宏基因组下一代测序（mNGS）在支气管扩张症患者管理中的应用：一项93例患者的单中心回顾性研究

The Utility of Metagenomic Next-Generation Sequencing (mNGS) in the Management of Patients With Bronchiectasis: A Single-Center Retrospective Study of 93 Cases.

作者信息

Zhang Hui, Shen Dongfeng, Zhou Jiaqi, Yang Qingyue, Ying Ying, Li Na, Cao Linfeng, Wang Wenmin, Ma Xiaolong

机构信息

Department of Respiratory Medicine, The First Hospital of Jiaxing (the Affiliated Hospital of Jiaxing University), The Key Laboratory of Precision Therapy for Lung Cancer, Jiaxing, Zhejiang, China.

Biological Medicine Research and Development Center, Yangtze Delta of Zhejiang, Hangzhou, Zhejiang, China.

出版信息

Open Forum Infect Dis. 2023 Aug 10;10(8):ofad425. doi: 10.1093/ofid/ofad425. eCollection 2023 Aug.

DOI:10.1093/ofid/ofad425

PMID:37663088

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10470666/

Abstract

BACKGROUND

Bronchiectasis is a chronic inflammatory respiratory disease mainly caused by pathogenic infections. However, standard methods of pathogen detection show prolonged cycle durations and unsatisfactory sensitivity and detection rates. Macrogenomic next-generation sequencing (mNGS) emerges as a promising technique for swift, effective, and unbiased pathogen detection and subsequent data interpretation.

METHODS

Here, a retrospective analysis of 93 patients with suspected bronchiectasis was performed to assess the clinical applicability of mNGS. Bronchoalveolar alveolar lavage fluid (BALF) samples were collected from these subjects, followed by standard assays and mNGS separately. The turnaround time, detection rate, and pathogen identification using mNGS were compared with those of standard methods.

RESULTS

mNGS identified a greater number of bacteria (72 vs 16), fungi (26 vs 19), and viruses (14 vs 0) than standard methods. Specifically, the commonly identified bacteria were , , , and , while the most detected fungi were and the most prevalent viruses were human herpesviruses. Of note, 29 out of 30 patients (96.67%) who received optimized treatment strategies based on mNGS results experienced recovery.

CONCLUSIONS

Collectively, these findings suggest that mNGS has the potential to improve the diagnosis and treatment of bronchiectasis patients by enabling rapid and precise pathogen detection, which can lead to timely and effective treatment strategies.

摘要

背景

支气管扩张是一种主要由病原体感染引起的慢性炎症性呼吸道疾病。然而，标准的病原体检测方法显示出检测周期长、灵敏度和检出率不尽人意的问题。宏基因组下一代测序（mNGS）作为一种有前景的技术出现，可用于快速、有效且无偏倚的病原体检测及后续数据解读。

方法

在此，对93例疑似支气管扩张患者进行回顾性分析，以评估mNGS的临床适用性。从这些受试者中采集支气管肺泡灌洗液（BALF）样本，然后分别进行标准检测和mNGS检测。将mNGS的周转时间、检出率和病原体鉴定结果与标准方法进行比较。

结果

与标准方法相比，mNGS鉴定出更多的细菌（72种对16种）、真菌（26种对19种）和病毒（14种对0种）。具体而言，常见的鉴定细菌为[具体细菌名称]，最常检测到的真菌为[具体真菌名称]，最普遍的病毒为人疱疹病毒。值得注意的是，30例根据mNGS结果接受优化治疗策略的患者中有29例（96.67%）康复。