Chen Song, Ouyang Tanglin, Wang Kaiyang, Hou Xuan, Zhang Rong, Li Meiyong, Zhang Haibin, He Qinghua, Li Xiuzhen, Liu Zezhang, Wang Xiaozhong, Huang Bo
Jiangxi Province Key Laboratory of Immunology and Inflammation, Jiangxi Provincial Clinical Research Center for Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
School of Public Health, Nanchang University, Nanchang, Jiangxi, China.
Front Cell Infect Microbiol. 2025 May 1;15:1513603. doi: 10.3389/fcimb.2025.1513603. eCollection 2025.
Metagenomic next-generation sequencing (mNGS) has been widely reported to provide crucial information for the diagnosis and treatment of infectious diseases. In this study, we aimed to evaluate mNGS in pathogens diagnosis of lung infections.
A total of 188 patients who were suspected of pulmonary infection and received medical treatment at the Second Affiliated Hospital of Nanchang University from August 2022 to December 2023 were enrolled in this study. Conventional microbiological tests (CMTs) and mNGS were employed for pathogens diagnosis.
Statistical results indicated that mNGS were significantly better than CMTs in sensitivity, negative predictive value, and negative likelihood ratio. Remarkably, the positive detection rate of mNGS was significantly higher than that of CMTs (86.17% 67.55%, < 0.01). Through mNGS, we identified 96 pathogens, comprising 59 bacteria, 18 fungi, 15 viruses, and 4 special pathogens. In contrast, CMTs detected 28 species, including 25 bacteria and 3 fungi. The effectiveness rate of antibiotic treatment decisions based on mNGS results was 40.60%. Out of 54 cases with positive treatment impacts, mNGS results contributed to the treatment and improved prognosis of 16 infections caused by atypical pathogens.
Our results proved the essential role of mNGS in lung infection diagnosis, enabling early detection and the prompt development of targeted anti-infection therapies. We recommended that the clinical application of mNGS can enhance treatment effectiveness and improve patient prognosis.
宏基因组下一代测序（mNGS）已被广泛报道可为传染病的诊断和治疗提供关键信息。在本研究中，我们旨在评估mNGS在肺部感染病原体诊断中的作用。
本研究纳入了2022年8月至2023年12月期间在南昌大学第二附属医院接受治疗的188例疑似肺部感染患者。采用传统微生物学检测（CMTs）和mNGS进行病原体诊断。
统计结果表明，mNGS在敏感性、阴性预测值和阴性似然比方面显著优于CMTs。值得注意的是，mNGS的阳性检出率显著高于CMTs（86.17%对67.55%，<0.01）。通过mNGS，我们鉴定出96种病原体，包括59种细菌、18种真菌、15种病毒和4种特殊病原体。相比之下，CMTs检测到28种，包括25种细菌和3种真菌。基于mNGS结果的抗生素治疗决策有效率为40.60%。在54例有积极治疗影响的病例中，mNGS结果有助于16例由非典型病原体引起的感染的治疗并改善预后。
我们的结果证明了mNGS在肺部感染诊断中的重要作用，能够实现早期检测并迅速制定针对性的抗感染治疗方案。我们建议mNGS的临床应用可以提高治疗效果并改善患者预后。
