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宏基因组下一代测序在支气管肺泡灌洗液检测肺结核中的价值。

The value of metagenomic next-generation sequencing for the diagnosis of pulmonary tuberculosis using bronchoalveolar lavage fluid.

机构信息

Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Key Laboratory of Respiratory Diseases, National Health Commission of the People's Republic of China, and National Clinical Research Center for Respiratory Diseases, Wuhan, China.

出版信息

Lab Med. 2024 Jan 6;55(1):96-102. doi: 10.1093/labmed/lmad041.

DOI:10.1093/labmed/lmad041
PMID:37267076
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10771034/
Abstract

OBJECTIVE: The aim of this study was to compare metagenomic next-generation sequencing (mNGS) with other methods, including Xpert MTB/RIF, Mycobacterium tuberculosis (MTB) culture, and acid-fast bacillus (AFB) staining in the diagnosis of pulmonary tuberculosis (PTB) using bronchoalveolar lavage fluid (BALF). METHODS: The data of 186 patients with suspected PTB were retrospectively collected from January 2020 to May 2021 at Tongji Hospital. BALF samples were collected from all patients and analyzed using AFB staining, MTB culture, Xpert MTB/RIF, and mNGS. RESULTS: Of the 186 patients, 38 patients were ultimately diagnosed as PTB. Metagenomic next-generation sequencing exhibited a sensitivity of 78.95%, which was higher than AFB staining (27.59%) and MTB culture (44.12%) but similar to Xpert MTB/RIF (72.73%). Utilization of combined methods demonstrates improvement for PTB diagnosis. In support of this, the area under the receiver operating characteristic curve for the combination of mNGS and MTB culture (0.933, 95% CI: 0.871, 0.995) was larger than those of mNGS, Xpert MTB/RIF, MTB culture, and the combination of Xpert MTB/RIF and MTB culture. CONCLUSION: The sensitivity of mNGS in the diagnosis of PTB using BALF specimen is similar to Xpert MTB/RIF. Metagenomic next-generation sequencing in combination with MTB culture may further improve the diagnosis of pulmonary tuberculosis.

摘要

目的：本研究旨在比较宏基因组下一代测序（mNGS）与其他方法，包括 Xpert MTB/RIF、分枝杆菌培养和抗酸杆菌染色，在支气管肺泡灌洗液（BALF）中诊断肺结核（PTB）的应用。

方法：回顾性收集 2020 年 1 月至 2021 年 5 月间 186 例疑似肺结核患者的数据。对所有患者采集 BALF 样本，进行抗酸杆菌染色、分枝杆菌培养、Xpert MTB/RIF 和 mNGS 分析。

结果：186 例患者中，最终 38 例诊断为肺结核。mNGS 的灵敏度为 78.95%，高于抗酸杆菌染色（27.59%）和分枝杆菌培养（44.12%），但与 Xpert MTB/RIF（72.73%）相似。联合方法的应用提高了 PTB 的诊断率。支持这一观点的是，mNGS 联合分枝杆菌培养的曲线下面积（0.933，95%置信区间：0.871，0.995）大于 mNGS、Xpert MTB/RIF、分枝杆菌培养和 Xpert MTB/RIF 联合分枝杆菌培养的曲线下面积。

结论：mNGS 对 BALF 标本诊断 PTB 的敏感性与 Xpert MTB/RIF 相似。mNGS 联合分枝杆菌培养可能进一步提高肺结核的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/24833974e77c/lmad041_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/c4e7088f1932/lmad041_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/1d719fca1dba/lmad041_fig2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/c8549576d20a/lmad041_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/24833974e77c/lmad041_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/c4e7088f1932/lmad041_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/1d719fca1dba/lmad041_fig2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/c8549576d20a/lmad041_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08f5/10771034/24833974e77c/lmad041_fig4.jpg

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引用本文的文献

[1]
Comparative analysis of the clinical characteristic and lung microbiota in adult and elderly patients with pulmonary tuberculosis.

Sci Rep. 2025-6-5

[2]
Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid.

Infect Drug Resist. 2025-5-3

[3]
Validation of mNGS results using extensive lab and clinical data.

BMC Microbiol. 2025-3-28

[4]
Diagnostic accuracy of metagenomic next-generation sequencing in pulmonary tuberculosis: a systematic review and meta-analysis.

Syst Rev. 2024-12-27

[5]
The value of metagenomic next-generation sequencing with blood samples for the diagnosis of disseminated tuberculosis.

Front Cell Infect Microbiol. 2024-12-9

[6]
Raman-enhanced sensor based on CRISPR-SERS technology for the rapid and hypersensitive detection of Mycobacterium tuberculosis.

Anal Bioanal Chem. 2024-11

[7]
Metagenomic next-generation sequencing for complex detection: a meta-analysis.

Front Public Health. 2023

本文引用的文献

[1]
Tuberculosis Diagnosis by Metagenomic Next-generation Sequencing on Bronchoalveolar Lavage Fluid: a cross-sectional analysis.

Int J Infect Dis. 2021-3

[2]
Clinical metagenomic sequencing for diagnosis of pulmonary tuberculosis.

J Infect. 2020-10

[3]
Evaluation of Plasma Microbial Cell-Free DNA Sequencing to Predict Bloodstream Infection in Pediatric Patients With Relapsed or Refractory Cancer.

JAMA Oncol. 2020-4-1

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WHO global progress report on tuberculosis elimination.

Lancet Respir Med. 2020-1

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Clinical Evaluation of Diagnosis Efficacy of Active Complex Infection via Metagenomic Next-Generation Sequencing of Direct Clinical Samples.

Front Cell Infect Microbiol. 2019-10-18

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Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis.

N Engl J Med. 2019-6-13

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Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults.

Cochrane Database Syst Rev. 2019-6-7

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Next-generation sequencing combined with routine methods to detect the pathogens of encephalitis/meningitis from a Chinese tertiary pediatric neurology center.

J Infect. 2019-5

[9]
Analytical and clinical validation of a microbial cell-free DNA sequencing test for infectious disease.

Nat Microbiol. 2019-2-11

[10]
Microbiological Diagnostic Performance of Metagenomic Next-generation Sequencing When Applied to Clinical Practice.

Clin Infect Dis. 2018-11-13

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