Cui-Lin Shi1, Peng Han2, Pei-Jun Tang1, Meng-Meng Chen2, Zhi-Jian Ye1, Mei-Ying Wu1, Jie Shen1, Hai-Yan Wu1, Zhu-Qing Tan1, Xin Yu3, Guan-Hua Rao4, Jian-Ping Zhang5. 1. The Affiliated Infectious Hospital of Soochow University, 10 Guangqian Road, Suzhou, Suzhou, Jiangsu 215131, China; The Fifth People's Hospital of Suzhou, Suzhou, China. 2. Genskey Medical Technology Co., Ltd, Beijing, China. 3. The Affiliated Infectious Hospital of Soochow University, 10 Guangqian Road, Suzhou, Suzhou, Jiangsu 215131, China; The Fifth People's Hospital of Suzhou, Suzhou, China. Electronic address: xinxin810104@126.com. 4. Genskey Medical Technology Co., Ltd, Beijing, China. Electronic address: gh.rao@genskey.com. 5. The Affiliated Infectious Hospital of Soochow University, 10 Guangqian Road, Suzhou, Suzhou, Jiangsu 215131, China; The Fifth People's Hospital of Suzhou, Suzhou, China. Electronic address: 906168980@qq.com.
Abstract
OBJECTIVES: The aim of this study is to investigate the clinical usefulness of metagenomic Next-generation sequencing (mNGS) on bronchoalveolar lavage fluid (BALF) samples to discriminate pulmonary tuberculosis (PTB) from Non-TB community-acquired pneumonia (CAP) in PTB suspects. METHODS: We investigate the performance of mNGS on BALF samples from 110 PTB suspects, in comparison with conventional microbiological testing (solid media culture, acid-fast bacilli staining (AFS), Xpert) of BALF or sputum samples and final clinical diagnosis. RESULTS: We finally clinically diagnosed 48 cases of pulmonary tuberculosis patients and 62 cases of non-tuberculosis patients. Comparing to the final clinical diagnosis, mNGS produced a sensitivity of 47.92%, which was similar to that of Xpert (45.83%) and culture (46.81%), but much higher than that of AFS (29.17%) for TB diagnosis in BALF samples. Apart from detecting Mycobacterium tuberculosis, mNGS also identified mixed infections in PTB patients, including 3 fungal cases and 1 bacteria case. Meanwhile, mNGS efficiently identified 14 of 22 (63.63%) cases of non-tuberculous mycobacteria (NTM), 7 cases of fungi, 1 case of viral infection, and other common bacterial pathogens in Non-PTB group. Finally, mNGS identified 67.23% infection cases within 3 days, while the conventional methods identified 49.58% infection cases for over 90 days. CONCLUSION: Our data show that mNGS of BALF represents a potentially effective tool for the rapid diagnosis of PTB suspects.
OBJECTIVES: The aim of this study is to investigate the clinical usefulness of metagenomic Next-generation sequencing (mNGS) on bronchoalveolar lavage fluid (BALF) samples to discriminate pulmonary tuberculosis (PTB) from Non-TB community-acquired pneumonia (CAP) in PTB suspects. METHODS: We investigate the performance of mNGS on BALF samples from 110 PTB suspects, in comparison with conventional microbiological testing (solid media culture, acid-fast bacilli staining (AFS), Xpert) of BALF or sputum samples and final clinical diagnosis. RESULTS: We finally clinically diagnosed 48 cases of pulmonary tuberculosispatients and 62 cases of non-tuberculosispatients. Comparing to the final clinical diagnosis, mNGS produced a sensitivity of 47.92%, which was similar to that of Xpert (45.83%) and culture (46.81%), but much higher than that of AFS (29.17%) for TB diagnosis in BALF samples. Apart from detecting Mycobacterium tuberculosis, mNGS also identified mixed infections in PTB patients, including 3 fungal cases and 1 bacteria case. Meanwhile, mNGS efficiently identified 14 of 22 (63.63%) cases of non-tuberculous mycobacteria (NTM), 7 cases of fungi, 1 case of viral infection, and other common bacterial pathogens in Non-PTB group. Finally, mNGS identified 67.23% infection cases within 3 days, while the conventional methods identified 49.58% infection cases for over 90 days. CONCLUSION: Our data show that mNGS of BALF represents a potentially effective tool for the rapid diagnosis of PTB suspects.