Optimizing treatment administration strategies using negative mNGS results in corticosteroid-sensitive diffuse parenchymal lung diseases
Chuwei Jing,
Yuchen Ding,
Ji Zhou,
Qun Zhang,
Mingyue Wang,
Qiuxiang Ou,
Jia Liu,
Ting Xv,
Chunlai Feng,
Dongmei Yuan,
Ting Wu,
Ting Weng,
Xiaoyong Xv,
Shanlin Dai,
Qian Qian,
Wenkui Sun
Affiliations
Chuwei Jing
Department of Respiratory Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
Yuchen Ding
Department of Respiratory Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
Ji Zhou
Department of Respiratory Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
Qun Zhang
Department of Respiratory Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
Mingyue Wang
Department of Respiratory Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
Qiuxiang Ou
Research & Development, Dinfectome Inc., Nanjing, Jiangsu, China
Jia Liu
Research & Development, Dinfectome Inc., Nanjing, Jiangsu, China
Ting Xv
Department of Respiratory Medicine, School of Southeast University Affiliated Nanjing Chest Hospital, Nanjing, Jiangsu, China
Chunlai Feng
Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
Dongmei Yuan
Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
Ting Wu
Department of Respiratory Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
Ting Weng
Nanjing Drum Tower Hospital Group Suqian Hospital, Jiangsu, China
Xiaoyong Xv
Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu, China
Shanlin Dai
Department of Respiratory Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
Qian Qian
Jiangsu Health Vocational College, Nanjing, Jiangsu, China; Corresponding author
Wenkui Sun
Department of Respiratory Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China; Corresponding author
Summary: Timely adjustments of antibiotic and corticosteroid treatments are vital for patients with diffuse parenchymal lung diseases (DPLDs). In this study, 41 DPLD patients with negative metagenomic next-generation sequencing (mNGS) results who were responsive to corticosteroids were enrolled. Among these patients, about 26.8% suffered from drug-induced DPLD, while 9.8% presented autoimmune-related DPLD. Following the report of the negative mNGS results, in 34 patients with complete antibiotics administration profiles, 79.4% (27/34) patients discontinued antibiotics after receiving negative mNGS results. Moreover, 70.7% (29/41) patients began or increased the administration of corticosteroid upon receipt of negative mNGS results. In the microbiota analysis, Staphylococcus and Stenotrophomonas showed higher detection rates in patients with oxygenation index (OI) below 300, while Escherichia and Stenotrophomonas had higher abundance in patients with pleural effusion. In summary, our findings demonstrated the clinical significance of mNGS in assisting the antibiotic and corticosteroid treatment adjustments in corticosteroid-responsive DPLD. Lung microbiota may imply the severity of the disease.
