The clinical utility of bronchoalveolar lavage fluid metagenomic next-generation sequencing in immunocompromised critically ill patients with invasive pulmonary aspergillosis: a multicenter retrospective study

mNGS demonstrated significantly higher specificity and area under the curve for diagnosing IPA in immunocompromised critically ill patients compared to CMTs. mNGS showed superior diagnostic performance over single methods, such as cultures, galactomannan test, and PCR, with higher sensitivity and sp...

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Published inMicrobiology spectrum Vol. 13; no. 8; p. e0058425
Main Authors Zhao, Junjie, Zhuge, Runxi, Guo, Kai, Tang, Jing, Sun, Yong, Zhang, Yi, Yuan, Lingmin, Qiu, Canhu, Yan, Youqin, Wang, Kaiyu, Jiang, Qin, Chen, Juan, Hua, Zhidan, Qiu, Liyan, Fang, Honglong, Zhuge, Jiancheng
Format Journal Article
LanguageEnglish
Published United States American Society for Microbiology 12.06.2025
Subjects
Adult
Aged
bronchoalveolar lavage fluid
Bronchoalveolar Lavage Fluid - microbiology
China
Critical Illness
etiology
Female
Galactose - analogs & derivatives
High-Throughput Nucleotide Sequencing - methods
Humans
Immunocompromised Host
immunocompromised patients
Intensive Care Units
invasive pulmonary aspergillosis
Invasive Pulmonary Aspergillosis - diagnosis
Invasive Pulmonary Aspergillosis - microbiology
Male
Mannans
metagenomic next-generation sequencing
Metagenomics - methods
Middle Aged
Retrospective Studies
ROC Curve
Sensitivity and Specificity
China
bronchoalveolar lavage fluid
immunocompromised patients
metagenomic next-generation sequencing
invasive pulmonary aspergillosis
etiology
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Summary:mNGS demonstrated significantly higher specificity and area under the curve for diagnosing IPA in immunocompromised critically ill patients compared to CMTs. mNGS showed superior diagnostic performance over single methods, such as cultures, galactomannan test, and PCR, with higher sensitivity and specificity for Aspergillus detection. The use of mNGS-guided antibiotic adjustments led to a significant reduction in 28-day mortality (46.51% vs. 66.67%) among immunocompromised patients. mNGS demonstrated utility in identifying mixed infections, supporting targeted therapy and better patient outcomes. The application of mNGS in diagnosing IPA and guiding treatment in ICU patients helped optimize antibiotic regimens, ultimately improving clinical prognosis.
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The authors declare no conflict of interest.
ISSN:2165-0497
2165-0497
DOI:10.1128/spectrum.00584-25