Metagenomic next-generation sequencing for the diagnosis of Pneumocystis jirovecii pneumonia after allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.cn121090-20230928-00147
- VernacularTitle:宏基因组二代测序在异基因造血干细胞移植后耶氏肺孢子菌肺炎诊断中的意义
- Author:
Rong FU
1
;
Ren LIN
;
Zhiping FAN
;
Fen HUANG
;
Na XU
;
Li XUAN
;
Yifei HUANG
;
Hui LIU
;
Ke ZHAO
;
Zhixiang WANG
;
Ling JIANG
;
Min DAI
;
Jing SUN
;
Qifa LIU
Author Information
1. 南方医科大学南方医院血液科，南方医科大学血液病研究所，广东省血液系统疾病临床医学研究中心，广州 510515
- Keywords:
Pneumocystis jirovecii pneumonia;
Allogeneic hematopoietic stem cell transplantation;
Metagenomic next-generation sequencing
- From:
Chinese Journal of Hematology
2024;45(1):62-67
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the value of metagenomic next-generation sequencing (mNGS) in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:The data of 98 patients with suspected pulmonary infection after allo-HSCT who underwent pathogen detection from bronchoalveolar lavage fluid between June 2016 and August 2023 at Nanfang Hospital were analyzed. The diagnostic performance of mNGS, conventional methods, and real-time quantitative polymerase chain reaction (qPCR) for PJP were compared.Results:A total of 12 patients were diagnosed with PJP, including 11 with a proven diagnosis and 1 with a probable diagnosis. Among the patients with a proven diagnosis, 1 was positive by both conventional methods and qPCR, and 10 were positive by qPCR only. Pneumocystis jirovecii was detected by mNGS in all 12 patients. The diagnostic sensitivity of mNGS for PJP was 100%, which was greater than that of conventional methods (8.3%, P=0.001) and similar to that of qPCR (91.6%, P=1.000) . A total of 75% of the patients developed mixed pulmonary infections, and cytomegalovirus and Epstein-Barr virus were the most common pathogens. Mixed infection was detected in eight patients by mNGS and in five patients by qPCR, but not by conventional methods ( P=0.008) . Conclusions:mNGS had good sensitivity for diagnosing PJP after allo-HSCT and was advantageous for detecting mixed infectious pathogens; therefore, mNGS might be an effective supplement to regular detection methods and qPCR.
