Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patients

BackgroundMycobacterial infections represent a major cause of morbidity and mortality in HIV-infected individuals. This study evaluated diagnostic techniques for mycobacterial identification and compared clinicopathological features between HIV-positive and HIV-negative patients.MethodsWe analyzed 8...

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Main Authors: Man Li, Jiamin Chen, Liang Zhang, Xiangmei Chen, Jianfeng Zhou, Feifei Liu, Xingang Zhou, Jiang Xiao, Kun Yang, Liming Qi, Xiaoyi Han, Ting Liu, Hongxin Zhao, Zhen Zhou, Xiaoyou Chen, Lei Sun
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Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1584189/full
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author Man Li
Jiamin Chen
Liang Zhang
Xiangmei Chen
Jianfeng Zhou
Feifei Liu
Xingang Zhou
Jiang Xiao
Kun Yang
Liming Qi
Xiaoyi Han
Ting Liu
Hongxin Zhao
Zhen Zhou
Xiaoyou Chen
Lei Sun
author_facet Man Li
Jiamin Chen
Liang Zhang
Xiangmei Chen
Jianfeng Zhou
Feifei Liu
Xingang Zhou
Jiang Xiao
Kun Yang
Liming Qi
Xiaoyi Han
Ting Liu
Hongxin Zhao
Zhen Zhou
Xiaoyou Chen
Lei Sun
author_sort Man Li
collection DOAJ
description BackgroundMycobacterial infections represent a major cause of morbidity and mortality in HIV-infected individuals. This study evaluated diagnostic techniques for mycobacterial identification and compared clinicopathological features between HIV-positive and HIV-negative patients.MethodsWe analyzed 88 tissue samples (with 41 matched blood and 28 sputum samples) using histopathology (HE and acid-fast staining), bacterial culture, MTB-PCR (sputum/biopsy), PCR-reverse dot blot hybridization (RDBH), and metagenomic pathogen detection technology (MetaPath™). Logistic regression analyses were performed to identify factors affecting detection rates.ResultsMycobacterial infection was detected in 95.5% (84/88) of patients. Among HIV-positive patients (n=63), 46% (29/63) had Mycobacterium tuberculosis (MTB) infections, and 44% (28/63) had non-tuberculous mycobacteria (NTM) infections, significantly higher than the 20% (5/25) NTM rate in HIV-negative patients. Univariate analysis identified HIV-positive status (p=0.009), lymph node involvement (p=0.020), and positive MetaPath™ results (p=0.002) as significant predictors of detection, while multivariate analysis confirmed these as independent factors (p=0.036; p=0.042; p=0.006). Lymph nodes were the most common infection site in HIV-positive patients (42.9%, 27/63), while lung tissue predominated in HIV-negative patients (48%, 12/25). MetaPath™ demonstrated superior sensitivity and specificity for detecting both MTB and NTM. Biopsy samples provided higher diagnostic accuracy than sputum or blood for lung and lymph node infections, but not for brain. In HIV-positive patients, NTM infections showed significantly more granuloma formation (p=0.032) and foam cells (p=0.005), but less necrosis (p=0.0005) compared to MTB infections. No significant differences were observed in HIV-negative patients.ConclusionsMetaPath™ is a highly effective diagnostic tool for mycobacterial infections, particularly in tissue biopsies. HIV-positive status, lymph node involvement, and MetaPath™ positivity independently predict mycobacterial detection. HIV-positive patients exhibit distinct clinicopathological features, emphasizing the need for tailored diagnostic and therapeutic approaches based on immune status.
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spelling doaj-art-49e40fa2c13c4a5283b40e31b280af102025-08-20T02:29:27ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-04-011510.3389/fcimb.2025.15841891584189Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patientsMan Li0Jiamin Chen1Liang Zhang2Xiangmei Chen3Jianfeng Zhou4Feifei Liu5Xingang Zhou6Jiang Xiao7Kun Yang8Liming Qi9Xiaoyi Han10Ting Liu11Hongxin Zhao12Zhen Zhou13Xiaoyou Chen14Lei Sun15Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Diagnostics, Beijing KingMed Center, Beijing, ChinaDepartment of Clinical Laboratory, Guangzhou Kingmed Center, Guangzhou, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaCenter for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaCenter for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Interventional Catheterization, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaCenter for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaBackgroundMycobacterial infections represent a major cause of morbidity and mortality in HIV-infected individuals. This study evaluated diagnostic techniques for mycobacterial identification and compared clinicopathological features between HIV-positive and HIV-negative patients.MethodsWe analyzed 88 tissue samples (with 41 matched blood and 28 sputum samples) using histopathology (HE and acid-fast staining), bacterial culture, MTB-PCR (sputum/biopsy), PCR-reverse dot blot hybridization (RDBH), and metagenomic pathogen detection technology (MetaPath™). Logistic regression analyses were performed to identify factors affecting detection rates.ResultsMycobacterial infection was detected in 95.5% (84/88) of patients. Among HIV-positive patients (n=63), 46% (29/63) had Mycobacterium tuberculosis (MTB) infections, and 44% (28/63) had non-tuberculous mycobacteria (NTM) infections, significantly higher than the 20% (5/25) NTM rate in HIV-negative patients. Univariate analysis identified HIV-positive status (p=0.009), lymph node involvement (p=0.020), and positive MetaPath™ results (p=0.002) as significant predictors of detection, while multivariate analysis confirmed these as independent factors (p=0.036; p=0.042; p=0.006). Lymph nodes were the most common infection site in HIV-positive patients (42.9%, 27/63), while lung tissue predominated in HIV-negative patients (48%, 12/25). MetaPath™ demonstrated superior sensitivity and specificity for detecting both MTB and NTM. Biopsy samples provided higher diagnostic accuracy than sputum or blood for lung and lymph node infections, but not for brain. In HIV-positive patients, NTM infections showed significantly more granuloma formation (p=0.032) and foam cells (p=0.005), but less necrosis (p=0.0005) compared to MTB infections. No significant differences were observed in HIV-negative patients.ConclusionsMetaPath™ is a highly effective diagnostic tool for mycobacterial infections, particularly in tissue biopsies. HIV-positive status, lymph node involvement, and MetaPath™ positivity independently predict mycobacterial detection. HIV-positive patients exhibit distinct clinicopathological features, emphasizing the need for tailored diagnostic and therapeutic approaches based on immune status.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1584189/fullmycobacterium tuberculosisnon-tuberculous mycobacteriaHIVgranulomasnecrosis
spellingShingle Man Li
Jiamin Chen
Liang Zhang
Xiangmei Chen
Jianfeng Zhou
Feifei Liu
Xingang Zhou
Jiang Xiao
Kun Yang
Liming Qi
Xiaoyi Han
Ting Liu
Hongxin Zhao
Zhen Zhou
Xiaoyou Chen
Lei Sun
Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patients
Frontiers in Cellular and Infection Microbiology
mycobacterium tuberculosis
non-tuberculous mycobacteria
HIV
granulomas
necrosis
title Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patients
title_full Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patients
title_fullStr Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patients
title_full_unstemmed Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patients
title_short Clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among HIV patients
title_sort clinicopathological characteristics and diagnostic performance of metagenomic pathogen detection technology in mycobacterial infections among hiv patients
topic mycobacterium tuberculosis
non-tuberculous mycobacteria
HIV
granulomas
necrosis
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1584189/full
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