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Metagenomic Next-Generation Sequencing versus Traditional Pathogen Detection in the Diagnosis of Peripheral Pulmonary Infectious Lesions

Authors Huang J, Jiang E, Yang D, Wei J, Zhao M, Feng J, Cao J

Received 18 October 2019

Accepted for publication 24 January 2020

Published 19 February 2020 Volume 2020:13 Pages 567—576


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Joachim Wink

Jie Huang,1,2 Erlie Jiang,3 Donglin Yang,3 Jialin Wei,3 Mingfeng Zhao,4 Jing Feng,1 Jie Cao1

1Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 2Graduate School, Tianjin Medical University, Tianjin, People’s Republic of China; 3Hematopoietic Stem Cell Transplantation Center, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People’s Republic of China; 4Department of Hematology, Tianjin First Central Hospital, Tianjin, People’s Republic of China

Correspondence: Jing Feng; Jie Cao
Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin 300052, People’s Republic of China
Tel +86 22 6036 2255

Purpose: The aim of this study was to evaluate the value of metagenomic next-generation sequencing (mNGS) in peripheral pulmonary infection management by comparing the diagnostic yield of mNGS and traditional pathogen detection methods on interventional specimens obtained by bronchoscopy.
Patients and Methods: This study enrolled patients suspected with pulmonary infection who were admitted to Tianjin Medical University General Hospital from June 2018 to August 2019. Specimens were obtained from bronchoscopy for mNGS analysis and traditional pathogen detection (including bronchoalveolar lavage fluid microbial culture, smear microscopy, and lung biopsy histopathology), and the diagnostic yields were compared between mNGS and traditional methods to evaluate the diagnostic value of mNGS in peripheral pulmonary infection diagnosis.
Results: In this study, by comparing mNGS with traditional pathogen detection, the results indicated that, first, mNGS identified at least one microbial species in almost 89% of the patients with pulmonary infection; second, mNGS detected microbes related to human diseases in 94.49% of samples from pulmonary infection patients who had received negative results from traditional pathogen detection; third, the accuracy and sensitivity of mNGS are higher than those of traditional pathogen detection; and, finally, mNGS could simultaneously detect and identify a large variety of pathogens.
Conclusion: Metagenomic NGS analysis provided fast and precise pathogen detection and identification, contributing to prompt and accurate treatment of peripheral pulmonary infection.

Keywords: pulmonary infection, metagenomic next-generation sequencing, bronchoscopy, bronchoalveolar lavage, smear microscopy, transbronchial lung biopsy

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