Abstract
BackgroundThe morbidity and mortality of community-acquired pneumonia are relatively high, but many pneumonia pathogens cannot be identified accurately. As a new pathogen detection technology, metagenomic next-generation sequencing (mNGS) has been applied more and more clinically. We aimed to evaluate the diagnostic significance of mNGS for community-acquired pneumonia (CAP) in the south of China.MethodsOur study selected CAP patients who visited the 3rd Xiangya Hospital from May 2019 to April 2021. Pathogens in bronchoalveolar lavage fluid (BALF) specimens were detected using mNGS and traditional microbiological culture. mNGS group: detected by both mNGS and BALF culture; control group: detected only by BALF or sputum culture. The diagnostic performance of pathogens and the antibiotic adjustments were compared within mNGS group.ResultsThe incidence of acute respiratory distress syndrome (ARDS) was 28.3% in the mNGS group and 17.3% in the control group. Within the mNGS group, the positive rate of pathogens detected by mNGS was 64%, thus by BALF culture was only 28%. Pathogens detected by mNGS were consisted of bacteria (55%), fungi (18%), special pathogens (18%), and viruses (9%). The most detected pathogen by mNGS was Chlamydia psittaci. Among the pathogen-positive cases, 26% was not pathogen-covered by empirical antibiotics, so most of which were made an antibiotic adjustment.ConclusionsmNGS can detect pathogens in a more timely and accurate manner and assist clinicians to adjust antibiotics in time. Therefore, we recommend mNGS as the complementary diagnosis of severe pneumonia or complicated infections.
Highlights
Community-acquired pneumonia (CAP) is a common disease with high mortality [1]
One hundred and seventy-three patients were in the metagenomic next-generation sequencing (mNGS) group, and the rest 173 patients were in the control group
The incidence of acute respiratory distress syndrome (ARDS) was significantly higher in the mNGS group (P = 0.021)
Summary
Community-acquired pneumonia (CAP) is a common disease with high mortality [1]. According to the clinical phenotype, the pathogens for up to 60% of infectious diseases were still unknown [2, 3], and the mortality of CAP in need of emergency treatment exceeds 40% [4]. Rare and atypical pathogens have been continuously detected, such as Mycobacterium abscessus, Mycobacterium kansas, etc. These pathogens may cause pneumonia, multiple-organ disorders and even acute respiratory distress syndrome (ARDS). The morbidity and mortality of community-acquired pneumonia are relatively high, but many pneumonia pathogens cannot be identified accurately. We aimed to evaluate the diagnostic significance of mNGS for community-acquired pneumonia (CAP) in the south of China
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
