The Application Of Metagenomic Next Generation Sequencing In Pathogen Diagnosis Of Respiratory Tract Infection

ObjectiveTo compare the efficacy of metagenomic Next Generation Sequencing with traditional standard combined etiological detection in the pathogen diagnosis of respiratory tract infections,and to evaluate its clinical value in an all-round way.MethodsThe study prospectively enrolled eligible patients with respiratory tract infections who were admitted to Sir Runrun Shaw Hospital of Zhejiang University School of Medicine,the First Affiliated Hospital of Zhejiang University School of Medicine,Zhejiang Provincial People’s Hospital,Zhejiang Provincial Traditional Chinese Medicine Hospital,Hangzhou First People’s Hospital and the Children’s Hospital of Zhejiang University School of Medicine from August to December 2018.The broncho-alveolar lavage fluids were collected for traditional standard combined etiological detection,and undergone metagenomic Next Generation Sequencing at the same time.ResultA total of 96 patients were enrolled in this study,of whom pathogens in 42 cases were identified by standard combined etiological detection,including 11 cases of bacteria,12 cases of fungi,2 cases of cytomegalovirus,8 cases of Mycobacterium tuberculosis and 9 cases of mixed infection.Pathogens were identified in 45 cases by metagenomic Next Generation Sequencing,including 15 cases of bacteria,4 cases of fungi,3 cases of cytomegalovirus,1 case of Mycobacterium tuberculosis,3 cases of non-Mycobacterium tuberculosis and 19 cases of mixed infection.metagenomic Next Generation Sequencing has a significantly higher detection rate for bacterial infection,mixed infection,viral infection,and pneumocystis infection.There are more cases in which pathogens can be identified only by metagenomic Next Generation Sequencing than traditional methods,especially for the diagnosis of pathogens which are difficult to detect by traditional methods and in whom broad-spectrum antimicrobials have been given before specimen collection.ConclusionMetagenomic Next Generation Sequencing can be used as an effective supplementary method to the traditional standard combined with etiological detection,further improving the efficiency of pathogen diagnosis in respiratory tract infection.