Rapid diagnosis of non-tuberculous mycobacterial pulmonary diseases by metagenomic next-generation sequencing in non-referral hospitals
作者全名："Wang, Jing; Xu, Huan; Wang, Xi; Lan, Jian"
作者地址："[Wang, Jing; Wang, Xi; Lan, Jian] Chongqing Med Univ, Dept Resp & Crit Care Med, Clin Hosp 2, Chongqing, Peoples R China; [Xu, Huan] Vis Med Ctr Infect Dis, Dept Sci Affairs, Guangzhou, Peoples R China"
通信作者："Lan, J (通讯作者)，Chongqing Med Univ, Dept Resp & Crit Care Med, Clin Hosp 2, Chongqing, Peoples R China."
来源：FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
关键词：non-tuberculous mycobacteria (NTM); pulmonary disease; metagenomic next-generation sequencing (mNGS); rapid diagnosis; earlier targeted treatment
摘要："ObjectivesThe incidence of non-tuberculous mycobacterial pulmonary disease (NTM-PD) has increased steadily globally, but the current culture-based diagnosis of NTM-PD is difficult and time-consuming, leading to a high possibility of misdiagnosis. Therefore, new methods should be introduced to improve the processes for clinical diagnosis of this disease. MethodsOur retrospective observational study enrolled 12 NTM-PD patients who were identified by way of metagenomic next-generation sequencing (mNGS), as well as the characteristic radiological presentation of slowly progressed, usually concomitant bronchiectasis, small cavitary opacity, and multiple nodules that respond poorly to empirical antibiotic therapy. These patients received the recommended drug regimen based on the identified non-tuberculous mycobacteria (NTM) species. Clinical data, including symptoms, laboratory tests, dynamic computed tomography imaging, treatment, and outcome, were recorded and analyzed. ResultsThe results of mNGS were all positive, with the standard specifically mapped read numbers (SDSMRN) of NTM ranging from 1 to 766; this was confirmed in six patients via quantitative polymerase chain reaction (qPCR) analysis. The duration fromsample collection tomNGS results was 1-4 days. Among our 12 patients (except for one lost to follow-up) the CT imaging for 11 patients showed significant absorption of lesions. ConclusionsOur results draw attention to NTM infection as a possible cause of community-acquired pneumonia, especially in patients with suggestive radiological presentation and poor responses to empirical antibiotic therapy. Our study also indicated that mNGS represented a potentially effective tool for the rapid identification of NTM in the respiratory sample. Improved clinician awareness combined with the utilization of mNGS could guide earlier diagnosis and targeted treatment, and finally improved the prognoses of patients with NTM-PD."
基金机构：Natural Science Foundation of Chongqing [cstc2019jcyj-msxmX0849]; Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) [2019QNXM004]
基金资助正文：This work was supported by the Natural Science Foundation of Chongqing (cstc2019jcyj-msxmX0849) and the Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) (2019QNXM004).