Evaluation of metagenomic next-generation sequencing in the etiological diagnosis of respiratory infection
Objective To determine the value of applying metagenomic next-generation sequencing(mNGS)for identifying pathogens in respiratory tract infections.Methods Forty-eight patients with a respiratory system infection,treated between December 2020 and January 2021 in Zhujiang Hospital of Southern Medical University,were enrolled in the study,and sputum mNGS detection and sputum culture were performed.The pathogen distribution,positivity rate,consistency rate,mixed infection rate and were compared using the two detection methods.The advantages and feasibility of using mNGS for sputum detection were analyzed.Specific methods were used to validate some specific pathogens.Results Sputum mNGS detected 75 pathogen strains,comprising 20 bacterial strains,24 fungal strains,16 viral strains,and 15 special pathogen strains.Sputum cultures detected 20 pathogen strains,comprising 8 bacterial strains,11 fungal strains,and 1 special pathogen strain.mNGS detection and sputum culture had an overall consistency rate of 35.42％(17 cases)for the detection of pathogens,the positive consistency rate being 22.92％(11 cases).The positive rate of pathogens detected by sputum mNGS was 87.50％(42 cases)and the mixed infection rate was 60.42％(29 cases),which were significantly higher than the positive rate of 29.17％(14 cases)and mixed infection rate 8.33％(4 cases)of sputum culture(x2=32.685,28.860;all P＜0.05).For the special pathogens Chlamydia psittaci,Mycobacterium tuberculosis complex(MTB)and Nocardia,the coincidence rate between the verification results and the sputum mNGS results was 100.00％(2 cases in each).Patients with Chlamydia psittaci were diagnosed according to the results of sputum mNGS,and the improvement rate was 100.00％(2 cases)after using sensitive drugs.Conclusions Sputum mNGS had a high positivity rate for detecting pathogens and had obvious advantages for detecting fungal,viral,special pathogen,and mixed infections.Sputum mNGS detection could provide a basis for the diagnosis and treatment of respiratory system infections.
Respiratory system infectionMetagenomic next-generation sequencingSputum culture
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NSTL
万方数据
