ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1521641
This article is part of the Research TopicAdvances in the Diagnosis and Management of Infectious DiseasesView all 18 articles
The impact of bronchoalveolar lavage fluid metagenomics next-generation sequencing on the diagnosis and management of patients with suspected pulmonary infection
Provisionally accepted
- 1Depatment of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China
- 2Department of Critical Care Medical, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- 3Vision Medicals Center for Infectious Diseases, Guangdong, China
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Objectives: This 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.We 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.Comparison between PI and NPI showed that individuals with feverish symptoms, 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), normal immune function 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)outcomes (42.79% vs. 62.86% and 58.56% vs. 71.43%, respectively).Conclusions: BALF mNGS identified a greater variety of pathogens than CMTs.Immunocompromised patients with suspected pneumonia may benefit more from BALF mNGS.
Keywords: BALF, MNGs, pulmonary infection, diagnosis, Management
Received: 02 Nov 2024; Accepted: 02 Jun 2025.
Copyright: © 2025 Mei, Sun, Chen, Xu, Liu, Lv, Zhang and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jianchu Zhang, Depatment of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hebei Province, China
Xianzhi Xiong, Depatment of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hebei Province, China
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