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支气管肺泡灌洗液宏基因组下一代测序用于鉴定肺部感染患者的病原体:一项回顾性研究。

Metagenomic next generation sequencing of bronchoalveolar lavage fluids for the identification of pathogens in patients with pulmonary infection: A retrospective study.

机构信息

Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China.

Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China.

出版信息

Diagn Microbiol Infect Dis. 2024 Sep;110(1):116402. doi: 10.1016/j.diagmicrobio.2024.116402. Epub 2024 Jun 12.

Abstract

Due to the limitations of traditional laboratory methods (TMs), identification of causative pathogens of numerous pulmonary infections (PIs) remains difficult. This study evaluated the value of metagenomic next generation sequencing (mNGS) in the identification of various respiratory pathogens. A total of 207 patients with TMs and mNGS data were collected for this retrospective study. TMs included sputum culture, blood, and bronchoalveolar lavage fluid (BALF) analysis, or polymerase chain reaction analysis of throat swabs. Otherwise, BALF was collected and analyzed using mNGS. For bacterial pathogens, sensitivities of mNGS as compared to TMs were 76.74 % and 58.14 % (P=0.012). For fungal pathogens, the detection rate of mNGS sensitivity was higher as compared to that of TMs (93.68 % vs 22.11 %; P<0.001). The positive predictive value and negative predictive value were also greater for mNGS. Use of mNGS for BALF analysis offers good specificity and thus facilitates to the clinical diagnosis of PIs.

摘要

由于传统实验室方法(TMs)的局限性,许多肺部感染(PIs)的病原体的鉴定仍然很困难。本研究评估了宏基因组下一代测序(mNGS)在鉴定各种呼吸道病原体中的价值。这项回顾性研究共收集了 207 例接受 TM 和 mNGS 数据的患者。TMs 包括痰培养、血液和支气管肺泡灌洗液(BALF)分析,或咽拭子聚合酶链反应分析。否则,使用 mNGS 收集和分析 BALF。对于细菌病原体,mNGS 的敏感性与 TM 相比分别为 76.74 %和 58.14 %(P=0.012)。对于真菌病原体,mNGS 的检测率高于 TM(93.68 %比 22.11 %;P<0.001)。mNGS 的阳性预测值和阴性预测值也更高。使用 mNGS 分析 BALF 可提供良好的特异性,从而有助于 PI 的临床诊断。

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