Application of metagenomic next-generation sequencing of bronchial
needle brushing specimen in precise diagnosis of infectious peripheral
pulmonary lesions
Abstract
Background: Reports on the application of metagenomic next-generation
sequencing (mNGS) to diagnose infectious peripheral pulmonary lesions
(PPLs) remain scarce. No research has ever explored which specimen is
preferred for mNGS. Methods: We applied mNGS to detect the presence of
pathogen in matched transbronchial lung biopsy (TBLB), bronchoalveolar
lavage fluid (BALF) and bronchial needle brushing (BB) specimens from 39
patients suspected of having infectious PPLs. We explored the
differences in the composition and diagnostic efficacy of the three
specimens. Results: We found that mNGS of TBLB, BALF, BB and TBLB + BALF
+ BB was more sensitive than conventional cultures for bacterial
infections, fungal infections and general infections, the difference in
sensitivity of mNGS between TBLB, BALF, and BB was not statistically
significant. The sensitivity of mNGS of TBLB + BALF + BB for the
diagnosis of fungal infections or general infections was higher than
mNGS of TBLB and not significantly higher than mNGS of BALF or BB. We
found that there was no statistically significant difference in the
relative abundance of pathogen amongst the three types of specimens and
in relative abundance of all of the six kinds of common oropharyngeal
microbiota between TBLB and BB specimens. Conclutions: The study
indicated that mNGS of TBLB, BALF or BB could yield a higher sensitivity
for pathogen identification. mNGS of the BB samples might be an
alternative choice for patients with infectious PPLs but couldn’t
tolerate more invasive TBLB procedures.