支气管肺泡灌洗
医学
肺炎
纳米孔测序
DNA测序
基因组
仆从
痰
微生物学
内科学
生物
肺结核
病理
肺
遗传学
基因
作者
Qiuxia Lin,Yake Yao,Xi Li,Shanshan Zhang,Hongqian Guo,Xiaolong Ma,Wenyu Chen,Chuhui Ru,Limin Wang,Bin Wang,Qiang Ma,Junfei Zhu,Xuemei Lin,Qi Chang,Hui Liu,Qi Chen,Junjun Chen,Zhu Zeng,Jianying Zhou,Yan Chen,Yunsong Yu,Hua Zhou
标识
DOI:10.1080/23744235.2023.2276785
摘要
To evaluate the value of nanopore targeted sequencing in diagnosing pneumonia pathogens.This large-scale multicentre prospective study performed in 8 hospitals across China from April to October 2022. Hospitalised patients with a diagnosis of pneumonia at admission were included. Complete clinical data were collected, and bronchoalveolar lavage fluid were obtained from each patient. These samples underwent simultaneous testing using conventional microbial testing, metagenomic next-generation sequencing, and nanopore targeted sequencing.A total of 218 patients were included. Among the 168 cases of pulmonary infection, 246 strains of pathogens were confirmed. Nanopore targeted sequencing outperformed conventional microbial testing, identifying more pathogens with a sensitivity increase of 47.9% (77.2% vs. 29.3%). Metagenomic next-generation sequencing had a sensitivity of 82.9%. Total of 70.1% patients had consistent results in both metagenomic next-generation sequencing and nanopore targeted sequencing. Nanopore targeted sequencing exhibited significantly higher sensitivity in detecting Pneumocystis jiroveci, cytomegalovirus, Mycobacterium tuberculosis, Nontuberculous mycobacteria, Streptococcus pneumoniae, and Mycoplasma pneumoniae compared to conventional microbial testing. However, metagenomic next-generation sequencing demonstrated higher sensitivity than nanopore targeted sequencing for Aspergillus (88.5% vs. 53.8%). Regarding the detection of co-infections, nanopore targeted sequencing displayed significantly higher sensitivity than conventional microbial testing (76.7% vs. 28.7%) and was on par with metagenomic next-generation sequencing (76.7% vs. 82.9%).Nanopore targeted sequencing performs equally well as metagenomic next-generation sequencing in bronchoalveolar lavage fluid for pathogen diagnosis in pneumonia, both methods showing higher sensitivity than conventional microbial testing. Nanopore targeted sequencing can be considered a reliable method for diagnosing pathogens in pneumonia.
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