Diagnostic value of metagenomic next-generation sequencing in patients with diabetes mellitus combined with commu-nity-acquired pneumonia

Du Shijun; Nuerziba Aili; Yang Haiyan; Zhang Xiaozhe; Xia Yu

doi:10.3969/j.issn.1671-6450.2025.11.002

Abstract：Objective To compare the diagnostic value of metagenomics next-generation sequencing(mNGS)in etio-logical detection of diabetes mellitus complicated with community-acquired pneumonia(CAP).Methods The clinical data of 134 patients with diabetes mellitus complicated with community-acquired pneumonia who treated at the Respiratory Center of the First Affiliated Hospital of Xinjiang Medical University from July 2021 to December 2024 were selected.All enrolled pa-tients received The conventional microbiological tests(CMTs)and mNGS,and the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV),pathogen distribution and the consistency of detection results of the two methods were compared.The diagnostic efficiency of the two methods for diabetes mellitus complicated with community-ac-quired pneumonia was compared.Results Among 134 patients with DM complicated with CAP,the detection sensitivity of mNGS examination for infectious pathogens(94.3％)was higher than that of CMTs(78.3％),and the difference was statisti-cally significant(x2=9.481,P=0.002).However,in terms of detection efficacy(0.775),specificity(60.7％),PPV(90.09％),and NPV(73.91％),there was no statistically significant difference compared with mNGS(P＞0.05).In terms of pathogen de-tection,the bacteria most frequently detected by mNGS were mycobacterium tuberculosis(19 cases).In terms of virus detec-tion,the most frequently detected virus was human herpes virus(66 cases).The incidence of mixed infection detected by mNGS in diabetes mellitus patients with community-acquired pneumonia was 51.49％(69/134),and the most common type of mixed infection was bacteria-virus infection.Conclusion NGS can improve the pathogen detection rate of diabetes melli-tus complicated with community-acquired pneumonia,effectively increase the detection efficiency of rare and special patho-gens,and provide reasonable suggestions for the formulation of anti-infection treatment.