Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failure

Background Respiratory failure (RF) is an important cause of intensive care unit (ICU) admission and mortality due to respiratory diseases. This study aimed to evaluate the clinical performance of metagenomic next-generation sequencing (mNGS) testing in pathogen diagnosis, medication guidance and to...

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Main Authors: Yong Sun, Kai Guo, Jing Tang, Junjie Zhao, Xiaojing Zhang, Youqin Yan, Lingmin Yuan, Yi Zhang, Canhu Qiu, Jian Luo, Weiwen Zhang, Honglong Fang, Juan Chen
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2514093
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author Yong Sun
Kai Guo
Jing Tang
Junjie Zhao
Xiaojing Zhang
Youqin Yan
Lingmin Yuan
Yi Zhang
Canhu Qiu
Jian Luo
Weiwen Zhang
Honglong Fang
Juan Chen
author_facet Yong Sun
Kai Guo
Jing Tang
Junjie Zhao
Xiaojing Zhang
Youqin Yan
Lingmin Yuan
Yi Zhang
Canhu Qiu
Jian Luo
Weiwen Zhang
Honglong Fang
Juan Chen
author_sort Yong Sun
collection DOAJ
description Background Respiratory failure (RF) is an important cause of intensive care unit (ICU) admission and mortality due to respiratory diseases. This study aimed to evaluate the clinical performance of metagenomic next-generation sequencing (mNGS) testing in pathogen diagnosis, medication guidance and to explore dynamic changes in the respiratory microbiota associated with prognosis.Methods This multicenter retrospective study enrolled ICU patients from five hospitals who underwent invasive mechanical ventilation (IMV) and had pathogenic microorganisms identified by both mNGS and conventional microbiological tests (CMT) from December 2021 to April 2024. Patients were classified into two groups based on discharge outcomes: survivors (n=122) and non-survivors (n=35).Results Compared with the survivors, non-survivors had a significantly higher proportion of smokers, dyspnea, type I RF, blood urea nitrogen, and C-reactive protein (p < 0.05). All the above indicators were identified as independent risk factors for mortality, except for type I RF. mNGS showed a better performance for pathogen identification than CMT in both groups, and nearly 60% showed consistent results between the two methods. Among survivors, antibiotic adjustment was mainly based on mNGS results (35.25%), whereas non-survivors more frequently received adjustments based on mNGS and CMT results (34.29%). The richness and abundance of lung microorganisms in the non-survivors were significantly lower than those in the survivors (p < 0.05).Conclusions mNGS is a promising method for identifying pathogens in pulmonary infections in IMV-supported RF patients and for exploring changes in lung microbial composition to provide a reference for patient prognosis.
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spelling doaj-art-8ff5f8311af446c8b1ca36dfe65d4a7a2025-08-20T03:09:51ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2514093Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failureYong Sun0Kai Guo1Jing Tang2Junjie Zhao3Xiaojing Zhang4Youqin Yan5Lingmin Yuan6Yi Zhang7Canhu Qiu8Jian Luo9Weiwen Zhang10Honglong Fang11Juan Chen12Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaZhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaWillingMed Technology Beijing Co., Ltd, Beijing, ChinaDepartment of Critical Care Medicine, People’s Hospital of Changshan County, Quzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, Longyou County People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, QuZhou KeCheng People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, Jiangshan People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Clinical Laboratory, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaBackground Respiratory failure (RF) is an important cause of intensive care unit (ICU) admission and mortality due to respiratory diseases. This study aimed to evaluate the clinical performance of metagenomic next-generation sequencing (mNGS) testing in pathogen diagnosis, medication guidance and to explore dynamic changes in the respiratory microbiota associated with prognosis.Methods This multicenter retrospective study enrolled ICU patients from five hospitals who underwent invasive mechanical ventilation (IMV) and had pathogenic microorganisms identified by both mNGS and conventional microbiological tests (CMT) from December 2021 to April 2024. Patients were classified into two groups based on discharge outcomes: survivors (n=122) and non-survivors (n=35).Results Compared with the survivors, non-survivors had a significantly higher proportion of smokers, dyspnea, type I RF, blood urea nitrogen, and C-reactive protein (p < 0.05). All the above indicators were identified as independent risk factors for mortality, except for type I RF. mNGS showed a better performance for pathogen identification than CMT in both groups, and nearly 60% showed consistent results between the two methods. Among survivors, antibiotic adjustment was mainly based on mNGS results (35.25%), whereas non-survivors more frequently received adjustments based on mNGS and CMT results (34.29%). The richness and abundance of lung microorganisms in the non-survivors were significantly lower than those in the survivors (p < 0.05).Conclusions mNGS is a promising method for identifying pathogens in pulmonary infections in IMV-supported RF patients and for exploring changes in lung microbial composition to provide a reference for patient prognosis.https://www.tandfonline.com/doi/10.1080/07853890.2025.2514093Invasive mechanical ventilationlung microbialmetagenomic next-generation sequencingpulmonary infectionrespiratory failure
spellingShingle Yong Sun
Kai Guo
Jing Tang
Junjie Zhao
Xiaojing Zhang
Youqin Yan
Lingmin Yuan
Yi Zhang
Canhu Qiu
Jian Luo
Weiwen Zhang
Honglong Fang
Juan Chen
Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failure
Annals of Medicine
Invasive mechanical ventilation
lung microbial
metagenomic next-generation sequencing
pulmonary infection
respiratory failure
title Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failure
title_full Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failure
title_fullStr Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failure
title_full_unstemmed Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failure
title_short Changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation-supported respiratory failure
title_sort changes of respiratory microbiota associated with prognosis in pulmonary infection patients with invasive mechanical ventilation supported respiratory failure
topic Invasive mechanical ventilation
lung microbial
metagenomic next-generation sequencing
pulmonary infection
respiratory failure
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2514093
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