Infection and Drug Resistance (Feb 2020)
Metagenomic Next-Generation Sequencing versus Traditional Pathogen Detection in the Diagnosis of Peripheral Pulmonary Infectious Lesions
Abstract
Jie Huang,1,2 Erlie Jiang,3 Donglin Yang,3 Jialin Wei,3 Mingfeng Zhao,4 Jing Feng,1 Jie Cao1 1Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Graduate School, Tianjin Medical University, Tianjin, People’s Republic of China; 3Hematopoietic Stem Cell Transplantation Center, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People’s Republic of China; 4Department of Hematology, Tianjin First Central Hospital, Tianjin, People’s Republic of ChinaCorrespondence: Jing Feng; Jie CaoDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin 300052, People’s Republic of ChinaTel +86 22 6036 2255Email [email protected]; [email protected]: The aim of this study was to evaluate the value of metagenomic next-generation sequencing (mNGS) in peripheral pulmonary infection management by comparing the diagnostic yield of mNGS and traditional pathogen detection methods on interventional specimens obtained by bronchoscopy.Patients and Methods: This study enrolled patients suspected with pulmonary infection who were admitted to Tianjin Medical University General Hospital from June 2018 to August 2019. Specimens were obtained from bronchoscopy for mNGS analysis and traditional pathogen detection (including bronchoalveolar lavage fluid microbial culture, smear microscopy, and lung biopsy histopathology), and the diagnostic yields were compared between mNGS and traditional methods to evaluate the diagnostic value of mNGS in peripheral pulmonary infection diagnosis.Results: In this study, by comparing mNGS with traditional pathogen detection, the results indicated that, first, mNGS identified at least one microbial species in almost 89% of the patients with pulmonary infection; second, mNGS detected microbes related to human diseases in 94.49% of samples from pulmonary infection patients who had received negative results from traditional pathogen detection; third, the accuracy and sensitivity of mNGS are higher than those of traditional pathogen detection; and, finally, mNGS could simultaneously detect and identify a large variety of pathogens.Conclusion: Metagenomic NGS analysis provided fast and precise pathogen detection and identification, contributing to prompt and accurate treatment of peripheral pulmonary infection.Keywords: pulmonary infection, metagenomic next-generation sequencing, bronchoscopy, bronchoalveolar lavage, smear microscopy, transbronchial lung biopsy
