Application of metagenomic next-generation sequencing in pulmonary tuberculosis complicated with pulmonary nontuberculous mycobacterial lung disease
10.3760/cma.j.cn115455-20250123-00094
- VernacularTitle:宏基因组二代测序在肺结核合并非结核分枝杆菌肺病中的应用
- Author:
Fei CHEN
1
;
Jing GUO
;
Feishen LIN
;
Xiaoyong XU
Author Information
1. 南京中医药大学附属南京医院（南京市第二医院）结核四科，南京 211131
- Publication Type:Journal Article
- Keywords:
Pulmonary tuberculosis;
Non-tuberculous mycobacterial pulmonary disease;
Metagenomic next-generation sequencing;
Pathogen diagnosis
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(10):933-938
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of metagenomic next-generation sequencing (mNGS) in the diagnosis of pulmonary tuberculosis (PTB) combined with non-tuberculous mycobacterial pulmonary disease (NTM-PD), compare it with conventional pathogen detection methods, and analyze its clinical characteristics.Methods:A retrospective analysis was conducted on the clinical data of 72 patients with PTB complicated by NTM-PD who were admitted to Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine (Nanjing Second Hospital) from November 2021 to November 2023. All patients were diagnosed using bronchoalveolar lavage fluid (BALF) mNGS and compared with traditional culture methods. Data on patient demographics, clinical manifestations, imaging features, and treatment outcomes were collected to analyze the advantages and clinical significance of mNGS in diagnosis.Results:The positive detection rate of Mycobacterium tuberculosis by mNGS was 100% (72/72), significantly higher than that of traditional culture 27.8%(20/72). The diagnostic time of mNGS was significantly shorter (2 d vs. 45 - 60 d, P<0.001). The majority of patients were elderly (mean age: 55.92 years) and often had underlying structural lung diseases (e.g., bronchiectasis, COPD) or immunocompromised conditions (e.g., diabetes). The main clinical manifestations were cough (68.06%) and sputum production (52.78%). Imaging features included bronchiectasis (63.89%), nodular shadows (47.22%), and tree-in-bud signs (25.00%). After 6 months of follow-up, 73.8% of patients showed significant improvement in lung lesions, while 26.2% had no significant change or disease progression. Conclusions:mNGS demonstrates rapid and accurate diagnostic advantages for PTB combined with NTM-PD, significantly outperforming traditional culture methods, and provides critical support for precise clinical treatment.
