Cargando…

Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients

BACKGROUND: To evaluate the value and challenges of real-world clinical application of metagenomic next-generation sequencing (mNGS) for bronchoalveolar lavage fluid (BALF) in HIV-infected patients with suspected multi-pathogenic pneumonia. METHODS: Fifty-seven HIV-infected patients with suspected m...

Descripción completa

Detalles Bibliográficos
Autores principales: Xie, Yirui, Dai, Bohao, Zhou, Xiaotang, Liu, Huiting, Wu, Wei, Yu, Fei, Zhu, Biao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9888013/
https://www.ncbi.nlm.nih.gov/pubmed/36733920
http://dx.doi.org/10.2147/IDR.S394265
_version_ 1784880458670014464
author Xie, Yirui
Dai, Bohao
Zhou, Xiaotang
Liu, Huiting
Wu, Wei
Yu, Fei
Zhu, Biao
author_facet Xie, Yirui
Dai, Bohao
Zhou, Xiaotang
Liu, Huiting
Wu, Wei
Yu, Fei
Zhu, Biao
author_sort Xie, Yirui
collection PubMed
description BACKGROUND: To evaluate the value and challenges of real-world clinical application of metagenomic next-generation sequencing (mNGS) for bronchoalveolar lavage fluid (BALF) in HIV-infected patients with suspected multi-pathogenic pneumonia. METHODS: Fifty-seven HIV-infected patients with suspected mixed pneumonia who were agreed to undergo the bronchoscopy were recruited and retrospectively reviewed the results of mNGS and conventional microbiological tests (CMTs) of BALF from July 2020 to June 2022. RESULTS: 54 patients were diagnosed with pneumonia including 49 patients with definite pathogens and five patients with probable pathogens. mNGS exhibited a higher diagnostic accuracy for fungal detection than CMTs in HIV-infected patients with suspected pulmonary infection. The sensitivity of mNGS in diagnosis of pneumonia in HIV-infected patients was much higher than that of CMTs (79.6% vs 61.1%; P < 0.05). Patients with mixed infection had lower CD4 T-cell count and higher symptom duration before admitting to the hospital than those with single infection. The detection rate of mNGS for mixed infection was significantly higher than that of CMTs and more co-pathogens could be identified by mNGS. The most common pattern of mixed infection observed was fungi-virus (11/29, 37.9%), followed by fungi-virus-bacteria (6/29, 20.7%) coinfection in HIV-infected patients with multi-pathogenic pneumonia. CONCLUSION: mNGS improved the pathogens detection rate and exhibited advantages in identifying multi-pathogenic pneumonia in HIV-infected patients. Early performance of bronchoscopy and mNGS are recommended in HIV-infected patients with low CD4 T cell counts and long duration of symptoms. The most common pattern of mixed infection observed was fungi-virus, followed by fungi-virus-bacteria coinfection in HIV infected patients with multi-pathogenic pneumonia.
format Online
Article
Text
id pubmed-9888013
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-98880132023-02-01 Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients Xie, Yirui Dai, Bohao Zhou, Xiaotang Liu, Huiting Wu, Wei Yu, Fei Zhu, Biao Infect Drug Resist Original Research BACKGROUND: To evaluate the value and challenges of real-world clinical application of metagenomic next-generation sequencing (mNGS) for bronchoalveolar lavage fluid (BALF) in HIV-infected patients with suspected multi-pathogenic pneumonia. METHODS: Fifty-seven HIV-infected patients with suspected mixed pneumonia who were agreed to undergo the bronchoscopy were recruited and retrospectively reviewed the results of mNGS and conventional microbiological tests (CMTs) of BALF from July 2020 to June 2022. RESULTS: 54 patients were diagnosed with pneumonia including 49 patients with definite pathogens and five patients with probable pathogens. mNGS exhibited a higher diagnostic accuracy for fungal detection than CMTs in HIV-infected patients with suspected pulmonary infection. The sensitivity of mNGS in diagnosis of pneumonia in HIV-infected patients was much higher than that of CMTs (79.6% vs 61.1%; P < 0.05). Patients with mixed infection had lower CD4 T-cell count and higher symptom duration before admitting to the hospital than those with single infection. The detection rate of mNGS for mixed infection was significantly higher than that of CMTs and more co-pathogens could be identified by mNGS. The most common pattern of mixed infection observed was fungi-virus (11/29, 37.9%), followed by fungi-virus-bacteria (6/29, 20.7%) coinfection in HIV-infected patients with multi-pathogenic pneumonia. CONCLUSION: mNGS improved the pathogens detection rate and exhibited advantages in identifying multi-pathogenic pneumonia in HIV-infected patients. Early performance of bronchoscopy and mNGS are recommended in HIV-infected patients with low CD4 T cell counts and long duration of symptoms. The most common pattern of mixed infection observed was fungi-virus, followed by fungi-virus-bacteria coinfection in HIV infected patients with multi-pathogenic pneumonia. Dove 2023-01-27 /pmc/articles/PMC9888013/ /pubmed/36733920 http://dx.doi.org/10.2147/IDR.S394265 Text en © 2023 Xie et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Xie, Yirui
Dai, Bohao
Zhou, Xiaotang
Liu, Huiting
Wu, Wei
Yu, Fei
Zhu, Biao
Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients
title Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients
title_full Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients
title_fullStr Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients
title_full_unstemmed Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients
title_short Diagnostic Value of Metagenomic Next-Generation Sequencing for Multi-Pathogenic Pneumonia in HIV-Infected Patients
title_sort diagnostic value of metagenomic next-generation sequencing for multi-pathogenic pneumonia in hiv-infected patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9888013/
https://www.ncbi.nlm.nih.gov/pubmed/36733920
http://dx.doi.org/10.2147/IDR.S394265
work_keys_str_mv AT xieyirui diagnosticvalueofmetagenomicnextgenerationsequencingformultipathogenicpneumoniainhivinfectedpatients
AT daibohao diagnosticvalueofmetagenomicnextgenerationsequencingformultipathogenicpneumoniainhivinfectedpatients
AT zhouxiaotang diagnosticvalueofmetagenomicnextgenerationsequencingformultipathogenicpneumoniainhivinfectedpatients
AT liuhuiting diagnosticvalueofmetagenomicnextgenerationsequencingformultipathogenicpneumoniainhivinfectedpatients
AT wuwei diagnosticvalueofmetagenomicnextgenerationsequencingformultipathogenicpneumoniainhivinfectedpatients
AT yufei diagnosticvalueofmetagenomicnextgenerationsequencingformultipathogenicpneumoniainhivinfectedpatients
AT zhubiao diagnosticvalueofmetagenomicnextgenerationsequencingformultipathogenicpneumoniainhivinfectedpatients