Metagenomic next-generation sequencing improves pulmonary infection diagnosis

A recent study on the application of Metagenomic next-generation sequencing (mNGS) found that mNGS can achieve early detection of pathogens and accelerate the development of targeted anti-infection treatment plans, thereby improving treatment outcomes and patient prognosis.

The research, conducted by the Department of Clinical Laboratory, the Second Affiliated Hospital of Nanchang University and BGI Genomics, was published in the journal Frontiers in Cellular and Infection Microbiology early in May.

The mNGS outperforms traditional methods

Conventional microbiological tests (CMTs) rely on culture growth, microscopy, and targeted PCR assays, offering specificity but limited scope. While CMTs remain cost-effective for common infections, mNGS provides unmatched breadth and speed, enabling diagnosis of rare/atypical pathogens (e.g., Pneumocystis, herpesviruses) within days-critical for guiding timely, precise therapy.

The results of the study reveals that mNGS detected pathogens in 86% of cases, significantly outperforming CMTs, which identified pathogens in only 67% of cases. Spectrum of detected pathogens results showed that mNGS identified 59 bacteria, 18 fungi, 14 viruses, and 4 special pathogens while CMTs detected just 28. This enhanced detection capability provides clinicians with a more comprehensive diagnostic tool for pulmonary infections.

Guiding precision medicine

The study further showed that mNGS guides treatment decisions in cases of difficult-to-diagnose atypical pathogens, leading to better patient outcomes. Treatment adjustments based on mNGS results improved the prognosis for 16 patients infected with pathogens typically missed by conventional tests.

The mNGS has proven to be a valuable tool in guiding clinical decisions for infection treatment. In the study, doctors used mNGS results to adjust antibiotic therapy for 133 patients, with 40.6% of cases benefiting from more targeted treatments. Although there was one instance of unnecessary antibiotic use, the overall results show the reliability of mNGS in optimizing patient care.

Detection of atypical pathogens

The mNGS excels at detecting atypical pathogens, such as Mycobacterium tuberculosis, Mycoplasma pneumoniae, Chlamydia psittaci, and fungal infections like Pneumocystis jirovecii and Talaromyces marneffei. These pathogens, often missed by traditional methods, were successfully identified by mNGS.

Metagenomic next-generation sequencing (mNGS) provides a broad-spectrum, rapid, and precise diagnostic approach for detecting pathogens in pulmonary infections. This enables personalized anti-infection therapy and enhances patient outcomes."

Professor Wang Xiaozhong, Director of the Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University and corresponding author of the study

"In the future, integrating mNGS with clinical manifestations, imaging findings, and traditional testing methods for multidimensional analysis will help establish an integrated diagnostic and treatment model featuring 'rapid identification-precise intervention-dynamic monitoring.'" Wang believes that this approach will provide patients with more scientific, efficient, and personalized treatment strategies.

The mNGS simplifies the pathogen detection process, offering higher sensitivity and broader detection capabilities compared to conventional methods. Its integration into clinical practice provides more accurate, timely diagnoses and enables more targeted treatments, ultimately improving patient outcomes in cases of pulmonary infections.