The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection
ObjectivesThis study aimed to enhance the comprehension of the practical utility of bronchoalveolar lavage fluid (BALF) metagenomic next-generation sequencing (mNGS) in the clinical management of patients with suspected pneumonia.MethodsWe retrospectively analyzed 296 individuals who underwent BALF...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Cellular and Infection Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcimb.2025.1521641/full |
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| author | Mei Zhou Shengwen Sun Long Chen Huan Xu Lanlan Liu Jiaxi Lv Jianchu Zhang Xianzhi Xiong |
| author_facet | Mei Zhou Shengwen Sun Long Chen Huan Xu Lanlan Liu Jiaxi Lv Jianchu Zhang Xianzhi Xiong |
| author_sort | Mei Zhou |
| collection | DOAJ |
| description | ObjectivesThis study aimed to enhance the comprehension of the practical utility of bronchoalveolar lavage fluid (BALF) metagenomic next-generation sequencing (mNGS) in the clinical management of patients with suspected pneumonia.MethodsWe retrospectively analyzed 296 individuals who underwent BALF mNGS and conventional microbial tests (CMTs) for suspected pneumonia. We compared the clinical characteristics between patients with pulmonary infection (PI) and those without pulmonary infection (NPI). The detection rate of mNGS and CMTs in different groups of patients were compared. The Sankey diagram was used to present the results of the influence of mNGS on diagnosis and treatment.ResultsComparison between PI and NPI showed that individuals with fever, concurrent malignant tumors, consolidation or ground-glass opacity on chest CT(Computed tomography) images, and elevated inflammatory markers on blood tests were more likely to develop lung infections. Analysis of the rate of positive detection between CMTs and mNGS in various subgroups revealed that mNGS had a significantly higher positive detection rate in patients with pulmonary infections (87.95% vs. 71.06%, p<0.001), in immunocompetent patients (86.91% vs. 68.08%, p<0.001), and in patients with malignant tumors (92.31% vs. 69.23%, p=0.035). Furthermore, mNGS helped initiate appropriate antibiotic treatment and confirmed the effectiveness of empirical treatment. Compared to immunocompetent patients, BALF mNGS in immunocompromised individuals with suspected lung infections yielded higher rates of accurate diagnosis (62.86% vs. 42.79%, p = 0.027) and more effective treatment (71.43% vs. 58.56%, p = 0.148).ConclusionsBALF mNGS identified a greater variety of pathogens than CMTs. Immunocompromised patients with suspected pneumonia may benefit more from BALF mNGS. |
| format | Article |
| id | doaj-art-df238e7ad5ed4757affd1000dc5fcbe7 |
| institution | DOAJ |
| issn | 2235-2988 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cellular and Infection Microbiology |
| spelling | doaj-art-df238e7ad5ed4757affd1000dc5fcbe72025-08-20T03:16:11ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-06-011510.3389/fcimb.2025.15216411521641The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infectionMei Zhou0Shengwen Sun1Long Chen2Huan Xu3Lanlan Liu4Jiaxi Lv5Jianchu Zhang6Xianzhi Xiong7Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Scientific Affairs, Vision Medicals for Infectious Diseases, Guangzhou, Guangdong, ChinaDepartment of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaDepartment of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, ChinaObjectivesThis study aimed to enhance the comprehension of the practical utility of bronchoalveolar lavage fluid (BALF) metagenomic next-generation sequencing (mNGS) in the clinical management of patients with suspected pneumonia.MethodsWe retrospectively analyzed 296 individuals who underwent BALF mNGS and conventional microbial tests (CMTs) for suspected pneumonia. We compared the clinical characteristics between patients with pulmonary infection (PI) and those without pulmonary infection (NPI). The detection rate of mNGS and CMTs in different groups of patients were compared. The Sankey diagram was used to present the results of the influence of mNGS on diagnosis and treatment.ResultsComparison between PI and NPI showed that individuals with fever, concurrent malignant tumors, consolidation or ground-glass opacity on chest CT(Computed tomography) images, and elevated inflammatory markers on blood tests were more likely to develop lung infections. Analysis of the rate of positive detection between CMTs and mNGS in various subgroups revealed that mNGS had a significantly higher positive detection rate in patients with pulmonary infections (87.95% vs. 71.06%, p<0.001), in immunocompetent patients (86.91% vs. 68.08%, p<0.001), and in patients with malignant tumors (92.31% vs. 69.23%, p=0.035). Furthermore, mNGS helped initiate appropriate antibiotic treatment and confirmed the effectiveness of empirical treatment. Compared to immunocompetent patients, BALF mNGS in immunocompromised individuals with suspected lung infections yielded higher rates of accurate diagnosis (62.86% vs. 42.79%, p = 0.027) and more effective treatment (71.43% vs. 58.56%, p = 0.148).ConclusionsBALF mNGS identified a greater variety of pathogens than CMTs. Immunocompromised patients with suspected pneumonia may benefit more from BALF mNGS.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1521641/fullBALFmNGSpulmonary infectiondiagnosismanagement |
| spellingShingle | Mei Zhou Shengwen Sun Long Chen Huan Xu Lanlan Liu Jiaxi Lv Jianchu Zhang Xianzhi Xiong The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection Frontiers in Cellular and Infection Microbiology BALF mNGS pulmonary infection diagnosis management |
| title | The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection |
| title_full | The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection |
| title_fullStr | The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection |
| title_full_unstemmed | The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection |
| title_short | The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection |
| title_sort | impact of bronchoalveolar lavage fluid metagenomics next generation sequencing on the diagnosis and management of patients with suspected pulmonary infection |
| topic | BALF mNGS pulmonary infection diagnosis management |
| url | https://www.frontiersin.org/articles/10.3389/fcimb.2025.1521641/full |
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