Diagnostic Value of Bronchoalveolar Lavage Fluid Metagenomic Next-Generation Sequencing in

Bronchoalveolar Lavage Fluid / microbiology Coinfection High-Throughput Nucleotide Sequencing / methods Humans Metagenomics / methods Pneumonia, Pneumocystis / diagnosis Sensitivity and Specificity
Pneumocystis jirovecii pneumonia bronchoalveolar lavage fluid diagnosis immunosuppressed patients metagenomic next-generation sequencing

Journal

Frontiers in cellular and infection microbiology
ISSN: 2235-2988
Titre abrégé: Front Cell Infect Microbiol
Pays: Switzerland
ID NLM: 101585359

Informations de publication

Date de publication:
2022
Historique:
received: 10 02 2022
accepted: 14 03 2022
entrez: 25 4 2022
pubmed: 26 4 2022
medline: 27 4 2022
Statut: epublish

Résumé

This study aims to assess the value of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) and its mixed infection in non-human immunodeficiency virus (HIV) immunosuppressed patients. A total of 198 non-HIV immunosuppressed patients with severe pneumonia were enrolled, including 77 PJP patients and 121 patients infected by other pathogens. BALF-mNGS and traditional detection methods were used. The positive detection rate of various pathogens of BALF-mNGS was higher than that of the conventional methods, especially for mixed pathogens. The sensitivity and specificity of BALF-mNGS for the diagnosis of PJP were 97.40% and 85.12%, respectively. Compared with traditional methods, the sensitivity of BALF-mNGS was significantly higher than that of blood fungal G (BG)/lactate dehydrogenase (LDH) and BALF-microscopy (p<0.05), and its specificity was significantly higher than that of BG/LDH (p<0.05). In addition, the average detection time of BALF-mNGS (32.76 ± 10.32 h) was also significantly shorter than conventional methods (p<0.01), especially for mixed infections that were common in non-HIV immunosuppressed patients. In patients only detected as positive by BALF-mNGS, the underlying diseases mainly manifested as hematological malignancies with agranulocytosis and within 8 months after hematopoietic stem cell or solid organ transplantation. BALF-mNGS technology is faster, more sensitive, and more comprehensive in detecting P. jirovecii and its mixed infection in immunosuppressed patients.

Identifiants

DOI: 10.3389/fcimb.2022.872813 PMID: 35463643 PMC: PMC9024294
pubmed: 35463643
doi: 10.3389/fcimb.2022.872813
pmc: PMC9024294
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

872813

Informations de copyright

Copyright © 2022 Sun, Wang, Zhang, Xu, Li, Gao, Wu, Han, Wang, Yao, Lou, Xia, Shi and Li.

Déclaration de conflit d'intérêts

ZL and HX are employed by Hugobiotech Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

He Sun (H)

Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

Feilong Wang (F)

Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

Ming Zhang (M)

Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.

Xiaoyong Xu (X)

Department of Pulmonary and Critical Care Medicine (PCCM), The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

Miaomiao Li (M)

Department of Respiratory and Critical Medicine, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China.

Wei Gao (W)

Department of Pulmonary and Critical Care Medicine (PCCM), Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China.

Xiaodong Wu (X)

Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

Huize Han (H)

Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

Qin Wang (Q)

Department of Respiratory and Critical Care Medicine, Jinling Hospital, Clinical School of Nanjing, Nanjing, China.

Gehong Yao (G)

Department of Respiratory and Critical Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Zheng Lou (Z)

Department of Scientific Affairs, Hugobiotech, Beijing, China.

Han Xia (H)

Department of Scientific Affairs, Hugobiotech, Beijing, China.

Yi Shi (Y)

Department of Respiratory and Critical Care Medicine, Jinling Hospital, Clinical School of Nanjing, Nanjing, China.

Qiang Li (Q)

Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

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Classifications MeSH

questionsmedicales.fr › Techniques d'investigation › Irrigation thérapeutique › Lavage bronchoalvéolaire › Liquide de lavage bronchoalvéolaire › Diagnostic Value of Bronchoalveolar Lavage...
questionsmedicales.fr › Infection › Co-infection › Diagnostic Value of Bronchoalveolar Lavage...
questionsmedicales.fr › Techniques d'investigation › Techniques génétiques › Analyse de séquence › Séquençage nucléotidique à haut débit › Diagnostic Value of Bronchoalveolar Lavage...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Diagnostic Value of Bronchoalveolar Lavage...
questionsmedicales.fr › Disciplines des sciences naturelles › Disciplines des sciences biologiques › Biologie › Génétique › Génomique › Métagénomique › Diagnostic Value of Bronchoalveolar Lavage...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumonie à Pneumocystis › Diagnostic Value of Bronchoalveolar Lavage...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Sensibilité et spécificité › Diagnostic Value of Bronchoalveolar Lavage...