肺泡灌洗液宏基因组新一代测序在成人下呼吸道感染中的应用

Application of Next-Generation Metagenomic Sequencing of Bronchoalveolar Lavage Fluid in Adult Lower Respiratory Tract Infection

摘要: 目的：评估下呼吸道感染患者肺泡灌洗液宏基因组新一代测序(mNGS)和常规微生物检测的阳性率和临床诊断的一致性。方法：研究对象为92例在我院治疗的下呼吸道感染患者。所有患者均接受了肺泡灌洗液mNGS检测以及常规微生物检测。通过对mNGS及常规方法检测结果的分析，比较不同检测方法的阳性率及检测结果一致性等指标。结果：mNGS在85个样本中鉴定出病原体，而常规微生物检测在54个样本中检测到病原体。mNGS总体阳性率显著高于常规微生物检测(92.4% vs. 58.7%, P < 0.001)。mNGS的阳性符合率和阴性符合率均显著高于常规微生物检测(95.3% vs. 53.7%, P < 0.001; 85.7% vs. 7.9%, P < 0.001)。结论：肺泡灌洗液mNGS技术的应用显著提高了呼吸道感染患者病原体的检出率，为临床提供了一种快速、全面的病原体检测方法。

Abstract: Objective: To evaluate the consistency between the positivity rate and clinical diagnosis of metagenomic next-generation sequencing (mNGS) and routine microbiological testing in bronchoalveolar lavage fluid of patients with lower respiratory tract infections. Methods: The research subjects are 92 patients with lower respiratory tract infections treated in our hospital. All patients underwent mNGS testing in bronchoalveolar lavage fluid and routine microbiological testing. By analyzing the detection results of mNGS and conventional methods, compare the positivity rate and consistency of detection results of different detection methods. Results: mNGS identified pathogens in 85 samples, while conventional microbiological testing detected pathogens in 54 samples. The overall positivity rate of mNGS was significantly higher than that of conventional microbiological testing (92.4% vs. 58.7%, P < 0.001). The positive and negative agreement rates of mNGS were significantly higher than those of conventional microbiological testing (95.3% vs. 53.7%, P < 0.001; 85.7% vs. 7.9%, P < 0.001). Conclusion: The application of mNGS technology in bronchoalveolar lavage fluid significantly improves the detection rate of pathogens in patients with respiratory infections, providing a rapid and comprehensive pathogen detection method for clinical practice.