Application of metagenomic next-generation sequencing of bronchoalveolar lavage fluid in etiological detection of community-acquired pneumonia
Objective To investigate the difference and diagnostic value between bronchoalveolar lavage fluid(BALF)metagenomic next-generation sequencing(mNGS)and traditional sputum culture in the diagnosis of community-acquired pneumonia(CAP).Methods A total of 153 patients with suspected CAP were selected from the Department of the Respiratory and Critical Care Medicine Affiliated Hospital of Southwest Medical University from October 2020 to February 2021.All patients underwent BALF-mNGS detection and traditional sputum culture,and their general information,BALF-mNGS results,and traditional sputum culture results were collected.The results of BALF-mNGS and traditional sputum culture were analyzed.Results Among 153 cases,the positive rate of BALF-mNGS detection was 89.54％;of which,mixed infection accounted for 70.80％,and mixed infection of bacteria and virus was common.The positive rate of traditional sputum culture was 20.26％;among which,the mixed infection accounted for 29.03％,and the mixed infection of bacteria and fungi was common.The positive rate of BALF-mNGS detection and the positive rate of BALF-mNGS detection for mixed infection were significantly higher than those of traditional sputum culture(x2=148.30,18.94;all P＜0.001).The positive rates of BALF-mNGS for rare bacteria,atypical pathogens,fungi and viruses were much higher than those of traditional sputum culture.Compared with traditional sputum culture,the etiological detection of BALF-mNGS increased sensitivity(25.64％vs.95.73％)and decreased specificity(97.22％vs.30.56％).Compared with the middle-aged group,the elderly group was mainly infected with G-bacteria;among which,Haemophilus and Pseudomonas aeruginosa were common,and the infection of atypical pathogens,viruses and Mycobacterium tuberculosis was more common in the middle-aged group than that in the elderly group.Conclusion For CAP,BALF-mNGS had higher diagnostic value for pathogens than traditional sputum culture,especially for infections with suspected rare bacteria,atypical pathogens,and viruses.
万方数据
维普
