Clinical Value of Bronchoalveolar Lavage Fluid TNGS Technique in the Etiological Diagnosis of Community-acquired Pneumonia

Wang Xiaofei; Xu Yan; Xu Mengjiao

doi:10.3969/j.issn.1004-5775.2025.15.003

Abstract：Objective:To analyze the clinical value of bronchoalveolar lavage fluid(BALF)targeted next-generation sequencing(tNGS)technique in the etiological diagnosis of community-acquired pneumonia(CAP).Methods:120 patients with suspected CAP in the hospital from May 2023 to April 2024 were selected.All patients were given routine pathogen detection and tNGS detection.The positive rate of pathogen detection and pathogen distribution were compared between the two detection methods.Through taking clinical diagnosis as the gold standard,the diagnostic efficiency of tNGS detection and routine pathogen detection was calculated.Results:The positive rate of tNGS detection was significantly higher than that of routine pathogen detection(x2=61.307,P＜0.05).A total of 140 pathogenic microorganisms of 32 species were detected by tNGS.A total of 59 pathogenic microorganisms of 18 species were detected by routine pathogen detection.With clinical diagnosis as the gold standard,112 CAP patients and 8 non-CAP patients were clinically diagnosed.The results of tNGS,routine pathogen detection and clinical diagnosis showed that the number of positive cases of tNGS detection was more than that of routine pathogen detection,and the number of negative cases of routine pathogen detection was more than that of tNGS detection.Clinical diagnosis was taken as the gold standard to calculate the diagnostic efficiency of tNGS detection and routine pathogen detection,and the sensitivity of tNGS detection was 94％,which was higher than 45％of routine pathogen detection.Conclusion:tNGS detection can enhance the positive rate of etiological detection of CAP,and can be used as one of the important methods to detect pathogens.It is suggested that routine pathogenic examination combined with BALF tNGS detection should be carried out in critically ill CAP patients to quickly and accurately determine the pathogens,which is of great significance for the diagnosis and treatment of pneumonia and better serve the clinic.