Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Cell Infect Microbiol. 2023 Aug 24;13:1223576. doi: 10.3389/fcimb.2023.1223576. eCollection 2023.
To assess the diagnostic efficacy of metagenomic next generation sequencing (mNGS) for proven invasive pulmonary aspergillosis (IPA).
A total of 190 patients including 53 patients who had been diagnosed with proven IPA were retrospectively analyzed. Using the pathological results of tissue biopsy specimens as gold standard, we ploted the receiver operating characteristic (ROC) curve to determine the optimal cut-off value of mNGS species-specific read number (SSRN) of in bronchoalveolar lavage fluid (BALF)for IPA. Furthermore, we evaluated optimal cut-off value of mNGS SSRN in different populations.
The optimal cut-off value of mNGS SSRN in BALF for IPA diagnosis was 2.5 for the whole suspected IPA population, and 1 and 4.5 for immunocompromised and diabetic patients, respectively. The accuracy of mNGS was 80.5%, 73.7% and 85.3% for the whole population, immunocompromised and diabetic patients, respectively.
The mNGS in BALF has a high diagnostic efficacy for proven IPA, superioring to culture in sputum and BALF and GM test in blood and BALF. However, the cut-off value of SSRN should be adjusted when in different population.
评估宏基因组下一代测序（mNGS）在确诊侵袭性肺曲霉病（IPA）中的诊断效能。
回顾性分析了 190 例患者，其中包括 53 例确诊 IPA 的患者。以组织活检标本的病理结果为金标准，绘制受试者工作特征（ROC）曲线，确定支气管肺泡灌洗液（BALF）中 mNGS 种特异性读长数（SSRN）用于 IPA 的最佳截断值。此外，我们评估了 mNGS SSRN 在不同人群中的最佳截断值。
对于整个疑似 IPA 人群，BALF 中 IPA 诊断的 mNGS SSRN 最佳截断值为 2.5；对于免疫功能低下和糖尿病患者，最佳截断值分别为 1 和 4.5。mNGS 对整个人群、免疫功能低下患者和糖尿病患者的诊断准确性分别为 80.5%、73.7%和 85.3%。
BALF 中的 mNGS 对确诊 IPA 具有较高的诊断效能，优于痰和 BALF 培养以及血和 BALF 的 GM 检测。然而，当在不同人群中时，SSRN 的截断值应进行调整。
