别为 72.6%、39.3%、37.5%、35.0%和 80.0%。
mNGS 具有筛查多种临床样本的潜力，总体上优于 TDMs。它可以有效地识别病原体，特别是那些使用 TDMs 难以识别的病原体，如 NTM、衣原体和寄生虫。
