Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, China.
Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China.
Front Cell Infect Microbiol. 2024 Aug 19;14:1438982. doi: 10.3389/fcimb.2024.1438982. eCollection 2024.
BACKGROUND: When individuals infected with human immunodeficiency virus (HIV) experience pulmonary infections, they often exhibit severe symptoms and face a grim prognosis. Consequently, early, rapid, and accurate pathogen diagnosis is vital for informing effective treatment strategies. This study aimed to use metagenomic next-generation sequencing (mNGS) and targeted mNGS (tNGS) to elucidate the characteristics of pulmonary infections in HIV and non-HIV individuals. METHODS: This study enrolled 90 patients with pulmonary infection at the Department of Infectious Diseases of The First Hospital of Jilin University from June 2022 to May 2023, and they were divided into HIV (n=46) and non-HIV (n=44) infection groups. Their bronchoalveolar lavage fluid (BALF) was collected for mNGS analysis to evaluate the differences in pulmonary infection pathogens, and tNGS detection was performed on BALF samples from 15 HIV-infected patients. RESULTS: A total of 37 pathogens were identified in this study, including 21 bacteria, 5 fungi, 5 viruses, 5 mycobacteria, and 1 mycoplasma. The sensitivity of mNGS was 78.9% (71/90), which is significantly higher than that of conventional methods (CTM) (39/90, P=1.5E-8). The combination of mNGS with CTM can greatly enhance the sensitivity of pathogen detection. The prevalence of (82.6% 9.1%), cytomegalovirus (CMV) (58.7% 0%), and Epstein-Barr virus (EBV) (17.4% 2.3%) was significantly higher in the HIV infection group than in the non-HIV infection group (<0.05). Although no statistically significant difference was observed, the detection rate of was higher in HIV-infected patients (17.4%) than in the non-HIV group (6.8%). Furthermore, the tNGS results of BALF from 15 HIV-infected patients were not entirely consistent with the mNGS results., and the concordance rate of tNGS for the detection of main pathogens reached 86.7% (13/15). CONCLUSION: Next-generation sequencing (NGS) can accurately detect pathogens in the BALF of patients with pulmonary infection. The sensitivity of tNGS is comparable to that of mNGS. Therefore, this technique should be promoted in the clinic for better patient outcomes.
背景：当感染人类免疫缺陷病毒 (HIV) 的个体出现肺部感染时，他们通常会表现出严重的症状和严峻的预后。因此，早期、快速和准确的病原体诊断对于制定有效的治疗策略至关重要。本研究旨在使用宏基因组下一代测序 (mNGS) 和靶向 mNGS (tNGS) 来阐明 HIV 和非 HIV 个体肺部感染的特征。
方法：本研究纳入了 2022 年 6 月至 2023 年 5 月吉林大学第一医院感染科收治的 90 例肺部感染患者，将其分为 HIV 感染组（n=46）和非 HIV 感染组（n=44）。采集其支气管肺泡灌洗液（BALF）进行 mNGS 分析，评估肺部感染病原体的差异，并对 15 例 HIV 感染患者的 BALF 样本进行 tNGS 检测。
结果：本研究共鉴定出 37 种病原体，包括 21 种细菌、5 种真菌、5 种病毒、5 种分枝杆菌和 1 种支原体。mNGS 的灵敏度为 78.9%（71/90），明显高于传统方法（CTM）（39/90，P=1.5E-8）。mNGS 与 CTM 联合应用可大大提高病原体检测的灵敏度。HIV 感染组中（82.6% 9.1%）、巨细胞病毒（CMV）（58.7% 0%）和 Epstein-Barr 病毒（EBV）（17.4% 2.3%）的患病率明显高于非 HIV 感染组（<0.05）。虽然差异无统计学意义，但 HIV 感染患者（17.4%）中 的检出率高于非 HIV 组（6.8%）。此外，15 例 HIV 感染患者的 BALF tNGS 结果与 mNGS 结果不完全一致，tNGS 对主要病原体的检测一致性率达到 86.7%（13/15）。
结论：下一代测序（NGS）可准确检测肺部感染患者 BALF 中的病原体。tNGS 的灵敏度与 mNGS 相当。因此，应在临床上推广该技术，以改善患者的预后。
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