Gao Nannan, Feng Saran, Yu Xiaoxiao, Zhao Jing, Wan Yunyan, Yao Zhouhong, Li Dezhi
Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Weiqi Road, Jinan, Shandong, 250021, China.
Department of Hematology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, 250000, China.
BMC Infect Dis. 2025 Mar 25;25(1):407. doi: 10.1186/s12879-025-10806-9.
Metagenomic next-generation sequencing (mNGS) is a novel method for identifying pathogens in infectious diseases. This study aimed to explored the application value of mNGS in diagnosing pulmonary infections with pleural effusion, confirmed by medical thoracoscopy.
We retrospectively reviewed 25 patients with pulmonary infections and pleural effusion between July 2020 and December 2021. All patients had their diagnosis confirmed by medical thoracoscopy to obtain tissue samples for both traditional testing and mNGS. Samples included pleural effusion, successive sputum, and tissue obtained through medical thoracoscopy. We wanted to assess how effective mNGS was in accurately diagnosing these infections.
This study found that the positive predictive value of mNGS (76% (19/25)) was significantly higher than that of traditional testing (32% (8/25)). The most commonly identified pathogens were Mycobacterium tuberculosis (n = 5), followed by Fusobacterium nucleatum (n = 4), Torque teno virus (n = 4), Streptococcus intermedius (n = 3), Peptostreptococcus stomatis (n = 2), Porphyromonas endodontalis (n = 2), and Campylobacter rectus (n = 2). The percentage of mNGS-positive cases was significantly higher than that from traditional testing for bacteria, but the superiority of mNGS for tuberculosis detection was insignificant. Ten cases were identified with mixed infections by mNGS, while no mixed infections were found by traditional testing.
Our study showed that using mNGS in combination with biopsy samples obtained through medical thoracoscopy resulted in higher positive rates compared to traditional tests and provided more evidence of pathogens for patients with infectious pleural effusion.
宏基因组下一代测序（mNGS）是一种用于识别感染性疾病病原体的新方法。本研究旨在探讨mNGS在诊断经内科胸腔镜确诊的伴有胸腔积液的肺部感染中的应用价值。
我们回顾性分析了2020年7月至2021年12月期间25例伴有肺部感染和胸腔积液的患者。所有患者均经内科胸腔镜确诊，以获取用于传统检测和mNGS的组织样本。样本包括胸腔积液、连续痰液以及通过内科胸腔镜获取的组织。我们想评估mNGS在准确诊断这些感染方面的效果如何。
本研究发现，mNGS的阳性预测值（76%（19/25））显著高于传统检测（32%（8/25））。最常见的病原体为结核分枝杆菌（n = 5），其次为具核梭杆菌（n = 4）、细小病毒B19（n = 4）、中间链球菌（n = 3）、口腔消化链球菌（n = 2）、牙髓卟啉单胞菌（n = 2）和直肠弯曲菌（n = 2）。mNGS检测细菌阳性病例的百分比显著高于传统检测，但mNGS在结核检测方面的优势不明显。mNGS检测出10例混合感染病例，而传统检测未发现混合感染病例。
我们的研究表明，与传统检测相比，mNGS联合内科胸腔镜活检样本可提高阳性率，并为感染性胸腔积液患者提供更多病原体证据。
