Clinical application of metagenomic next-generation sequencing for identifying non-tuberculous mycobacteria from bronchoalveolar lavage fluid
10.3760/cma.j.issn.1674-2397.2025.01.003
- VernacularTitle:宏基因组高通量测序在支气管肺泡灌洗液中鉴定非结核分枝杆菌的临床价值
- Author:
Jieyuan ZHENG
1
;
Dan ZHANG
1
;
Jieting ZHOU
1
;
Jingchao WANG
1
;
Lingjun YUAN
1
;
Mengxiao XIE
1
;
Binxiao LI
1
;
Dongsheng HAN
1
Author Information
1. 浙江大学医学院附属第一医院检验科，杭州 310003
- Publication Type:Journal Article
- Keywords:
Non-tuberculous mycobacteria;
Metagenomic next-generation sequencing;
Pneumonia;
Bronchoalveolar lavage fluid
- From:
Chinese Journal of Clinical Infectious Diseases
2025;18(1):19-24
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the application of metagenomic next-generation sequencing（mNGS）in the identification of non-tuberculous mycobacteria（NTM）.Methods:A retrospective analysis was conducted on mNGS results of 358 bronchoalveolar lavage fluid（BALF）samples positive for NTM collected at the First Affiliated Hospital of Zhejiang University School of Medicine from February 2021 to January 2024. The analysis included the distribution of NTM species，the detection of mixed pathogens，and the performance of conventional mycobacterial detection methods.Results:The results showed that 362 strains of 15 NTM species were identified from 350 specimens，8 specimens were not precise to the species level. The most frequently detected species were Mycobacterium intracellulare（37.3%，135/362）， Mycobacterium abscessus（26.8%，97/362），followed by Mycobacterium avium（11.0%，40/362）， Mycobacterium kansasii（8.0%，29/362）and Mycobacterium chelonae（7.7%，28/362）. Single NTM species were detected in 339 specimens，while two or three NTM species were simultaneously detected in 11 specimens（3.1%，11/358）. Non-NTM microorganisms co-infected were detected in 53.4%（191/358）of NTM-positive BALF samples，including common pathogens such as Pseudomonas aeruginosa， Staphylococcus aureus，and Aspergillus fumigatus；and difficult-to-identify pathogens such as Legionella pneumophila and Talaromyces marneffei. In NTM-positive patients detected by mNGS，the results supported the diagnosis of NTM infection in 298 cases（298/358，83.2%）and 105 cases（105/358，29.3%）initiated anti-NTM treatment accordingly；while in 60 cases（60/358，16.8%）the positive results were considered as colonization or unrelated to clinical infection. For samples tested with acid-fast staining，mycobacterial liquid culture，and DNA microarray，the positivity rates for NTM were 31.5%（73/232），48.7%（57/117），and 43.0%（46/107），respectively. Conclusions:mNGS demonstrates advantages in identification of NTM. However，the test may detect multiple microorganisms，in that case，the interpretation with clinical and radiological results is requried to determine the main pathogens.
