Analysis of the value of mNGS in the detection of pathogens and drug resistance genes in alveolar lavage fluid of patients with severe pneumonia
10.3760/cma.j.issn.1674-2397.2024.06.007
- VernacularTitle:mNGS在重症肺炎患者支气管肺泡灌洗液中病原体及耐药基因检测的价值分析
- Author:
Jing SUN
1
;
Sai ZHANG
;
Ran CHEN
;
Qinglian HAN
;
Zhen LI
;
Qinghua LIU
Author Information
1. 肥城市人民医院医学检验科，肥城 271600
- Publication Type:Journal Article
- Keywords:
Metagenomics next-generation sequencing;
Severe pneumonia;
Bronchoalveolar lavage fluid;
Pathogens;
Drug resistance genes
- From:
Chinese Journal of Clinical Infectious Diseases
2024;17(6):457-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of metagenomics next-generation sequencing（mNGS）in the detection of pathogens and antimicrobial resistance genes in bronchoalveolar lavage fluid（BALF）of patients with severe pneumonia.Methods:Clinical data of 93 patients with severe pneumonia who underwent both BALF traditional microbial culture and mNGS testing from May 2020 to September 2021 in the intensive care unit of the Second Affiliated Hospital of Shandong First Medical University were retrospectively collected. Using traditional cultivation methods as the gold standard，analyze the sensitivity，specificity，bacterial resistance phenotype，and resistance genes of mNGS in detecting bacteria and fungi. SPSS 22.0 software was used to analyze the data.Results:The positive rate of mNGS was 84.9%（79/93），and the positive rate of traditional culture was 49.5%（46/93），and the difference was statistically significant（ χ2=26.56， P<0.01）. mNGS mixed infection detection rate was 60.2%（56/93），which was significantly higher than that of traditional culture 16.1%（15/93）（ χ2=38.29， P<0.01）. Using traditional cultivation methods as the gold standard，the sensitivity of mNGS for detecting bacteria and fungi was 97.8%（45/46），specificity was 31.0%（13/42），positive predictive value was 60.8%（45/74），and negative predictive value was 92.9%（13/14）. The consistency of the detection results between the two methods was 65.9%（58/88）. mNGS detected a total of 26 cases（28.0%）harboring resistance genes based on the mNGS results，the treatment regimen was adjusted in 50（53.8%）patients. Conclusion:The mNGS can improve the detection rate of pathogens in BALF of patients with severe pneumonia and can obtain antimicrobial drug resistance genes，which can provide the basis for clinical realization of precise antimicrobial drug-targeted therapy.
