Diagnostic strategy of metagenomic next-generation sequencing for gram negative bacteria in respiratory infections

呼吸道感染革兰氏阴性菌的宏基因组二代测序诊断策略

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作者:Wenyan Liang, Qun Zhang, Qian Qian, Mingyue Wang, Yuchen Ding, Ji Zhou, Yi Zhu, Yu Jin, Xuesong Chen, Hui Kong, Wei Song, Xin Lu, Xiaodong Wu, Xiaoyong Xu, Shanling Dai, Wenkui Sun

Conclusion

Proper interpretation of mNGS data is crucial for accurately diagnosing respiratory infections caused by GNB. CI is recommended for this purpose.

Methods

The effectiveness of mNGS was assessed on BALF samples collected from 583 patients, and the

Objective

This study aims to identify the most effective diagnostic method for distinguishing pathogenic and non-pathogenic Gram-negative bacteria (GNB) in suspected pneumonia cases using metagenomic next-generation sequencing (mNGS) on bronchoalveolar lavage fluid (BALF) samples.

Results

mNGS outperformed culture significantly. Among the interpretational approaches, Clinical Interpretation (CI) demonstrated the best diagnostic performance with a sensitivity of 87.3%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 98.3%. CI's specificity was significantly higher than Simple Interpretation (SI) at 37.9%. Additionally, CI excluded some microorganisms identified as putative pathogens by SI, including Haemophilus parainfluenzae, Haemophilus parahaemolyticus, and Klebsiella aerogenes.

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