Song Jiafu, Liu Suxia, Xie Yongpeng, Zhang Chen, Xu Caiyun
Department of Respiratory and Critical Care Medicine, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China.
Department of Critical Care Medicine, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China.
Heliyon. 2024 May 3;10(9):e30712. doi: 10.1016/j.heliyon.2024.e30712. eCollection 2024 May 15.
We aimed to evaluate and compare the diagnostic performance of RNA-mNGS and DNA-mNGS workflow in bacterial pneumonia, fungal pneumonia and tuberculosis.
A total of 134 cases suspected pneumonia undergoing both DNA and RNA based mNGS of bronchoalveolar lavage fluid (BALF) and also traditional etiological examination were evaluated retrospectively.Sensitivity, specificity, PPV, NPV and accuracy rate of DNA and RNA based mNGS were estimated.
In the diagnosis performance of bacterial pathogens in LRTIs,the specificity of RNA-mNGS was higher than that of DNA-mNGS(82.3 % vs. 61.9 %, < 0.01). There was no significant difference of sensitivity between the two process(71.4 % vs. 85.7 %, = 0.375).In the diagnosis performance of fungal pathogens in LRTIs,the specificity of RNA-mNGS was higher than that of DNA-mNGS (72.3 % vs. 27.3 %, < 0.001). There was no significant difference of sensitivity between the two process(96.5 % vs. 98.8 %, = 0.125).In the diagnosis performance of tuberculosis in LRTIs,the sensitivity of DNA-mNGS was higher than that of RNA-mNGS (91.7 % vs. 33.3 %, = 0.016),the specificity was similar in the two process (100 %).
RNA-mNGS may reduced the misdiagnosis rate of bacterial and fungal pathogens in LRTIs.Compared to RNA-mNGS, DNA-mNGS may could improve the diagnostic rate of tuberculosis.
我们旨在评估和比较RNA宏基因组二代测序（RNA-mNGS）和DNA宏基因组二代测序（DNA-mNGS）流程在细菌性肺炎、真菌性肺炎和肺结核诊断中的性能。
回顾性评估134例疑似肺炎患者，这些患者均接受了基于支气管肺泡灌洗液（BALF）的DNA和RNA宏基因组二代测序以及传统病因学检查。评估了基于DNA和RNA的宏基因组二代测序的敏感性、特异性、阳性预测值、阴性预测值和准确率。
在下呼吸道感染（LRTIs）细菌病原体的诊断性能方面，RNA-mNGS的特异性高于DNA-mNGS（82.3%对61.9%，P<0.01）。两个流程之间的敏感性无显著差异（71.4%对85.7%，P = 0.375）。在LRTIs真菌病原体的诊断性能方面，RNA-mNGS的特异性高于DNA-mNGS（72.3%对27.3%，P<0.001）。两个流程之间的敏感性无显著差异（96.5%对98.8%，P = 0.125）。在LRTIs肺结核的诊断性能方面，DNA-mNGS的敏感性高于RNA-mNGS（91.7%对33.3%，P = 0.016），两个流程的特异性相似（均为100%）。
RNA-mNGS可能降低LRTIs中细菌和真菌病原体的误诊率。与RNA-mNGS相比，DNA-mNGS可能提高肺结核的诊断率。
