Application Value of mNGS and Traditional Detection Methods in the Diagnosis of Pathogens in Severe Infections

ZHANG Songsheng; XU Zhou; XIE Jieyao; PAN Tingjun; LUO Weiwen; ZHANG Min; ZHONG Yingyu; ZOU Xinhui

doi:10.3969/j.issn.1002-3429.2025.15.014

Abstract：Objective To explore the diagnostic performance of metagenomics next-generation sequencing(mNGS)and traditional detection methods in the diagnosis of pathogens in severe infections.Methods A total of 100 patients with severe infections admitted from March 2022 to April 2023 were selected.Samples of bronchoalveolar lavage fluid(BALF)and blood were collected for traditional microbial culture and mNGS detection,and the results of mNGS technology and traditional detection were statistically analyzed.The final clinical diagnosis was used as the gold standard,the diagnostic performance of mNGS technology and traditional detection were compared for pathogen infection,as well as the concordance rate of the two detection methods for diagnosing pathogen types in different sample sources.The impact of mNGS technology and traditional detection on inflammatory indicators[white blood cell count(WBC),procalcitonin(PCT),C-reactive protein(CRP)]was analyzed.Results Based on clinical diagnosis,there were 100 patients with lung infection and 68 with sepsis.Among them,70 patients underwent BALF sampling and testing,with 61 pathogens detected by mNGS and 43 pathogens detected by traditional detection methods.In addition,71 patients underwent blood sample sampling and testing,with 33 pathogens detected by mNGS and 8 pathogens detected by traditional detection methods.The accuracy and sensitivity of mNGS technology in diagnosing pathogens in severe infections from BALF and blood samples were higher than those of traditional detection methods(P<0.01);the consistency rate of pathogen type diagnosis using mNGS based on BALF samples was the highest,which was higher than that of traditional detection based on BALF samples,mNGS based on blood samples,and traditional detection(P<0.01);the consistency rate of mNGS detection based on BALF and blood samples was higher than that of traditional detection(P<0.05).Among the 100 patients,54 patients had their medication regimen adjusted during treatment,including 36 patients in mNGS group and 18 in the traditional group,respectively.The decrease in PCT and CRP levels in the mNGS group was greater than that in the traditional group within 5 d after medication adjustment(P<0.05).Conclusion Compared with traditional detection,mNGS technology is beneficial to improving the diagnostic performance of pathogens in severe infections,and adjusting the medication regimen based on the mNGS detection results can improve the inflammatory state of patients.