Meng Ziyu, Li Dong, Yang Wei, Tang Jihong
Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 200062, Shanghai, China.
Colortech (Suzhou) Biotechnology, 200062, Jiangsu, China.
Open Life Sci. 2025 May 12;20(1):20251074. doi: 10.1515/biol-2025-1074. eCollection 2025.
This study evaluated the effectiveness of metagenomic next-generation sequencing (mNGS) in detecting pathogens in patients with pulmonary infections, comparing a low-data-volume, human-depleted quantitative (Q) method and a high-data-volume, non-human-depleted pathogen capture engine (PACE) method. A total of 133 patients were enrolled, comprising 59 in a control group (traditional culture) and 74 in an mNGS group (51 Q and 23 PACE). Bronchoalveolar lavage fluid samples were collected for pathogen detection. was predominantly detected via general mNGS, whereas and Epstein-Barr virus were more frequently identified by PACE and Q, respectively. Among participants, 22.97% had bacterial mono-infections, and 2.70% had viral mono-infections; the most common co-infection involved bacteria and viruses (25.68%). Patients with fever, abnormal white blood cell, neutrophil percentage, and D-dimer levels exhibited higher detection rates. PACE showed consistently high sensitivity (decreasing from 100 to 92% as thresholds became more stringent) and specificity and accuracy that peaked at 100 and 96%, respectively. The Q method maintained 100% sensitivity at the lowest threshold but showed variable specificity (0.52-0.67) and accuracy (71-75%). These findings highlight the need for caution in clinical applications when using low-data-volume, human-depleted approaches, especially for complex pulmonary infection cases.
本研究评估了宏基因组下一代测序（mNGS）在检测肺部感染患者病原体方面的有效性，比较了低数据量、去除人源定量（Q）方法和高数据量、非去除人源病原体捕获引擎（PACE）方法。共纳入133例患者，其中对照组（传统培养）59例，mNGS组74例（51例Q方法和23例PACE方法）。收集支气管肺泡灌洗液样本进行病原体检测。通过常规mNGS主要检测到[未提及的病原体名称]，而PACE和Q方法分别更频繁地鉴定出[未提及的病原体名称]和EB病毒。参与者中，22.97%为细菌单重感染，2.70%为病毒单重感染；最常见的合并感染是细菌和病毒（25.68%）。发热、白细胞、中性粒细胞百分比及D - 二聚体水平异常的患者检测率较高。PACE表现出始终较高的敏感性（随着阈值变得更严格，从100%降至92%），特异性和准确性分别在100%和96%达到峰值。Q方法在最低阈值时保持100%的敏感性，但特异性（0.52 - 0.67）和准确性（71 - 75%）有所变化。这些发现凸显了在临床应用中使用低数据量、去除人源方法时需谨慎，尤其是对于复杂的肺部感染病例。
