Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Eur Rev Med Pharmacol Sci. 2023 May;27(10):4752-4763. doi: 10.26355/eurrev_202305_32486.
The absence of proper pathogen treatment in the early stages can result in missing out on treatment chances or the overuse of antibiotics, both of which are the primary factors behind fatalities caused by lung infections. In this study, we aimed to investigate the efficacy of metagenomic next-generation sequencing (mNGS) in comparison to conventional detection methods in detecting infectious pathogens.
In this retrospective study, the infection pathogens of 104 patients were examined, and 86 bronchoalveolar lavage fluid (BALF), eight pleural effusions, and ten sputum samples were collected. The conventional detection approaches and mNGS analysis were used to determine the infection pathogen profiles and their detection rates were analyzed.
Our study showed that mNGS was more sensitive (89.42%) than the conventional detection methods (56.73%) (p < 0.001), with a 32.69% improvement in sensitivity. The efficacy of mNGS in detecting mixed infections was significantly higher than that of conventional detection methods, with a detection rate of 85.29% compared to 17.65% (p < 0.001). The study demonstrated that mNGS had a higher sensitivity than the conventional detection methods when it came to diagnosing pulmonary infections, making it a potentially useful tool for clinical diagnosis.
Combining mNGS with other pathogenic detection techniques can be an effective way to increase the rate of detecting pulmonary infections, as well as to provide guidance for treatment adjustments. Furthermore, the timing of sample collection and antibiotic administration can influence the effectiveness of mNGS when used on BALF specimens.
在早期阶段缺乏适当的病原体治疗可能会错失治疗机会或过度使用抗生素，这两者都是肺部感染导致死亡的主要因素。本研究旨在比较宏基因组下一代测序（mNGS）与传统检测方法在检测感染病原体方面的疗效。
在这项回顾性研究中，检查了 104 名患者的感染病原体，采集了 86 份支气管肺泡灌洗液（BALF）、8 份胸腔积液和 10 份痰液样本。采用传统检测方法和 mNGS 分析来确定感染病原体谱，并分析其检测率。
我们的研究表明，mNGS 比传统检测方法（56.73%）更敏感（89.42%）（p<0.001），敏感性提高了 32.69%。mNGS 检测混合感染的效果明显优于传统检测方法，检测率为 85.29%，而传统检测方法为 17.65%（p<0.001）。研究表明，mNGS 在诊断肺部感染方面比传统检测方法具有更高的敏感性，因此可能是一种有用的临床诊断工具。
将 mNGS 与其他病原体检测技术相结合，可以有效提高肺部感染的检测率，并为治疗调整提供指导。此外，样本采集和抗生素使用的时间会影响 BALF 标本上 mNGS 的有效性。
